In the United States of America, the law requires everyone to have medical insurance. Most people who are employed get a group rate plan that their employer helps them pay for. People who are not offered insurance help through their employer are required to get medical coverage that meets the government standard, and pay for it on their own or face a large fine by the government. If the person meets the government standards for living below the poverty level, they can apply for Medicaid, which is insurance that is partially paid for by the state they.
What is Medicare?
In the U.S.A., when a person reaches the age of 62, they have a right to retire. They then begin drawing the Social Security taxes, that they have paid for (through payroll deduction) during their entire working life. The amount of money you will be paid is based on how much money you earned and therefore paid in during your life. If you choose to wait until you are 65 your check will be higher and if you wait until you are 67 to retire, you will draw the maximum amount. If a person is ill or unable to work they can draw a Social Security Disability check, regardless of your age.
When you retire, some companies will allow you to continue to participate in their group insurance coverage, if they pay their share.
If you cannot keep your coverage, you may enroll in government insurance coverage. That insurance is called Medicare.
Related: What is Medicare and How to Get it
Mistake number 1
Do not wait to contact Medicare. There is a time limit on how long you have to enroll. If you do not enroll in Medicare by the end of the month after you retire, you will be charged a penalty. Check your options beginning a month or two before you retire.
Mistake number 2
Do not assume this is free. There are several parts of Medicare.
- Medicare part A does not cost you a premium. Medicare Part A only pays for a portion of your medical cost if you are admitted to the hospital. Note, going to the hospital for an emergency or test does not count. You must be admitted in order for this to kick in.
- Medicare Part B pays your doctor. They pay 80% and there are some things they do not cover. You pay a premium for this coverage The average cost in 2018 is usually $134.00 per month.
- Medicare Part C is also known as Medicare Advantage. This is a plan that allows you to contact private insurance companies to help with your coverage. There are several plans available. These are much like your PPO plans. The insurance company is paid the $134.00 per month from Medicare. Anything you owe over that is also deducted from your check. For example, if the plan you choose cost $184.00 per month. Your insurance company will receive the $184.00 per month for your coverage. The coverage and options for the Advantage plan are much better than Medicare alone.
- Medicare Part D is your drug coverage. Your insurance company will advise what will be covered and what will not. They also have different prices, depending upon the group your medication falls into. There are co-pays.
Mistake number 3
Not understanding what is covered and what is not. Many seniors assume that the doctor knows they have Medicare and certainly will order tests and medications that are covered. But that is not accurate. Ask your doctor if what he is doing is covered. If you are confused, contact your insurance agent. Check your medication as well. One brand medication could be in a tier that could cost $400.00, while a different brand can be a tier 1, with a co-pay of $3.00.
Mistake number 4
Do not assume you have dental and vision coverage. Unless you enroll in vision and dental coverage through your Medicare Advantage company, you do not have those coverages. If you opt for dental and vision insurance, it will cost you additional premiums which will be added to the money reduced from your check.
Medicare is confusing and mistakes can cost you more than you can afford to pay. Contact Medicare and make sure you understand what you are getting and how much it is costing you.