Medicare FAQs

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What is Medicare?

Medicare is a federal program providing health insurance for most people aged 65 and over. It is also available to some people younger than 65 including sufferers from Lou Gehrig’s Disease (amyotrophic lateral sclerosis or ALS) and people with permanent kidney failure known as end-stage renal disease (ESRD).

What does Medicare cover?

There are five main options available to those eligible for Medicare benefits.

  • Medicare Part A provides basic coverage for expenses related to hospitalization.
  • Medicare Part B covers outpatient care costs such as doctor’s visits and diagnostic tests.
  • Medicare Part C or Medicare Advantage is a private coverage option that covers both Part A and Part B with some additional benefits.
  • Medicare Part D provides coverage for prescription drugs.
  • Medicare supplements or Medigap plans offer private coverage that help cover additional out-of-pocket expenses such as copayments, co-insurance or deductibles.
How much does Medicare cost?

Once you are enrolled in Medicare you will be required to pay an insurance premium. Should you need any treatment you will also have to pay the amount up to your deductible and any other co-payments incurred. Premiums, deductibles and copays maybe subject to annual changes so it is wise to contact your insurance agent to find out your best options and current pricing.

How can I cover additional costs not covered by Medicare?

You can acquire supplemental coverage from a Medigap plan or a Medicare Advantage plan. Some people may be eligible for Veterans Affairs (VA) or other such benefits. Talk to your local insurance agent to find out your options.

What factors should I consider when choosing a Medicare Supplement?

There are several factors that should be considered relative to your health, your budget, your preferences and what, if any, coverage may be provided by your employer if you are currently employed.

If you are in relatively good health and seldom need doctor or hospital visits you might not need as expensive coverage as you might if you suffer poor health. If you regularly take medications may also be a factor to consider.

You budget may limit the coverage you can afford though you may be able to take advantage of a high deductible plan if you are reasonably healthy and prefer a lower premium. Perhaps you can afford to pay higher copays, co-insurance and other out-of-pocket expenses, in return for reduced premiums.

It may cost you more if you prefer to select which doctors, hospitals or pharmacies you wish to use, over network restrictions. Do you need coverage for foreign travel? Are you covered by any other plans provided by an employer or the Veterans Affairs or other organization?

What is a Medicare Deductible?

The Medicare deductible is the amount you have to pay for services before your insurance coverage kicks in. For example, if your deductible is $3,500, you will have to amass this amount in charges over one or multiple doctor or hospital visits or stays, before your insurance picks up the costs. Deductibles renew on an annual basis.

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