Are you over the age of 65? If so, you might qualify for Medicare.

This form of healthcare coverage is popular among American seniors. But what is it? And how do you know if you meet the requirements?

In this post, we’ll cover all the details you need to know about coverage. So read on! You’ll soon have the facts to make an educated decision on Medicare enrollment.

Medicare vs. Medicaid

Before we dive in, it’s important to know the difference between Medicare and Medicaid.

These two services often get confused with one another due to their similar names. But in reality, they’re very different services.

While both are government-based health care programs, Medicare is administered by the federal government. Medicaid, on the other hand, is a service that is both a federal and a state program.

Understanding Medicare

Medicare coverage is a form of healthcare issued by the federal government to American citizens 65 or older. It’s funded by the taxes we pay to Social Security and Medicare directly, plan premiums, and a designated portion of the federal budget.

Original Medicare includes two parts: A and B.

Part A covers inpatient treatment while part B covers outpatient medical needs. However, you can choose Medicare prescription drug coverage (also known as Part D) if you opt into a Medicare Private Drug Plan. This is often referred to as a PDP.

There are different types of Medicare plans for individuals looking for coverage with different rules, costs, and restriction options. One popular option is Medicare Advantage, which is classified as Part C.

Alphabet soup aside, Medicare is an affordable healthcare option offered to individuals of retirement age. The goal is to ensure they have medical coverage even after they retire from their careers.

Understanding Medicaid

Medicaid coverage, on the other hand, is for individuals who cannot afford a health care plan on their current budget. This safety net is available to Americans of all ages, from elderly individuals to children.

Funded by both federal and state governments, Medicaid has a very strict vetting process. This ensures their funds are going toward individuals who need their services the most.

Like Medicare coverage, Medicaid offers different programs based on the applicant’s level of needs. However, in general, it covers in-patient and out-patient services.

Medicare costs vary based on certain factors, including the level of coverage and your income level.

Why Apply for Medicare Coverage?

As we get older, our health begins to require more maintenance. This includes visits to doctors, specialists, and a higher risk of inpatient care.

However, these services aren’t cheap. Without the proper medical coverage, Americans can find themselves steeped in debt very quickly.

Medicare offers elderly Americans and retirees the opportunity to have quality health care coverage at a price that’s affordable. There are many advantages to this federally funded option, including:

  • Lower Premiums (if any). Most Medicare users don’t pay premiums for Part A of their coverage, whereas Part B’s average monthly premium is a minimal $134.
  • Lower Deductibles. Part A of Medicare has a $1,340 deductible.
  • Medicare Supports Preventative Care. Many preventative care measures are included in your coverage, such as flu shots and wellness visits.
  • You Can Shop Prescription Drug Coverages. There are many different options for prescription drug coverages so you can opt into what you need.

When you don’t have a job to supplement the costs of health coverage, policies become very expensive, very quickly. Medicare makes healthcare in our golden years more affordable. With it, you can get the coverage you need even after you’ve entered retirement.

With the average healthcare cost over the course of retirement averaging around $275,000 per couple, you definitely don’t want to go without!

Determining Whether You Qualify for Medicare

Now that we’ve established what Medicare coverage is, it’s time to dig deeper. Individuals who qualify for Medicare include:

  • New or soon-to-be-retired Americans who are 65 or older
  • Younger individuals who have a disability
  • Individuals suffering from End Stage Renal Disease

To avoid paying premiums, you must have paid Medicare taxes for a minimum of 10 years to opt into this government-funded medical coverage.

However, if you did not, that doesn’t mean you can’t benefit. You can opt into Part A of Medicare, but you will have to pay premiums.

Everyone, regardless of their level of eligibility, must pay for Part B of Medicare’s services. Part B’s premium is taken automatically from your check provided through Social Security, Railroad Retirement, or Civil Service Retirement.

Not sure where you fall within these requirements?

The best way to determine your level of eligibility is by using Medicare’s online eligibility tool. This simple online questionnaire will walk you through the steps to determine what benefits you qualify for and can enroll in.

When to Apply for Medicare Coverage

Unless you already receive social security, you won’t automatically receive Medicare coverage on your 65th birthday. In order to take part in this form of health care coverage, you must apply.

Like regular health coverage, there are specific deadlines to pay attention to, so don’t delay this process. As you approach your 65th birthday and/or enter into retirement, make Medicare part of your to-do list.

Open enrollment starts three months prior to your 65th birthday and remains open for four months after your birth date. That’s seven months total, but don’t let the extensive time frame cause you to procrastinate.

As the old saying goes, time flies. It’s better to start early and lock in the coverage you need. After all, making a mistake when seeking medical coverage can lead to late charges or scenarios that prevent you from qualifying.

Learn More About Your Healthcare Options

Whether you qualify for Medicare or you’re looking for another healthcare solution to meet your needs, the process starts with education.

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