Understanding Medicare

Glenna Darst
Business Office Coordinator
Abbyshire Place Skilled Nursing and Rehab Center

Medicare is a key program for millions of seniors and disabled Americans but many do not understand how these programs work.  Medicare is a complex program but there are key things you should know.

Medicare provides individual coverage and will not cover your spouse or any dependents.

Medicare is comprised of various coverage plans.  The most common being:

  • Medicare A: Hospital or inpatient skilled care.
  • Medicare B: Doctor’s service, outpatient care, therapy and medical equipment.
  • Medicare C: Medicare Advantage Plans Medicare that is managed by an Insurance Company.
  • Medicare D: Prescription drug Plan
  • Medicare G &F: Medicare supplement policies (Secondary insurance)

medicareDon’t assume that you will have no cost associated with these plans.  Typically the Part A plan is available with no premiums due to credits earned during your working years by yourself or a former spouse.  Or you may be able to buy into Part A coverage by paying premiums if you have never worked.  Part B and Part D coverage are available regardless of how long you have worked or not worked, just by paying the required premiums (provided you are a US Citizen or a legal permanent resident).  There are also resources available for lower income individuals that may cover your premiums.  Also there are additional cost associated with deductibles and copays.   Medicare Advantage Plan costs and coverages are different and vary among plans.

Don’t assume that Medicare will cover all your medical needs.  It does cover a large range of medical services but there are gaps in coverage for routine vision, hearing and dental care.  Medicare does not cover the non-medical cost of long-term care in nursing homes.

Medicare has many choices and deadlines.  Being informed is the best way to avoid errors and costly mistakes.  Don’t expect Medicare to contact you when it’s time to apply.  You need to know your personal deadline, be sure to contact the Social Security Administration 90 days prior to turning 65 years old.