How Old Do You Need To Be For Medicare?
I know, right?
If you're already retired, no need to read this.
Just keep on keepin' on.
If you're still employed, though, then this is the guide for you.
What is Medicare?
As you probably know, Medicare is a government-subsidized health insurance program for the elderly and those with disabilities. It has been standing since 1965 and remains one of the largest social welfare programs in the history of the United States.
This guide will tell you about "Part A" and "Part B" of Medicare.
Part A: Hospital Insurance
What does Part A cover?
Part A covers inpatient care for an eligible person in a hospital or hospice, as well as skilled nursing facilities.
Part A also covers a wide-range of preventative care services, including some outpatient care, medical equipment, and home health care.
Should I get Part A?
Unless you have other health insurance coverage (such as an employer plan or a spouse), you should get Part A.
Many seniors have both Part A and Part B.
If you have senior health insurance coverage, are you eligible for Part A?
Your eligibility for Part A depends on four factors:
- You must be a citizen or legal resident of the U.S.
- You must have lived in the U.S. for at least five years.
- You must have paid Medicare taxes for at least ten years.
- You cannot be eligible for Part A through your spouse.
Do you already have health insurance?
If so, you probably don't need Part A.
Many seniors have both Part A and Part B.
Part B: Medical Insurance
What does Part B cover?
Part B covers medically necessary services like doctor visits, and it covers some outpatient care.
Part B also covers some preventative care like annual check-ups. It also covers screenings, like colonoscopies and pap smears.
What preventative services does Part B cover?
Part B covers a wide-range of preventative care services, including the following:
- Annual check-ups.
- Screenings, like colonoscopies and pap smears.
- Diabetes monitoring supplies.
What preventative services does Part B NOT cover?
Part B does not cover routine dental care or vision care.
Part B does not cover contraceptives.
Do you have any other coverage?
If so, you likely do not need Part B.
If you have private insurance, you likely do not need Part B.
How much does Part B cost?
Part B costs you a monthly premium, which is generally deducted from your Social Security check.
If you do not have other health insurance, the premium should be automatically deducted from your Social Security check. You should never have to pay it directly.
Part B premiums are based on your income. If your income is less than $85,000 a year, you will pay the standard premium. If your income is greater than $85,000 a year, you pay an income-based premium.
How much will Part B cost you?
Most people pay the standard premium. If your income is less than $85,000 a year, you pay the standard premium. If your income is greater than $85,000 a year, you pay an income-based premium.
What are the standard premiums?
In 2017, the standard hospital insurance premium is $134.
Medicare Part B Deductibles
The Part B deductible is the amount of money you must pay out-of-pocket for medical services before Medicare will cover them.
Medicare Part B has a deductible and an out-of-pocket limit.
The Part B deductible is $183 and the out-of-pocket limit is $6,700.
What happens when I reach the deductible and/or out-of-pocket limit?
- If your doctor visit costs more than the deductible, Medicare will pay 80%.
- If your doctor visit costs more than the deductible AND the out-of-pocket limit, Medicare will pay 100%.
- If your doctor visit costs less than the deductible and/or out-of-pocket limit, you will pay the remaining cost from your pocket.
Are there any exceptions to the deductible and out-of-pocket limit?
Yes, there are a few.
- Your deductible and out-of-pocket limit do not apply if you are admitted to a hospital as an inpatient for at least three consecutive days.
- Your deductible and out-of-pocket limit do not apply if you go to a hospital or ambulatory surgical center for a potentially life-threatening condition.
- Your deductible and out-of-pocket limit do not apply if you need out-patient treatment for a chronic condition.
- Your deductible and out-of-pocket limit do not apply if you are admitted to a hospital as an inpatient for an accidental injury.
Part C: Medicare Advantage Plans
Medicare Advantage Plans are private insurance policies that cover Medicare benefits.
There are two kinds of Medicare Advantage Plans:
- Medicare Advantage Plans that are run by private insurance companies.
- Medicare Advantage Plans that are run by health maintenance organizations (HMOs).
Do you want to keep your current insurance?
If so, you do not need a Medicare Advantage Plan.
How much does a Medicare Advantage Plan cost?
Medicare Advantage Plans are more expensive than traditional Medicare, but they do have their benefits.
You will likely pay a higher premium for a Medicare Advantage Plan than you would for traditional Medicare.
What are the benefits of a Medicare Advantage Plan?
- Medicare Advantage Plans have lower deductibles and