For retirees and a large body of disabled Americans, getting healthcare coverage can be a real hassle. The good news is individuals from these groups could qualify to receive Medicare benefits.
Med. Care stands as the primary healthcare insurance option for retired Americans. If you are closing in on retirement age (65 years old), it might be time for you to start thinking about how you are going to manage your healthcare in the future. To that end, you should educate yourself about the benefits associated with Med. Care insurance.
In the sections below, the information is going to focus on letting you know everything you need to know about this retirement benefit.
What is Medicare?
Medicare is a U.S. insurance benefit that the U.S. government provides to retirees 65 years or over. The insurance plan is also available to Americans who become disabled either temporarily or permanently. The cost of basic coverage is statutory and changes each year. For 2021, Part B costs per participant will be $148.50 with Part A provided for free for most beneficiaries. (more on Part Descriptions below).
Enrollment for Part A and Part B is handled through the Social Security Administration (SSA). For other levels of insurance related to this government program, enrollment is handled through a wide range of private insurance carriers.
In the following sections, the focus will shift to the different parts of the program.
Med. Care Plan A is often referred to as the “hospital plan.” Plan A helps pay for inpatient care in a hospital as well as some aftercare home nursing costs, rehab/nursing facility services, and some hospice costs.
Note: Plan A is only free to participants if they have met the minimum requirement of paying SS taxes for 10 years (40 calendar quarters) or more.
Plan B is considered the core part of the entire Med. Care insurance program. Together with Plan A, they form what is generally considered “the Original” Med. Care option.
Plan B covers services related to doctor visits and other types of healthcare providers. It also covers outpatient care, home health care, the use of durable medical equipment, and some types of preventive services.
As a supplemental component to Med. Care, Medigap helps covers some of the out-of-pocket a beneficiary might incur. That would include copayments, coinsurance fees, and deductible medical expenses.
Med. Care Advantage Plan
This part was originally known as Part C. With an Advantage Plan, the insured would opt out of the “original Med. Care” option and get their insurance through one of many private healthcare insurance providers that offer the Advantage Plan option according to medicareusa.com/
The Med. Care Advantage Plan is equal to a combination of Plans A & B, plus the addition of Plan D, which is the prescription medication plan. It could also include additional benefits such as vision, hearing, and dental, which all get bundled together in one plan for an additional premium.
The cost of Med. Care Advantage for the Plan A and Plan B portions is actually paid by the SSA with any additional premiums being charged directly to the insured. The amount of the additional premiums will depend on the additional benefits the insured chooses.
As indicated above, prescription drug cost coverage is handled through Plan D. An insured person can choose an individual Plan D through a private insurance provider or get said coverage through a Med. Care Advantage Plan as stated above.
For retirees approaching their 65th birthday, the Med. Care enrollment period starts three months prior to their 65th birthday and continues until three months after their birthday. Everyone automatically qualifies for Plan A on their birthday.
For Plan B, participants are required to enroll. The enrollment process can be handled online or through a local SSA office. If a person misses their regular enrollment period, they may be able to squeeze into a “special enrollment period.” If not, the participant might have to pay an additional premium of 10% above regular costs for each 12-month period they were eligible for Part B but didn’t enroll for it. Additionally, there is an annual general enrollment period that runs from January 1 through March 31. However, the insured’s coverage will not begin until July 1 of that year.
For persons with temporary disabilities, the Med. Care enrollment is automatic after the individual has been receiving disability benefits (SSDI) for 24 months. However, the 24 month waiting period is backdated to the date the person’s disability started. As long as a disabled person is receiving SSDI benefits, they will remain eligible for Med. Care.
The Med. Care Card
All Med. Care participants will be issued a plan card. Each person’s card has a unique identifying number that is tied to the SSA system. Upon seeking healthcare services, the card should be presented to providers for cross-checking in the Med. Care system and verification of benefits.
After enrolling in the Med. Care program, insured persons can make informational changes like an address to their account through the Med Care online system.
Managing Your Healthcare After Retirement
Before heading into retirement, you need to make a plan to cover your healthcare. When you qualify for Med. Care, you benefit by having a good portion of your medical costs covered by the plan. However, there is always the potential that your medical costs could exceed your benefits.
The last thing you want in retirement is to have a medical problem hurt you financially. For that reason, you should be thinking today about ways you can save additional money for medical emergencies. Some of the options you may have at your disposal include:
- Roth IRA
- 401K Plan through your employer
- Health savings account
When it comes to your health and financial stability, you don’t want to leave anything to chance.