Still Struggling to Understand Medicare? Read This Breakdown Today

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Medicare is the federal program that some 60 million Americans rely on for much of their healthcare coverage. Many people are very happy with the care they receive through these public benefits and find that Medicare meets all of their needs.

But even the program’s biggest advocates will admit that is sure can be confusing. So, unfortunately, to get the most out of your plan, you need to understand how it all works.

This can be difficult even for people who have been using it personally for years — let alone anyone just nearing the enrollment age and trying to figure it all out for the first time.

It is very important to get it all right, however. So you’re going to need to do a little bit of homework. After all, for most seniors, this will be the primary healthcare plan you use for the rest of your life.

The good news is that, once you understand the basics, it isn’t as complicated as it might seem. And the following breakdown will help you get started as you learn the verbiage, logistics, eligibility requirements, and enrollment process for both Medicare and Medicare Advantage coverage.

Medicare Eligibility

Who is eligible for Medicare? In general, most U.S. citizens become eligible for Medicare enrollment once they hit 65 years old as long as they are also eligible for Social Security. Anyone who has hit 65 and has been a legal permanent resident for at least the past five consecutive years will also receive Medicare eligibility.

And while the program is mostly used by seniors, some others do apply as well. Younger people who have been diagnosed with ALS (Amyotrophic Lateral Sclerosis or Lou Gehrig’s Disease) or end-stage renal disease (ESRD) are eligible for Medicare.

Original Medical

Medicare is broken up in four main components known commonly as Part A, Part B, Part C, and Part D. The first two parts, Part A (Hospital Insurance) and B (Medical Insurance), are referred to as Original Medicare because they were the main aspects of the program when it was created in 1965. Respectively, these two parts are mainly designed to cover emergency hospitalizations and general doctor visits — the basic healthcare coverage that all eligible people receive when they enroll.

Medicare Advantage Coverage

Medicare Parts C and D are a form of expanded coverage. And these optional add-on plans are generally known as Medicare Advantage Coverage. While they are not included in the basic healthcare coverage of Original Medicare, they are an increasingly popular option that most seniors now want to enroll in. They not only give you access to a wider network of healthcare professionals and allow you to see a specialist directly without a primary care physician referral, but cover a broad range of prescription drugs that many older Americans rely on.

Medicare Enrollment

Enrolling in Medicare is something that most people should do as soon as possible once they turn 65 years old. Many workers do continue in their jobs past this age and therefore want to stay on their current employer-provided healthcare plan. That is definitely a good option for some people. But because there are only certain time periods each year that offer open enrollment, it makes the most sense to enroll formally as soon as possible even if you don’t plan to start relying on the benefits right away.

Getting Ready for Medicare

With any public program managed in Washington, there are going to be a ton of details. That’s just par for the course. And when the program is as big as Medicare? Well, all the provisions and finer points could probably fill up an entire encyclopedia.

But to start out, most people just need to get a good grasp on the basics. If you or a loved on is nearing 65, the first key is to understand who is eligible for Medicare. Then you want to learn the difference is between Original Medicare and Medicare Advantage coverage. Finally, read up on the enrollment process and why formalizing your status is best done as soon as possible.

For most people, it will definitely pay off to get the best coverage you can afford by weighing all your options with Part C and Part D Medical Advantage coverage.

But especially as you begin to figure out all the logistics and understand what the best plan is for you, just knowing everything explained here will help set your mind at ease and get your ready for transitioning onto Medicare.

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