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10 Things You May Not Know About Medicare

10 Things You May Not Know About Medicare

April 15, 2024
Medicare is the nation’s health insurance program for people aged 65 and older, as well as certain younger individuals with disabilities. It’s a crucial part of the healthcare landscape, but many people may not fully understand how it works or its finer details. Here are 10 things you might not know about Medicare:
1. Medicare has different parts: Medicare is divided into several parts, each covering different services. Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B covers outpatient care, doctor visits, and preventive services. Part C, also known as Medicare Advantage, offers an alternative way to receive Medicare benefits through private insurance plans. Part D covers prescription drugs.
2. You have choices with Medicare Advantage: Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans provide all your Part A and Part B coverage and often include additional benefits like vision, dental, and prescription drug coverage. They may also have lower out-of-pocket costs than Original Medicare.
3. Medicare is not free: While most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working, there are costs associated with other parts. Part B has a standard monthly premium, and Part D premiums vary by plan. Medicare Advantage plans may have their own premiums, deductibles, and copayments.
4. You can delay enrollment without penalty if you have employer coverage: If you or your spouse are still working and have employer-sponsored health insurance, you can delay enrolling in Medicare Part B without penalty. Once your employer coverage ends, you have an 8-month Special Enrollment Period to sign up for Part B.
5. Medicare doesn’t cover everything: Medicare covers many health care services, but it doesn’t cover everything. For example, it doesn’t cover long-term care (like nursing home care), most dental care, eye exams related to prescribing glasses, dentures, cosmetic surgery, acupuncture, or hearing aids and exams for fitting them.
6. Medicare beneficiaries can get a free annual wellness visit: Medicare Part B covers a yearly wellness visit with your doctor at no cost to you. This visit is designed to help prevent disease and disability by developing or updating a personalized prevention plan based on your current health and risk factors.
7. You can change your Medicare coverage during certain times: There are specific times when you can sign up for Medicare, change plans, or switch between Medicare Advantage and Original Medicare. These include the Initial Enrollment Period, the Annual Enrollment Period, and Special Enrollment Periods.
8. Medicare offers financial help for those with limited income and resources: If you have limited income and resources, you may qualify for help to pay for some health care and prescription drug costs. Programs like Medicaid, Extra Help, and Medicare Savings Programs can assist with these expenses.
9. Medicare fraud is a serious issue: Fraudulent activities related to Medicare can cost taxpayers billions of dollars each year. Protect yourself by guarding your Medicare card like a credit card, checking your Medicare Summary Notice for errors, and reporting suspicious activities.
10. Medicare is constantly evolving: Medicare isn’t static; it changes over time. This includes updates to coverage, costs, and benefits. Staying informed about these changes can help you make the most of your Medicare coverage.
Understanding Medicare can be complex but knowing these 10 key facts can help you navigate the program more confidently. Medicare is a valuable resource for millions of Americans, providing access to essential healthcare services as they age or manage disabilities