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5 Medicare Planning Topics You Want To Know!

For most people, age 65 is when Medicare – the federal insurance program – becomes a part of their lives. But as widely used as Medicare is amongst eligible “beneficiaries,” there are several choices when it comes to coverage. And that’s a good thing.

Choosing the right plan begins with finding out what’s offered and matching a plan with the specific benefits you’re looking for. From monthly payments and out-of-pocket costs to health issues and prescription drug usage, finding the right plan that fits your needs is crucial.

And once you pick your plan, you’ll want to make sure you maximize your benefits. Whether it’s the free preventive services offered by most plans like cardiovascular screenings every five years, annual mammograms, annual flu shots, and screenings for cervical, prostate and colorectal cancers, or unique perks like a fitness club membership or access to a Medicare consultant, make sure you take advantage of all the benefits offered to you.

Prescription drug coverage is offered to everyone with Medicare, but to get it you must join a plan run by an insurance company or other private company approved by Medicare. While each plan varies in cost and drugs covered, there are two ways to get drug coverage: Medicare Prescription Drug Plans (Part D) or Medicare Advantage Plans (Part C).

Medicare Prescription Drug Plans (Part D) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans and Medicare Medical Savings Accounts Plans. Medicare Advantage Plans (Part C) often come in the form of an HMO or PPO, and you must have Part A and Part B of Medicare to join a Medicare Advantage Plan.

It’s best to consider all your drug coverage choices before making a decision. If you already have drug coverage from an employer, union or something else, you’ll want to compare it with Medicare drug coverage to make sure you choose the plan that’s right for you.

Whether you’re new to Medicare, getting ready to turn 65, or preparing to retire, you’ll need to make several important decisions about your health coverage.

One of the most important things to know is that timing matters. When you turn 65 or otherwise become eligible for Medicare, enrollment windows open. But some of these windows close quickly and, if you wait until later to sign up, you may have fewer choices and have to pay more.

The first time you can enroll in Medicare is called your Initial Enrollment Period, a seventh-month stretch of time that usually begins three months before you turn 65 and ends three months after you turn 65. Anyone who has worked and paid taxes for at least 10 years during their life is automatically enrolled in Part A, but some must enroll in Part B, and there is a premium associated with it.

If you wait to enroll, you may not only have to pay a penalty, but also end up with a gap in your coverage. If you’re automatically enrolled in Part A and Part B, you’ll get a red, white and blue Medicare car in the mail either three months before your 65th birthday or on your 25th month of disability. If not, you’ll need to take the necessary steps to apply for Medicare online.

Medicare is broken down into four parts, with each part covering specific services.

Medicare Part A , known as Hospital Insurance, helps pay for “medically necessary” care – for an illness or medical condition – that involves an inpatient stay at a hospital. It also covers care for a stay in a skilled nursing facility as a follow-up to a hospital stay, hospice care for the terminally ill and some skilled home health care services for the homebound.

Medicare Part B,  known as Medical Insurance, helps pay doctor’s care for an illness or medical condition. Services like doctor’s office visits, care in hospitals and clinics when you are not admitted for an inpatient stay, lab tests and diagnostic screenings, surgical and medical supplies, some physical and occupational therapy are all covered under Part B.

Medicare Part C,  known as Medicare Advantage Plans, combines Parts A and B together in one plan. These types of plans are provided by private companies that partner with Medicare and are generally offered as HMO, PPO, Special Needs Plans or Private Fee-for-Service plans. Most Medicare services are covered through these plans and many also offer prescription drug coverage.

Medicare Part D,  known as Prescription Drug Coverage, can be a standalone plan or it can be combined with a Medicare Advantage Plan, or Medicare Part C. This helps to cover the cost of prescription drugs, and may also help lower overall out-of-pocket expenses and protect against higher costs in the future.

Medicare Advantage Plans cover all Medicare services in Part A and Part B, and many also offer extra coverage for things like vision, hearing and dental. Most will include prescription drug coverage in a plan type known as a Medicare Advantage Prescription Drug Plan. If you’re looking for a plan that covers everything, Medicare Advantage Plans may be the right choice.

Medicare Advantage Plans are administered by private companies. Often times there are involve certain restrictions and plans are costume for each person. From requiring referrals to see specialists to having to choose a doctor within the plan’s network for coverage, and the chance of changes in premiums, benefits and copayments each year, some Medicare Advantage Plans can prove to be a disadvantage.

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