What is Medicare? Medicare is a federal program older Americans and people with disabilities use for healthcare coverage. According to AARP, Medicare will help more than 61 million people pay for healthcare-related costs such as hospital stays, doctor visits and prescription drugs this year alone. Those who receive Social Security are automatically enrolled in Medicare. Whether you’re enrolling for the first time or want to make changes to your plan, you must do so between October 15-December 7 for the plan to take place on January 1. It’s no secret that Medicare is a complex program with many different parts. If you’re preparing to enroll in Medicare or are planning to make changes to your current plan, here’s what you need to know to get started.
Medicare is a comprehensive program that provides coverage for all healthcare needs. In general, Medicare offers lower out-of-pocket costs when compared to traditional commercial healthcare plans. To make the program easier to navigate, it’s broken down into four major parts.
Medicare Part A covers inpatient hospital care, including hospice care and short-term skilled nursing care. You’re automatically enrolled in Part A when you apply for Medicare. In addition to hospitalization, Part A will cover doctor services and lab tests that were done while you are in a hospital or other healthcare facility. While you don’t have to pay a premium, Part A does require a yearly deductible and coinsurance costs.
Medicare Part B covers doctor visits, lab tests, diagnostic screening, medical equipment, and ambulance transportation. Part B can involve more out-of-pocket expenses, so if you have insurance through your job or a spouse, you might consider deferring. However, if you don’t have other coverage and choose not to enroll in Part B, you’ll likely pay a higher monthly premium for the duration of your enrollment. In addition, Part B requires an annual deductible and payment of 20% of doctor visits and outpatient services costs.
Medicare Part C is the Medicare Advantage program, which offers an alternative to traditional Medicare (Parts A and B). Medicare Advantage programs are Medicare plans that are offered by Medicare-approved private insurance companies. These plans include Parts A, B and usually Part D in addition to other benefits such as vision, hearing and dental programs. While deductibles and copays are usually lower when compared to traditional Medicare, the premiums are higher. Some people choose Medicare Advantage programs for more coverage and to make paperwork and communication easier and more efficient.
Medicare Part D covers prescription drugs and is purchased through a private insurer. Many options are depending on your needs and prices can vary. It’s best to check medicare.gov to see whether the plans you’re considering cover the medications you need.
As open enrollment is approaching, it’s important to be aware of the changes being made to Medicare. According to the official U.S. government Medicare handbook, here’s what you need to know before open enrollment:
Many people with Medicare coverage are at a higher risk of developing complications and serious illness due to COVID-19. To help protect these individuals, Medicare has continued and expanded coverage of COVID-19 related services to include the following:
When you see your provider for an annual wellness check, they may perform a cognitive assessment that looks for signs of Alzheimer’s disease and other forms of dementia. These signs can include difficulty remembering, learning new things, concentrating, managing finances, and making decisions about your everyday life. Medicare covers a separate visit with your regular healthcare provider or specialist to do a full review of your cognitive function and establish or confirm a diagnosis. A diagnosis can help your healthcare team establish a care plan and manage symptoms.
Medicare covers preventive services such as colorectal cancer screenings to help find precancerous growths or find cancer early. This year, Medicare has added another lab test used to identify colorectal cancer. This lab test is available once every three years to those ages 50-85 and who have an average risk of developing colorectal cancer and have not experienced symptoms.
At Maplewood Senior Living, health is our number one priority. We know Medicare can be confusing, but enrolling in the program and knowing about Medicare changes in 2022 will allow you to access the best healthcare possible. For more information, or to schedule a tour, please contact us here.
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