What Is Medicare?
Medicare is federal health insurance meant for people aged 65 and older. People under the age of 65 may also qualify for the program if they meet specific requirements.
To register for Medicare, you must meet the eligibility requirements. The three ways you can qualify for Medicare enrollment are by age, disability benefits, or if you have certain health conditions — like Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).
Eligibility
Age: You can qualify for Medicare by age once you are 65 years or older. You will become eligible to enroll three months before your 65th birthday until three months after turning 65. This window is called the Initial Enrollment Period. You can apply for Original Medicare during this period if you are eligible. If you decide to delay your enrollment, you may face a late enrollment penalty whenever you decide to enroll for Medicare at a later time. However, you can avoid these late enrollment penalties as long you qualify and enroll during a Special Enrollment Period.
Disability: People who receive Social Security Disability benefits can qualify for Medicare once they have received benefits for 24 months. Individuals in this category become automatically eligible on the 25th month.
Health Condition: People suffering from End-Stage Renal Disease and Amyotrophic Lateral Sclerosis may become eligible for Medicare even when under 65. Those with kidney failure who need a transplant or frequent dialysis qualify for Medicare automatically. Medicare will begin coverage after the first dialysis.
Medicare and You
Medicare is divided into various parts. There is Medicare Part A and Part B, also known as Original Medicare, Medicare Part C/Medicare Advantage, Part D, and Medicare Supplement plans.
Medicare Part A covers inpatient medical care and other services such as hospice care and skilled nursing facility care. Part A deals with inpatient hospital costs and is premium-free for most people. If you paid up to 40 quarters of Medicare taxes while employed, you are qualified for premium-free Medicare Part A. However, Part A comes with deductibles and copayments for hospital stays and other services.
Part B covers outpatient healthcare services and other services such as ambulance services, durable medical equipment, doctor visits, lab tests, and preventive screenings. Unlike Part A, Part B cannot be premium-free. Part B also has a yearly deductible, and the beneficiary will be responsible for a 20% coinsurance of Medicare-approved services once the deductible is met.
Medicare Advantage is also known as Medicare Part C. Medicare Advantage plans serve as an alternative to Original Medicare. Private, Medicare-approved insurance companies provide them. Part C covers the same benefits as Original Medicare and extra services such as vision, dental, hearing, and prescription drug coverage.
Medicare Part D provides coverage for retail prescription drugs. You can get this coverage through Medicare Advantage or purchase a standalone Part D plan while enrolled in Original Medicare.
Medicare Supplement plans help to offset the out-of-pocket costs associated with Original Medicare. The plans are standardized in every state, including Florida, and are lettered from A to N.
Have Questions?
For more help with understanding the coverage provided by each plan, contact us today. We are local to Sarasota/Manatee Counties in the beautiful state of Florida, and are ready to help!