The ABCs – and More – of Medicare

Enrolling in Medicare can be a major project, and it’s important to have help along the way, like the Area Office on Aging of Northwestern Ohio (AOoA).

“We have 10 trained, certified, knowledgeable counselors who will work with you throughout the process,” said Julie Forrester, AOoA’s RSVP program manager. “We’ll give you all the information we have,” so you can make the best personal decisions, she said.

Enrollment, the big first step

The initial enrollment period for Medicare is during the three months before the month of your 65th birthday, your birthday month and the three months after. If you miss that window, you can sign up during the general enrollment period from January 1 through March 31 each year, but your coverage won’t begin until July 1 of that year, and you may face late enrollment penalties for Medicare Part B (insurance) and Medicare Part D (prescription drug coverage).  Switching plans can be done during the Medicare open enrollment period, this year from October 15 through December 7.

Medicare ABCs – and D

Medicare introduces a new vocabulary in health care, starting with primary coverage areas:

  • Medicare Part A covers hospital and skilled nursing facility care, hospice care and home health care.
  • Medicare Part B pays 80 percent of costs for doctors, outpatient services, medical equipment and preventive services such as screenings, shots or vaccines and “wellness” visits. 
  • Medicare Part C, also known as Medicare Advantage, is a bundled plan that typically includes Part A, B and D coverage.
  • Medicare Part D provides options for covering prescription drug costs.

“Original Medicare” includes Parts A and B. Most people will not pay a fee for Part A coverage and do pay a premium (based on annual income) for the 80 percent of medical costs Part B covers. 

“Our number 1 question about Medicare planning is concerning drug expenses,” said Forrester. “If people don’t qualify for specific programs and benefits (usually based on income levels), drug costs can be very high. We research other agencies and programs, and can offer a library of resources people can use.”

Supplements and Advantages to the rescue

While Medicare covers a significant portion of medical and care costs, there are equally significant areas of coverage that you can access by purchasing additional insurance coverage. Many medical and health services are not included under the Medicare program, according to AARP, so you’ll have to obtain coverage for them separately, including:

  • Opticians and eye exams, including cataract surgery – check Advantage programs, or sign up for additional coverage
  • Hearing aids – covered by some Advantage programs, and over-the-counter hearing aids are available
  • Dental work –  covered by some Advantage programs, or add a dental insurance plan 

Choosing an advantage or supplemental plan can be very confusing, said Forrester. “It’s important to evaluate programs based on what you need in your life,” she said. 

Personalized care and service 

What if you have extenuating conditions that impact when your Medicare can begin and how much and who it may cover? Medicare.gov offers personalized services to walk you through all the options available to you. In addition, working through the online site can link you to a range of Supplemental and Advantage programs to review (and those providers can talk to you by phone). 

While Medicare is not “free,” and may be surprised by the costs associated with it, the program can be adjusted to meet your changing needs as you get older.

Comments

Similar Articles

Most Popular

Student Mentoring Programs In 11 Toledo Elementary Schools

Mentors in Toledo Schools (MiTS) volunteers focus on literacy tutoring for kindergarten through third grade students to enhance their classroom performance.

Hospice of Northwest Ohio searching for new visitation volunteers

Hospice of Northwest Ohio is currently searching for volunteers to perform visitations either in patients’ homes or at one of its facilities. There are two...

Thor: Love and Thunder

"Thor: Love and Thunder" is the sequel to 2017's "Thor: Ragnarok" and the fourth Thor movie in the Marvel Cinematic Universe. Taika Waititi is...