Medicare 101: Understanding Medicare

Navigating Medicare can often feel like stepping into a maze, whether you're just starting out or have been managing your coverage for years. If you’re new to Medicare, it might seem like there’s an endless amount of information to sift through, making it hard to know where to start or what’s most important for you.

If you’ve been on Medicare for a while, you might still find certain aspects confusing or frustrating. And if you’re helping a loved one with their Medicare, you’re likely facing the challenge of understanding a complex system while trying to ensure they receive the best care possible.

You’re not alone in feeling this way. Many people share these concerns and often wonder if they’re missing something crucial about their Medicare coverage. That's really the reason I'm starting this blog, to cut through the complexity and provide clear, straightforward explanations. We’ll help you understand the essential components of Medicare, from the basics of eligibility to the different parts and how they work together.

My name is Brittany Garrison, I'm a licensed Health & Life Insurance Broker and I love making Medicare make sense.

Many people worry about understanding the different parts, eligibility requirements, and enrollment periods. But don’t worry—I'm here to help simplify the process and guide you every step of the way.

So, let's get started!

What is Medicare and Who is Eligible? Medicare is a federal health insurance program that was designed to provide coverage for individuals aged 65 and older. It’s also available for certain younger people who have disabilities or those diagnosed with End-Stage Renal Disease (ESRD), which is permanent kidney failure requiring dialysis or a transplant.

• Eligibility for People 65 and Older:?Generally, if you are 65 or older and a U.S. citizen or a permanent legal resident for at least five years, you are eligible for Medicare. Enrollment typically begins three months before you turn 65.
• Eligibility for Younger Individuals:?If you are under 65 but have been receiving Social Security Disability Insurance (SSDI) for 24 months, you will automatically qualify for Medicare.

The part that I've seen most people deem to be the most confusing are the ABCs of Medicare, so let's break that down.

Medicare is divided into four parts, each serving a specific purpose and covering different healthcare services:

• Part A: Hospital Insurance -- Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Most people do not have to pay a premium for Part A if they or their spouse paid Medicare taxes while working for 10 years or 40 quarters.
• Part B: Medical Insurance -- Part B covers outpatient services, doctor visits, preventive services, and some home health care. It involves a monthly premium, which varies based on your income -- in 2024, the Part B premium is $174.70.

Part A and Part B are what is referred to as Original Medicare.

• Part C: Medicare Advantage Plans -- Medicare Advantage Plans are offered by private insurance companies approved by Medicare. They include all the benefits of Part A and Part B and often come with additional perks such as vision, dental, and hearing coverage and many of these Medicare Advantage plans also include prescription drug coverage (Part D). So think of this as Part A, Part B and Part D wrapped up in one box -- called Part C.
• Part D: Prescription Drug Coverage -- Part D is what provides coverage for prescription medications. These plans are also offered by private insurers and can help lower your drug costs. It’s important to choose a plan that includes the medications you need.

How Do I Enroll in Medicare?

Enrollment in Medicare can be automatic or require action depending on your circumstances:

• Automatic Enrollment:?If you’re already receiving Social Security benefits by the time you turn 65, you will be automatically enrolled in Medicare Parts A and B. You will receive your Medicare card in the mail three months before your 65th birthday.
• Manual Enrollment:?If you’re not receiving Social Security benefits, you will need to sign up manually during your Initial Enrollment Period, which starts three months before your 65th birthday and ends three months after. You can enroll online, by phone, or in person at your local Social Security office.

Lastly, I want to ensure we breakdown some common terminology that you may hear when going over your plan options. This is important because as many of us would have heard and read these terms several times while going over healthcare products over the years, I've found that they are still not truly understood -- here's a breakdown of some key terms:

• Premium:?The amount you pay for your Medicare coverage each month. For Part B, this is deducted from your Social Security benefits.
• Deductible:?The amount you must pay out-of-pocket for healthcare services before Medicare starts to pay. For example, Part A has a deductible for hospital stays, and Part B has an annual deductible.
• Copayment/Coinsurance:?Your share of the cost for healthcare services after you’ve met your deductible. For instance, you might pay a copayment for each doctor visit or a coinsurance percentage for hospital services.

Medicare doesn’t have to be overwhelming and my goal is to aid you in having a higher level of understanding by simply breaking it down into its core components and simplifying the key aspects of enrollment and terminology. Together, we are going to make Medicare more approachable and less intimidating.

If you have questions or need personalized guidance tailored to your unique situation, I'm here to help. Feel free to reach out for one-on-one support.

Together, we can navigate the complexities of Medicare, ensuring you have the information and resources you need to make confident, informed decisions about your healthcare coverage. Your journey to better understanding Medicare starts here—let’s take it together.

Talk soon!

Brittany

#Medicare #Medicare101 #MedicareHelp

Watch Medicare 101: The Four Parts You Need to Know on Youtube!