Medicare Basics & Facts

Keeping up with Medicare basics and updates is important for seniors currently on Medicare and for those older adults approaching Medicare eligibility. Beyond all the intricate details, here are a few Medicare basics to understand facts.

Fact #1 Eligibility Rules

 

You’re eligible for full Medicare benefits if you’re 65 or older and a U.S. citizen or a permanent legal resident for at least 5 years. Many other situations exist where you may be eligible under 65 that involve disability and health issues. You can read more at

cms.gov <https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol>

 

You can also see a quick comparison of benefits and details on our Medicare Comparison Chart

 

 

Fact #2 Coverage Parts

 

Medicare has four parts that cover expenses for Medicare enrollees

 

Here’s a quick glance:

 

Part A – Covers in-patient hospital stays, hospice and nursing facilities.

 

Part B – Covers visits to doctor’s office, lab, outpatient care, and medical equipment

 

Part C – Medicare Advantage involves private insurance plans contracted with  Medicare to cover Part A and Part B

 

Part D – Covers prescription drugs for those enrolled in a PDP, known as a Medicare Prescription Drug Program

 

 

Fact #3 Medicare Isn’t Free to Enrollees

 

Rates and premiums generally change on an annual basis. It’s important to be aware of changes that happen each year and how it may affect your own financial picture.

 

In November 2021 Medicare announced rate increases for 2022.  Outpatient care coverage will increase 14.5% from $148.50 to $170.10. The deductible for Part B will increase 14.8% and Part A will increase from $1,484 to $1,556.

 

Other variables play a part in premiums. For most social security beneficiaries, a “hold harmless” provision protects through a cost-of-living increase to social security checks. Essentially, this provision caps Part B premium increases so the premium increase doesn’t exceed an enrollee’s cost-of-living-adjustment referred to as COLA.

 

Since everyone’s situation is different, we recommend talking with your advisor or family.

 

 

Fact #4 Extra Benefits

 

Medicare previously limited telehealth services prior to the global pandemic. Since Covid, Medicare has expanded telehealth services. Medicare also offers several free wellness exams for enrollees during a calendar year. Check with your primary care physician to learn more about your available healthcare options covered through Medicare.

 

 

Medicare, driven by rules and regulations, can feel confusing or overwhelming. A good place to learn more is the government website <www.cms.gov/medicare>. Reach out to your legal and geriatric advisors, senior friends, doctors, and family for more support as you make decisions.


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