Medicare Facts You Should Care About

Last Updated on March 26, 2019

Having an excellent understanding of Medicare facts can be your stronghold in retirement. Without it, your entire retirement plan will weaken, your healthcare may be hopeless and finances will be scrambling down the drain. Seems too harsh or too bad to be true? But it is possible!

Understanding Medicare is important. The healthcare coverage it provides is indispensable especially that it includes annual wellness visits to Medicare-accepting doctors. Additional perks of having Medicare are free screenings such as colonoscopies, mammograms, diabetes screenings and many more! This information is just the tip of an iceberg. There are lots of things to know and learn about this federal government health program.

Also read: Get the best out of Medicare with these tips.

To make the most out of Medicare and avoid undesirable surprises, you’d better start learning about it ahead of time. Here are 5 Medicare facts you should care about.

1.     Time is of the essence

Medicare is surrounded by time-sensitive details. The time is crucial during enrollment, same with other options like Medicare supplemental insurance plans or Medicare Advantage Plan.

Once you turn 65, enrolling in Medicare is not automatic (except for those who are already receiving Social security). You can enroll in Medicare three months before you turn 65, during your birthday month, and three months after your birthday. Missing those vital periods when you can enroll may cost you expensive penalties for the rest of your lives.

Same with a Medicare option, Medicare supplement plan (Medigap). Medigap also has an open enrollment period when you can only enjoy certain rights and perks. Missing it will have costly consequences or worst – you may not be able to enroll in a policy anymore.

2.     Medicare has different parts

Medicare isn’t a single bloke of health insurance. It has different parts and different forms. Original Medicare has Medicare Part A and Part B which essentially cover hospital and medical expenses. There is also a form called Part C, also known as a Medicare Advantage plan. It provides the coverage of both Part A and Part B plus other additional benefits. There is also Part D or Prescription Drug Coverage.

More than 13 million people with Original Medicare opted to get a Medicare Supplement policy.  This additional coverage helps minimize out-of-pocket costs in Medicare. It also provides additional benefits like health coverage abroad.

3.     Medicare isn’t free!

You read it right, folks! Medicare isn’t free all the way. You still have to shed your hard earned money to pay for some premiums and out-of-pocket expenses in Medicare.

What are those?

  • Medicare Part A is generally free, but some people may pay a small amount for its premium.
  • While Medicare Part A is generally free, there is a deductible amount that you have to pay every benefit period. It is $1,364 for 2019. Take note that this is every benefit period. So, if you got hospitalized several times in a year, you may have to pay the deductible same number of times that year.
  • Medicare Part B premiums.
  • Medicare Part B deductible ($185 for 2019). Once this deductible is paid, you still have to shoulder 20% of the amount of the Medicare-approved Medical services that you will need.

Related article: Are you ready for the 2019 Medicare Changes?

4.     Medicare does not cover everything

Unfortunately, Medicare can’t be your sole “knight of the shining armor” who will save you from all of your healthcare expenses. While Medicare covers a lot of services, it also doesn’t cover a lot of things such as:

  • Vision care
  • Hearing care
  • Dental expenses,
  • Basic home health help, such as assistance with bathing or toileting (unless you’re also receiving skilled nursing care).
  • Alternative medicines or treatments (such as acupuncture, acupressure, homeopathy, or chiropractic care) are generally not covered.
  • Care received outside the US
  • Long term care

5.     You may need additional coverage

At the end of the day, you might realize that having only Original Medicare is not enough to protect you.

As mentioned above, Medicare isn’t free. It also comes with deductibles, copayments or coinsurance which can build up and become hard to shoulder.

Medicare Advantage plans

You can opt to have your Medicare Part A and Part B coverage through the Medicare Advantage plan. In addition, it also provides additional benefits such as vision, hearing and dental care.

Also, Medicare Advantage plans have out-of-pocket costs for Medicare-approved services annual spending limit. Once you reach that limit, the rest will be fully covered by the plan. Out-of-pocket cost cap may vary from plan to plan and may change every year.

Related article: Do you know the difference between Medigap and Medicare Advantage Plan?

Medicare Supplement plans (Medigap)

If you are someone who is in and out of the hospital or someone who requires medical attention frequently, this option may be right for you. Out-of-pocket expenses (deductibles, copays or coinsurance) can be problematic if it adds up over time. Medigap works with Original Medicare by paying for the Medicare-approved expenses not paid or left by the program.

Medigap may be right for you if:

  • You want to have coverage for deductibles, copayments, and
  • You frequently need medical services.
  • Have preferred doctor or facilities.
  • Often travels abroad or different

Are Medicare Supplement Plans worth it? Yes, If You…

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Wait there’s more! Here’s 9 more Medicare facts  that you may want to know

Click on each image to show the additional Medicare facts you may want to also know: