You’ve heard about Medicare your whole life, but what happens when it’s time to use it? If you’re like most people, you find it a bit overwhelming. Medicare is an excellent program that supports lifelong health after you make key choices about coverage. We’re here to break it down into an easy-to-understand set of steps. Let’s look at 5 things you might not know about Medicare.
#1 Some People Have Misconceptions About Medicare.
There are plenty of myths and misconceptions out there when it comes Medicare. One of the most common misunderstandings is whether Medicare is mandatory or automatic for everyone who lives in the United States.
Medicare isn’t mandatory, strictly speaking, but you’ll have to decline coverage if you do not want it. Everyone must sign up for Medicare at age 65, even if they’re still working and have insurance through their employer. You can then change your coverage, which is discussed in more detail below.
Are you wondering if Medicare is automatic? No, unless you have special circumstances (described on page 13 here). When you turn 65, you must take action. Even if you’re still getting insurance through an employer, it’s best to go ahead and get at least Part A which usually comes at no cost to you.
If you’re curious to know if enrolling in Medicare can be complicated, here’s the honest answer: Yes! Medicare can be very challenging to navigate for the first time. It also can be difficult to enroll late, add options, and understand the full range of your benefits.
These are some of the best resources you can use to learn the basics of Medicare:
- Medicare & You: a handbook
- Medicare.gov: the official website
- Medicare Glossary: common Medicare terms
- Medicare Options: free consultation from a Peel & Holland licensed insurance agent
#2 You’re Part of a Nationwide Trend.
If you’re using Medicare now or preparing to use it soon, you’re already in good company. Medicare participation is on the rise as the U.S. population ages and needs extra assistance.
This is a long-term trend. The growing group of people aged 65 and older has set the stage for increased Medicare participation in the past few decades.
Facts About Medicare
- More than 63 million people use Medicare.
- 62% are enrolled in Part A or Part B.
- 37% use Medicare Advantage under Part C.
- 74% use Part D drug coverage and 13% have private drug coverage.
Confused about what Parts A, B, C, and D mean? No problem. Below, we’ll explain more about the various parts of Medicare and what they could mean for you.
#3 Medicare is Divided Into Four Parts.
Medicare has four parts and you could end up using more than one part of its coverage. Some parts are optional, and some are required. Here’s how it breaks down.
Medicare Part A: Hospital Coverage
Part A involves hospital insurance, which covers you when you’re in the hospital or a nursing facility and covers home health care or hospice care. Generally speaking, it covers your room, meals, medical care, and lifesaving treatments you may need, like blood transfusions.
Medicare Part A coverage is free as long as you worked for at least 10 years in the U.S. and paid taxes or are married to someone age 65 and older who worked for 10 years and paid taxes. It’s excellent coverage for many types of health needs, but it doesn’t cover everything. In some cases, Part B provides coverage instead.
Medicare Part B: Medical Coverage
Part B Medicare coverage involves outpatient care, doctors’ services, tests, imaging, lab work, surgery, ambulance trips, and diagnosis-dependent treatment like chemotherapy and dialysis. If you need equipment like a wheelchair or walker, it’s covered by Part B and not Part A.
Many people enroll in both Part A and Part B increase their healthcare coverage. A general rule of thumb is that if you’re using only Medicare for your healthcare and have no other coverage, you’ll likely need both Part A and Part B. They often work in conjunction to ensure inpatient and outpatient healthcare needs are covered, but be aware these plans are limited.
Medicare Part C: Medicare Advantage
Part C is also known as the Medicare Advantage plan. It was established in 1997 under the Balanced Budget Amendment, and about 48% of all Medicare users use it, which is about 28 million people. Using this part of Medicare, you purchase Medicare coverage from a private health insurer and bundle it together. This means you pay one premium, but your coverage involves both Medicare and your private health insurance.
Many people find Medicare Advantage to be one of the most confusing aspects of Medicare. It involves making complex choices about things like Medigap, Medicare Supplement, and your network provider. If you get stuck on this aspect of Medicare, you’re welcome to request a free consultation with Peel & Holland.
Medicare Part D: Prescription Coverage
Part D of Medicare is optional but is specifically about accessing prescription drug coverage. The most important thing you need to know about Medicare Part D is that it provides optional drug coverage and can keep your co-pays low. Enrollment and unenrollment periods also have strict deadlines.
#4 Medicare Comes With Built-in Penalties.
Medicare enrollment is quite a journey. It’s like a choose-your-own-adventure story where your outcome depends on the options you select, and a happy ending isn’t guaranteed.
You should be aware that there can be enrollment penalties for failing to participate or enrolling late. Some parts of the program, like Part C and Part D, are optional. Other parts require you to take action or face government scrutiny, lost coverage, and extra stress.
Here’s the good news: You don’t have to tackle this alone. Read below to learn about a free, no-obligation option that could make your Medicare enrollment process much easier.
#5 Peel & Holland Provides Help at No Cost & No Obligation.
Peel & Holland provides free Medicare consultations to help people make informed choices, and there is no obligation to enroll. Our agents are fully licensed insurance agents, and our fees are covered by the insurance companies we work with, so you experience a truly 100% free service.
The only catch is that you have to work with us as early in the process as possible. It’s always sad to have to tell people that it’s already too late and they should have contacted us sooner.
Don’t wait! You can work with a local medicare licensed insurance agent now. Their job is to make your experience easier and hassle-free. Peel & Holland is here to help you.
Schedule a no-cost, no-obligation consultation by calling Jill Lewis at 270.527.6168. She’s ready to assist you with navigating your Medicare options with confidence.
(Free consultation. No obligation to enroll.)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.