Five out of six Medicare beneficiaries are aged 65 or older.
As of 2010, Medicare is used by more than 40 million people in the United States, most of then over the age of 65. Medicare is a health insurance program designed primarily for senior citizens, but people with certain health conditions may also qualify, even if they are under 65. Medicare comes in four parts, labeled A through D. There are also standardized plans to use in combination with Medicare, often called Medigap. Some Medicare issues can cause confusion or additional expenses for beneficiaries if not properly understood and planned for.
Enrollment Issues
Enrolling in Medicare itself can be confusing. People who are already receiving benefits from Social Security are automatically enrolled in both Medicare Part A and Part B when they turn 65. All others have to take the initiative to enroll themselves as they approach 65. The initial enrollment period for Medicare is from three months before your 65th birthday until three months after. You do not have to enroll in both parts of Medicare if you do not want them; however. If you are automatically enrolled in Part B, you will have un-enroll yourself by following the directions on your Medicare card. But if you do not take Part B when you first have the chance and then change your mind, you will have to pay a late-enrollment penalty.
Cost Issues
Part A is often, but not always, offered free, but all other parts of Medicare require monthly premiums. The amount depends on several factors. The standard monthly premium for new members of Part B Medicare in 2011 is $115.40. If you get your Part A, B and/or D benefits through a Medicare Advantage (Part C) plan, your insurance company will set the premiums. Companies offering Part D Medicare stand-alone plans also set their own premiums. Even after premiums, there are other costs for Medicare, as all parts come with co-pays, deductibles and excess charges. Part D also comes with what is commonly called the doughnut hole. Part D helps cover prescription drug benefits only until their retail value reaches a certain point, and then drop off completely until drug costs meet the federal catastrophic coverage level, creating a "doughnut hole" of no insurance benefits for medications.
Benefit Issues
While Medicare offers many important health insurance benefits, including those for hospitalizations, hospice, home health care and preventive services, there are many medical services that are not covered. To obtain these services, beneficiaries are required to purchase more insurance. Medicare Advantage plans offer basic Medicare bundled with other kinds of services, such as vision, dental or hearing plans. but the exact benefits depend on which plan you buy and from which provider. Part D prescription drug plans include benefits for only certain kinds or brands of medication.
Plan Issues
The premiums for basic Medicare are set by the federal government, but premiums for Parts C, D and Medigap are decided by individual companies and can vary dramatically for the same services. Medigap, Medicare Advantage and stand-alone Part D plans are also not offered in all areas, and you can only join Medigap or Medicare Advantage plans during certain times of the year. In most places, if you move out of the service area for your plan, you will have to enroll in a different one as well, with no guarantee that your premiums, benefits or even insurance company will remain the same. You will also have to pick another plan if your first company decides to stop participating in Medicare.
Tags: Medicare Advantage, will have, Advantage plans, automatically enrolled, basic Medicare
