If you’re approaching your golden years, it’s time to get serious about your own medical needs. Medicare is a federally funded program for seniors 65 and older. This is a great program for receiving quality, affordable health care, yet many seniors don’t understand the system and how to make the most of it.
Making the big move from employer health insurance to Medicare is confusing, and with good reason. Medicare is broken into 4 parts, and they aren’t always clear to understand. If you aren’t careful, Medicare premiums can be expensive, and you’ll still be stuck with out-of-pocket costs. How can you make a smart choice to make sure you have the coverage and care you need? Start with reading these 7 tips below.
1. Understand the Basics
One of the main reasons seniors make the wrong choice about their own coverage when it comes to Medicare is because they don’t understand the different parts. Let’s break them down in simple terms everyone can understand so you know what to make of the program. Part A is your hospital coverage. If you have to stay in the hospital or in a care facility, this will cover you up to a certain point.
Next, Part B is your traditional insurance. This is what covers your outpatient care like office visits, tests, and some in-home care. Part C is also known as Medicare Advantage, and it’s through a private insurance company. You can choose between Part B and Part C depending on your needs, but Part C gives you more flexibility in price and providers.
Finally, Part D is your prescription coverage. Depending on your location, there will be different plans to choose from. Those are the four parts, but you can also look into Medigap. This refers to supplemental plans that fill your gaps in coverage.
2. Know Your Enrollment Window
Your enrollment period for Medicare starts 3 months before your 65th birthday and continues for 3 months after. If you miss this window, you can still enroll, but there will be penalties and fees. You’ll also have to wait for the yearly window to come around at the beginning of the year, so that could mean lapses in coverage.
If you’re currently still covered by your employer or a spouse, you might be able to get an extension on this window. Check with your local social security office to learn more about your unique enrollment window so you don’t miss your opportunity.
3. Medicare Only Pays 80%
The original Medicare plan will only pay 80% of covered expenses. Unlike traditional insurance, there are no caps on what you might have to pay. The only way to cover this remaining 20% is through a Medicare Advantage plan or a Medigap policy. These have different out-of-pocket safeguards that can keep you from stressing about that remaining percentage.
4. Shop Yearly for Part D Plans
Because your local Part D plans change yearly based on expected drug costs, it’s worth doing your homework. If you know you’ll need certain prescription drugs, you can shop for the lowest price plan that includes the right coverage. Talk to your doctor about your anticipated drug needs, then go online to find your local healthcare marketplace to compare prices. You’re allowed to change your Part D plan every year, so always see if you can find a cheaper option for the same drug coverage.
5. Strategic Scheduling
If you’re not yet at that 65-year mark and you still have your employer insurance, you might want to plan ahead. Sometimes you’ll have the ability to plan elective surgeries, and you might have more financial freedom if you’re willing to wait a few years. If your employer plan has great coverage, for instance, you might save money by scheduling an expected surgery a few months earlier before you make the switch.
On the other hand, many times you’re better off with medicare’s hospitalization coverage. That might mean it’s worth waiting a bit for those treatments if you want to save the most cash going into your golden years. Talk to your doctor about a timeline that works for both your health and your wallet.
6. Additional Coverage
A lot of people don’t realize that traditional Medicare doesn’t offer coverage for many things like vision, dental, and more. This might lead to gaps in your health, and that’s never a good idea. You can purchase Medigap coverage or make sure these supplements are included in your Medicare Advantage Plan.
Extra coverage like final expense insurance is almost never included, but they can be a smart way to ease the burden on yourself and your family. Nobody should have to worry about what will come after, and final expense insurance is an affordable way to put your mind at ease. This guide will help you get started: Final Expense Insurance – All you need to know.
7. Utilize the Benefits
There are a lot of benefits to being enrolled in Medicare. You should take advantage of all early screenings, yearly tests, and wellness services that make your life better. Catching potential problems early is not only more affordable, but it will leave your body open to more forms of treatment.
Your health is the most important thing you have. Treat it wisely, and know how to make the most of your Medicare coverage. Depending on your plan, you’ll have different free wellness services. These aren’t much different from your employer offered benefits, but they’re usually superior for those who struggle with chronic conditions or who need complex care.
Final Thoughts
Are you approaching your golden years? Now’s the time to learn about Medicare so you can feel confident when your enrollment window rolls around. Your health is worth the extra attention, and you’ll be glad you did your homework. From shopping for plans to talking to your doctor, you’ll need to keep your best interest at heart.
These can be the best years of your life if you take care of yourself and make smart choices. Medicare is a great program, and it gives many seniors access to affordable, high-quality healthcare. Just make sure you’re aware of the limitations so you can be prepared every step of the way.