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Medicare Planning: What You Need to Know

Medicare is a government-run health insurance program that provides coverage to Americans 65 years or older, as well as younger people with certain disabilities. It offers several different health plans, which can be confusing for seniors who are trying to choose the right one. In this blog post, we will provide an overview of medicare and medicare health plans, as well as information on how to apply for medicare and when to do so.

What Is Medicare?  
Medicare is a federal health insurance program that provides coverage to Americans 65 years or older, as well as younger people with certain disabilities. It offers several different health plans, which include Medicare Part A, B, C, D, and Medicare supplement insurance.

What Is Medicare Part A For?  
Medicare Part A is for hospital insurance. It covers inpatient care, including hospice care and some home health care.

You can also expect the following to be included in this plan:

  • A semi-private room

  • Your hospital meals

  • Skilled nursing services

  • Care in special units, such as intensive care

  • Medical supplies, drugs and medical equipment used during an inpatient stay

  • X-rays, medical equipment and lab tests, as an inpatient

  • Operating room and recovery room services

  • Some blood transfusions in a skilled nursing facility or hospital

  • Inpatient or outpatient rehabilitation services after a qualified inpatient stay

  • Part-time, skilled care for the homebound

  • Hospice care for the terminally ill, including medications for pain control and to manage symptoms

What Is Medicare Part B For?
Medicare Part B is for medical insurance. It covers outpatient care, including doctor visits, preventive services, and some home health care options like therapists.

You can expect the following to be included:

  • Routine physician care, including hospital care

  • Annual wellness and preventive services, such as flu shots and mammograms

  • Blood tests and other lab services

  • X-rays and some diagnostic testing

  • Certain health programs, such as obesity counseling, smoking cessation and cardiac rehab

  • Occupational therapy, speech-language pathology, and physical therapy

  • Diabetic care, including screenings, education, and supplies

  • Mental health services

  • Required medical equipment like walkers and wheelchairs

  • Ambulatory surgery centers

  • Emergency room and ambulance services

What Is Medicare Part C For?  
Medicare Part C is also known as a Medicare Advantage plan. These plans are offered by private companies that contract with Medicare to provide all of your Part A and Part B benefits. Some plans may also offer extra benefits, such as prescription drug coverage or dental and vision coverage.

You can expect the following to be included:

  • All Part A benefits except hospice care, which is covered by Part A itself

  • All Part B benefits

  • Prescription medications

  • Other health benefits like:

  1. Eye exams, along with corrective lenses and eyeglasses

  2. Dental cleanings, exams, and x-rays

  3. Wellness programs, fitness memberships, and worldwide emergency coverage

  4. Rides to appointments and necessary home safety devices

  5. Hearing tests and hearing aids

What Is Medicare Part D For?  
Medicare Part D is for prescription drug coverage. It helps cover the costs of prescription drugs.

You can expect the following to be included:

  • The most commonly prescribed types of drugs per federal standards.

  • Specified generate drugs and brand name drugs found on the drug list.

  • Commercially available vaccines that aren’t covered under Part B.

What Is Medicare Supplement Insurance?  
Medicare supplement insurance, also known as Medigap, is a type of health insurance coverage that helps fill in the gaps left by Medicare. It can help cover some or all of the costs not covered by Medicare, such as deductibles, coinsurance, and co-payments.

How To Apply For Medicare  
You can apply for Medicare online, by phone, through an agency such as The Sosa Insurance Group, or in person at your local Social Security office. If you are already receiving benefits from Social Security or the Railroad Retirement Board, you will automatically be enrolled in Medicare Part A and Part B.

When To Apply For Medicare 
If you are not already receiving benefits from Social Security or the Railroad Retirement Board, you should sign up for Medicare three months before your 65th birthday.  This will ensure that your coverage starts on the first day of the month you turn 65.

You can also sign up for Medicare during the seven-month period that begins three months before your 65th birthday and ends three months after your birthday. However, if you wait to sign up during this period, you may have to pay a late enrollment penalty.

How To Choose The Best Medicare Plan  
The best Medicare plan for your needs will depend on a number of factors, including your budget, your health, and whether you need prescription drug coverage.

If you are healthy and have a limited budget, you may want to consider a Medicare Advantage plan. These plans typically have lower premiums than the other Medicare plans.

If you have a more robust budget and/or need prescription drug coverage, you may want to consider a traditional Medicare plan. These plans typically have higher premiums but offer more comprehensive coverage.

You can also choose to enroll in a Medicare supplement insurance plan to help fill in the gaps left by Medicare.

Where To Find More Information On Medicare Plans  
For more information on medicare plans, contact The Sosa Insurance Group. We can help you compare medicare plans and find the best option for your needs. Give us a call today!

Still have more questions about medicare planning? Check out our website for more information:

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Or give us a call at 973-273-3767. We’re happy to help!

The Sosa Insurance Group is committed to helping our clients navigate the complex world of Medicare insurance. Contact us today to learn more about medicare planning and how we can help you choose the best plan for your needs. Thanks for reading!