What is it and do I need it? The Federal Government provides this fee-for-service plan for all Americans over the age of 65. It begins with the arrival of your red, white and blue card about 3 months before your 65th birthday.
The arrival of the card will precede a large amount of printed material with all of the instructions for the next steps. The things that need to be decided are if you will need Parts B and D and if so, how soon. If you are receiving health benefits from your employer or your spouse’s employment you will not need to participate on either. If you do not have other health benefits, then this is the time to apply for both. Part B will cover your medical visits and Part D will cover prescriptions. Both of these are fee-for-service plans. Part D will be with a medicare approved insurance company. Your physical conditions and your prescription drugs will determine the best company for you to enroll with.
You will be required to pay a deductible before Medicare will kick in to pay their part. It may not be the entire cost. You will pay your co-insurance or your co-pay. If you have a medigap policy in place it may pay for these costs.
A lot depends on whether your supplement would be an HMO or a PPO. With the HMO you are dealing with doctors, hospitals, labs and services that are within their network. The network members will receive the assigned copay. If you go to a doctor or facility outside of the network, your personal costs can be greatly increased.
PPO will give you a little more leeway. If the doctor accepts medicare, chances are you will be covered with your PPO without the restrictions of a network. This applies to hospitalization and lab studies as well as x-ray costs. These are two important choices you need to make. Most people will make these decisions based on their income and disposable cash.
Some of these plans work in conjunction with your state Department of Human Services. In the event that your income is below a certain level, most states have programs to supplement the cost of any of the medicare plans to ease the burden on the recipients.
Dental coverage is not included in medicare coverage. If you travel outside the United States there are other things that are not covered by medicare. These include eye exams, hearing aids or emergency health care. If you travel frequently you should choose a medigap plan that will cover your needs regardless of where in the world you may be.
There are tools within the medicare.gov site that will help you compare and choose. If you do not have internet access a phone call to medicare will get you the same information. Take your time. Make wise choices and do not allow some insurance sales person to persuade you to join their plan just be being pleasant. Medicare itself is the best source of the bulk of this information. If the plan is approved by medicare, that is step one. Your needs will determine which of these plans is best for you.