Aging comes with advantages, but some drawbacks exist as well. The older you become, the more wear and tear is placed on your body. Several health conditions are more likely to affect older individuals. Your immune system begins to decline with age which increases your odds of getting sick. Another side effect of a weakened immune system is it takes you longer to recover, so relatively minor illnesses have the chance to turn into something more severe. While this sounds intimidating, many of these health concerns are manageable with proper healthcare. It is important for senior citizens to get health insurance.
Many senior citizens worry about how expensive health insurance will be as they age. Most senior citizens want to retire by the time they turn 65 years of age, which not only means a loss of income but a loss of work-related insurance as well. Seniors who live in an assisted living facility have more medical expenses. Fortunately, senior citizens have access to some of the best and most affordable health insurance in the United States through Medicare.
Another critical difference between Medicare and Medicaid is the way the programs are divided. Medicaid is a single health insurance plan with optional components for additional coverage. Medicare is divided into four separate programs known as Medicare Part A-D. Medicare Part A provides hospital care, while Part B provides general medical insurance. These are the two most common plans and cover most health needs for seniors.
Medicare Part C refers to any Medicare plan covered by a private insurance company instead of the federal government. It is sometimes known as the Medicare Advantage Plan. Medicare Part C coverage varies depending on who provides the insurance plan. Medicare Part C offers the most customization out of any Medicare plan. If you know you only want a few services from Parts A and B, find a private insurer who allows you to make your own plan. This plan is less expensive than enrolling in either of the previous plans.
Part D is considered an add-on program for the existing Medicare plans. Part D only covers prescription drug costs. Some limited elements of Medicare Part D are covered in the previous plans, but if you take multiple prescriptions, especially more costly medications, look over Part D plans.
Medicare eligibility requirements change depending on the plan you select. Some shared requirements exist with all Medicare parts. You must be at least 65 years of age to enroll in Medicare, no matter the plan. Medicare Part A is considered the standard form of Medicare and is the easiest to acquire. Most senior citizens are automatically eligible for Medicare Part A.
If you paid Medicare taxes for at least 10 years, you are eligible for free Part A coverage. Any senior citizen who is eligible for Social Security retirement benefits or Railroad Retirement Benefits is eligible for Part A coverage. Senior citizens who do not meet any of these requirements are still allowed to get Part A coverage, but they must purchase it like any other insurance plan.
Part B uses the same eligibility requirements as Part A, but senior citizens are not eligible for free Part B coverage. Parts A and B share some components, but senior citizens are strongly encouraged to get Part B coverage if they enroll in Part A.
Standard eligibility requirements for Part C do not exist. Since Part C comes from a private insurance provider, he or she determines the eligibility requirements. Most Part C plans have minimal eligibility requirements to encourage senior citizens to purchase these plans over Part A and B.
Since Part D is an add-on insurance plan, it does not have additional requirements. If you have either Part A-C, you can apply for Part D coverage.
Before you commit to purchasing a plan, make sure you understand what coverage is available. No matter which plans you choose, you can expect traditional insurance payments, such as co-pays, premiums and deductibles. How much these charges cost vary depending on your insurance plan, medical and financial history. Medicare Part A coverage focuses on inpatient hospital care, which includes expenses for skilled nursing facilities or assisted living communities. Hospice care is covered. The plan provides generalized health services, like doctor visits and yearly screenings.
Part B includes the costs for outpatient services. Costs for specialized medical equipment is covered under Part B. Part B covers generalized health services but offers more options for preventative care.
Part C can be customized to include elements of Part A and B, as decided by a private insurer. Part D only covers prescription drug costs using a coverage gap. The coverage gap is a certain amount of money you must pay out of pocket. Once you reach your coverage gap, your Medicare insurance covers all prescription costs.
Medicare has specific enrollment periods, known as the annual and initial enrollment periods. Several months before you turn 65 years of age, you receive a pamphlet of the plan through the mail. This pamphlet includes information about each enrollment period, including the earliest date to apply for coverage. This is known as the initial enrollment period. The pamphlet includes whether you are automatically eligible for coverage.
The annual enrollment period is a set time where any senior citizen may apply for coverage. There is a special enrollment period for applicants who previously had an insurance plan during their initial or annual enrollment period but lost their old plan and now need coverage. You may be eligible for special enrollment depending on your medical history.
If you are automatically eligible for coverage, you do not need to take any extra steps. Otherwise, you apply for Medicare coverage through your Social Security office. If you wish to apply for Part C, you must go through a private insurance company.