Medicare can be very confusing and frustrating for those turning 65, in fact, 50% of Americans over 60 don’t understand how Medicare works. There’s a lot to know and no doubt you have a lot of questions. So, we’re here to make Medicare easier to understand.
How do I know if I qualify for Medicare coverage?
- Are you turning 65?
- Are you 65 and over?
- Are you of any age diagnosed with end stage renal disease?
- Are you of any age with a severe disability like amyotrophic lateral sclerosis?
- Have you been receiving Social Security benefits for at least 24 months?
Ok, I qualify for Medicare. Now what happens?
Now we need to see which Medicare plans and options best suit your needs and your lifestyle. We have two options: Original Medicare or Medicare Advantage.
Original Medicare vs. Medicare Advantage
Original Medicare is made up of Parts A, B, and D, while Medicare Advantage plans combines Parts C & D.
In general, Medicare Part A covers hospital care, skilled nursing facility care, hospice and home health services. Coverage is based on three main factors:
- Federal and state laws
- National coverage decision made by Medicare about whether something is covered
- Local coverage decisions made by companies in your state that decide if something is medically necessary and should be covered.
In addition to medically necessary doctors’ visits, Part B covers the following preventative services:
- Clinical Research
- Ambulance Services
- Durable Medical Equipment
- Second Opinions
- Limited Outpatient Drugs
Part C (also known as Medicare Advantage)
To enroll in part C you must first enroll in Parts A and B. Part C supplements those plans and includes a completely separate premium. The cost however can be offset by benefits from the extended coverage and various services that are provided.
While Part C is more expensive than other plans, it can be a life-saver for those hoping to receive dental, vision, and hearing tests. Part C also covers the resulting visits and treatments that could ensue. Medicare Part C or other Medicare Advantage plans could be a good match for those looking for a few extra benefits.
Part D (Optional)
To receive Medicare Prescription Drug Coverage (Medicare Part D), you will need to enroll in a plan that is either run by an insurance company or by another private company that is approved by Medicare. The cost and drugs covered will vary by plan.
Applying for Medicare
You may apply for original Medicare at medicare.gov, over the phone or at your local Social Security office. Need help with extra benefits? We have highly qualified local Tennessee agents that will come to you to explain the benefits you are eligible for. Give us a call at (615) 541-4257 to schedule an appointment.