As most people approach the age of 65, it’s time to begin learning about Medicare and how it differs from the traditional employer-sponsored health insurance plans. Medicare is a federally funded healthcare system for people over the age of 65, people under the age of 65 with certain disabilities, and people with End-Stage Renal Disease. As part of that research, it’s important to learn about eligibility, enrollment, coverage options, and coverage choices. Seniors who lack understanding about the many choices and deadlines could end up making mistakes that cost them money.
Riverside residents should be aware that everyone over the age of 65 must sign up for Medicare, unless they are already receiving Social Security benefits. One of the mistakes that many people make is believing that the Medicare program will notify them when it’s time to enroll. Unless you are already receiving Social Security benefits, you will not get any kind of notice telling you that it’s time to sign up for Medicare or advising you on how to enroll. The initial enrollment period begins 3 months prior to your 65th birthday and continues for 4 months after that. Failure to enroll past this initial enrollment period can cause you to be without health insurance coverage and cost you permanent late penalties. If you are still working at the age of 65, you may delay enrolling in Medicare, but you must enroll in Medicare within 8 months of stopping work, even if you continue receiving COBRA or employer-sponsored retiree health benefits.
The main differences between traditional health care plans and Medicare has to do with the types of services they cover, as well as whom the plan covers. Prior to the Affordable Care Act, many health care plans excluded pre-existing conditions. With the implementation of the Affordable Care Act, health insurers are no longer able to exclude members based upon past health histories. Medicare does not exclude pre-existing conditions either, but it doesn’t cover all types of services either. Another important difference that is unlike traditional health plans is that Medicare does not offer dependent health insurance coverage. Your children and other household dependents will need to seek out their own health care insurance options. If you’ve never worked or haven’t worked long enough to qualify for Medicare benefits, you may be able to qualify based upon the Medicare taxes that your current or former spouse paid. Others that don’t qualify at all may be able to buy in to the Medicare program.
Most people will not have to pay a premium for Medicare Part A, but there will be costs for Medicare Part B. Many people find it more advantageous to enroll in Medicare Advantage, which covers Medicare Parts A and B, which includes hospitalization and medical costs within a combined plan. Either way, you won’t be denied coverage or charged higher premiums because of pre-existing conditions. You will still have to pay copayments for most services unless you have extra insurance coverage somewhere else.
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