- Posted by Canopy KC
- On June 3, 2016
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The Medicare of today is not the Medicare of 1965 that was signed into law to help seniors gain access to healthcare. In fact, the complexity of the Medicare of today has left many seniors over the age of 65 without adequate coverage, paying higher out of pocket costs, and experiencing gaps in their prescription coverage. Medicare myths are as complex as Medicare facts and knowing the difference will help you make informed healthcare choices. Continue reading to learn the facts behind these 4 myths about Medicare.
- Myth: Medicare will notify you when to enroll.
- Fact: Unless you are already receiving Social Security benefits, Medicare will not send you a personal reminder. The initial enrollment period is seven months for Medicare Part A and Part B, three months before your birth month, your birth month, and three months after your birth month.
- You can delay signing up for Part B if you or your spouse are still working and receiving health care coverage through an employer. However, when employment ends, you only have eight months to enroll in Part B to avoid a higher premium. You can enroll after the seven month deadline but it is not recommended due to possible penalties and delayed coverage.
- Myth: Traditional Medicare is comprehensive.
- Fact: There are several parts and options related to Medicare coverage, each covering different aspects of healthcare. These options include, Part A, Part B, Medicare Supplement, Part C/Medicare Advantage, and Part D.
- Part A: Part A can be considered “hospital insurance,” covering a portion of inpatient hospital stays, skilled nursing facility stays, and hospice. Part A also covers lab tests, doctor visits and home health.
- Part B: Part B can be considered “medical insurance,” covering some of the cost related to doctor visits, outpatient care, durable medical equipment, home health, and limited preventative care.
- Medicare Supplement: A Medicare Supplement plan is designed to supplement Part A and Part B coverage and fill in coverage gaps leftover by Part A and B.
- Part C or Medicare Advantage (MA): Medicare Advantage plans are contracted by the government using private health insurance companies to incorporate Part A, Part B and usually include Part D (prescription coverage). These plans are part of Medicare and are not considered supplement plans. MA plans use networks of hospitals, doctors and pharmacies for members to use.
- Part D: Part D is prescription drug coverage and again you must be enrolled in Part A but not always in Part B to be eligible. There are guidelines and limitations associated with Part D prescription drug coverage.
- Myth: Medicare is Free
- Fact: No, Medicare is not free.
- Monthly Premium: No, unless you purchase Part A and then a set monthly premium will incur.
Deductible and Coinsurance: Yes. Part A requires an annual deductible with coinsurance to be met prior to any related hospital coverage.
- Monthly Premium: Yes.
Deductible and Coinsurance: Yes. An annual deductible based on your joint income must be met prior to Medicare coverage of 80% of approved Medicare Part B costs.
Part C or Medicare Advantage (MA):
- Monthly Premium/Deductible/Co-Pay: Yes. Monthly premiums, annual deductible and co-pay’s vary with each plan.
- Monthly Premium: Yes. Monthly premiums are plan dependent.
To learn more about specific Medicare 2016 costs, seek assistance from a Senior Market consultant at Canopy or visit medicare.gov.
- Myth: Once enrolled, costs and coverage are locked in
- Fact: Medicare coverage and costs change each year and like typical health insurance, there is an open enrollment period to review, compare and make changes specifically to Part D drug plans or Part C Medicare Advantage plans. Open enrollment begins October 15th and ends December 7, with coverage beginning on January 1st you can make changes after January 1st within certain Medicare limitations or if you have experienced a life qualifying event.
The Medicare of today can be as simple as the Medicare of 1965 with the right knowledge of what each Medicare plan has to offer. Contact us for a free face-to face consultation with one of our expert Senior Market consultants here at Canopy to discuss these 4 Medicare myths and others vs Medicare facts.