Medicare is the national health insurance program in the United States for retirees and other qualifying individuals. It figures to play a major role in each person’s post-career life, often offering protection for the one of the most costly expenses in retirement. It’s important, however, to be aware of how Medicare works, as well as how you can properly leverage it to work for you and protect you from those expenses. Without the proper knowledge and qualified guidance, it can be difficult to know just how to use it best, accounting for your providers and prescriptions. Retirement Healthcare Maze aims to give you that knowledge and guidance to help you maximize your healthcare benefit in retirement to ensure that your plan is selected with your care providers and prescriptions in mind.
Peace of Mind in Your Healthcare
Part A
Part A is the first part of the United States Medicare program. Most people who have worked and paid Medicare taxes for at least 10 years are eligible for Part A coverage at no cost.
Those eligible for Part A will generally be covered for:
- Inpatient hospital care
This includes hospitalizations, surgeries, and any necessary medical supplies and services received during the hospital stay.
- Skilled Nursing Facility Care
If you need nursing care and rehabilitation services after a hospital stay, Part A may cover your stay in a skilled nursing facility for a limited time.
- Hospice care
This includes care for those with a terminal illness, and may include medical care, counseling and other supportive services.
- Home health care services
Part A may cover some medically necessary short-term skilled nursing care and therapy services you receive at home.
Part B
If you are eligible for Part B coverage, you will generally pay a monthly premium based on your income. You will also be responsible for paying a deductible and co-pays for many covered services.
Part B coverage includes the following services:
- Doctor Visits
This includes office visits, check-ups and consultations with specialists.
- Outpatient Care
This includes medical services that do not require an overnight hospital stay, such as diagnostic tests, imaging services and outpatient surgeries.
- Preventive Services
This includes screenings, vaccines and counseling services to help you stay healthy and prevent illness.
- Medical Equipment and Supplies (DME)
This includes durable medical equipment like wheelchairs and oxygen equipment, as well as some home health supplies.
- Mental Health Services
This includes counseling and therapy services for mental health conditions.
Part C
Medicare Part C, also known as Medicare Advantage, is an alternative way for Medicare beneficiaries to receive their Medicare benefits through private insurance companies. Medicare Advantage plans typically replace Parts A and B but can also offer additional benefits, such as vision, dental and hearing care for those looking for extra coverage.
In addition to covering all of the services that are covered by Parts A and B, Medicare Advantage plans may offer additional services such as:
- Prescription Drug Coverage
Many Medicare Advantage plans include prescription drug coverage as part of their benefits.
- Wellness Programs
Some Medicare Advantage plans offer wellness programs, such as gym memberships or discounts on health and wellness products.
- Care Coordination
Many Medicare Advantage plans provide care coordination services to help you manage your medical care and treatment.
- Network Restrictions
Most Medicare Advantage plans have a network of healthcare providers that you must use in order to receive the maximum benefits.
It’s important to review your Medicare plan each year during the open enrollment period to determine if you have coverage that fits your needs. Retirement Healthcare Maze can help!
Part D
Part D of Medicare covers prescription drugs and is available for beneficiaries to opt into. It’s designed to help those with Medicare coverage pay for necessary prescription drugs, which can become even more important as you approach and transition through the different phases of retirement.
Those who are enrolled in Medicare Parts A and B are eligible for Part D coverage, however those with a Medicare Advantage plan through a private insurer often have access to prescription drugs through their chosen plan. Part D plans are also offered by private insurance companies and come with an additional a monthly premium for the coverage. On top of the premium, beneficiaries may also be required to pay a deductible and copays for the cost of your prescription drugs.
Part D covers a wide variety of prescription drugs from many companies, brands and manufacturers; however, the cost of coverage can depend upon the beneficiary’s need for care. The additional cost can also be determined by the plan selected by the insured. There are different Part D plans, and it’s important to ensure that you’ve selected the plan that most closely matches your needs.
Each year during the open enrollment period, you can either add to or adjust your coverage to find a plan that may cover your needs at a greater level. Retirement Healthcare Maze can look at your prescriptions and match you with a plan tailored to your situation!
Important Things to Remember
Medicare is one of your most important benefits in retirement. Here are some things you should know as you plan for your healthcare in retirement:
The Initial Enrollment Period
The initial enrollment period for Medicare begins three months before the month of your 65th birthday and ends three months after the month of your 65th birthday. If you miss this seven-month enrollment period, you may have to pay higher premiums for the rest of your life.
What Medicare Doesn’t Cover
There are some gaps in Original Medicare coverage, such as dental and vision. Additionally, Medicare does not cover long-term care, which can be extremely expensive, with or without the means to cover the cost. It can be a good idea to look into additional insurance policies or hybrid policies that supplement your current level of care and have the potential to protect you.
The Open Enrollment Period
Each year from Oct. 15 to Dec. 7, beneficiaries can change, adjust and add additional Medicare coverage. It’s important to review your plans to ensure that you have the level of coverage that meets your needs and gives you the best chance to avoid outrageous medical bills. At Retirement Healthcare Maze, we specialize in assessing your needs and plans to find the plan that fits your circumstances, all while communicating with you to provide appropriate service and a suitable plan.
Our Founder
Our founder, Jim Ball, is an experienced professional in Medicare planning and financial services, and he looks forward to every opportunity to help a new retiree maximize their benefits. He has seen the flaws in the system, and despite knowing that he can’t change the overall process, it won’t stop him from trying. At Retirement Healthcare Maze, we welcome any retiree, whether you’ve had difficulty with your Medicare or not, to our offices, and we invite you to be a part of our family. We look out for one another, protecting each other from the pitfalls that come with Medicare and its many confusing elements. Those philosophies are spearheaded by our founder, and we invite you to meet him!
Reaching Out in the Community
Your retirement and your healthcare are personal, which is why we make an extensive effort to reach you in person. On a regular basis, we host live events and virtual events to help you understand your retirement benefits and give you a better chance to protect yourself. We also enjoy forming personal connections, and we think that those connections thrive when they take place on a face-to-face basis. We look forward to continuing to host these events and meeting more retirees as we fight miseducation and ill-advised actions when it comes to your most precious assets.
