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Medicare
Navigating into the Medicare world can be mind boggling, there are many things that must be considered and done in a timely manner.
However, the benefits are often times wonderful!
Medicare is available to people who have turned 65 or have received Disability Benefits for 24 months. US citizens & Legal Green Card holders are eligible for Medicare Part A & B the first day of the month of their 65th birthday. If your birthday falls on the first day of the month, you are eligible for Medicare Part A & B the first day of the prior month. The best rule of thumb is to contact Hourglass Insurance Services (or the Social Security office) 3 or 4 months prior to your 65th birthday. Medicare Part B has a cost associated with it, Part A is a free benefit as long as you have worked and paid Medicare Taxes for 40 quarters. If you do not sign up for Medicare within the the 7 month time frame, 3 months before your 65th birth month and 3 months after your 65th birth month, you will not be eligible to sign up until the following January/February and your coverage would not start until the following July.
Medicare is complicated, contact us while you are still 64….
Original Medicare Part A covers part of Hospital related care.
Original Medicare Part B covers part of Doctors’ Services and other medically necessary items including preventative services.
Medicare Advantage Part C is covered through private insurance company plans that usually use HMO’s, POS’s or PPO’s and typically include Parts A, B and D.
HMO is a health maintenance organization where all of the doctors need to be in the network.
POS is a point of service network that allows in and out of network coverage, out of network services cost more.
PPO is a preferred provider organization that also allows in and out of network care, out of network services cost more.
Medicare Part D is Prescription Drug Coverage, it is optional, however, you may have to pay a small lifetime penalty if you do not acquire the coverage when you become eligible. *** See more information under the Rx section.
Medigap aka Medicare Supplemental Insurance plans help cover the out of pocket costs of Original Medicare.
There are rules that must be followed to meet the eligibility requirements of Medicare if you are not a US citizen or Green Card holder and do not have at least 40 quarters of paying into Social Security/Medicare. For instance non-working spouses may have coverage through their eligible spouse even if they have not worked 40 quarters .