Feb 3rd, 2013 | By | Category: Social Security & Medicare

Medicare Benefits Explained

The Medicare program is fairly easy to explain and understand, for the most part.  It is a federally funded health care program primarily for senior citizens and the disabled; other citizens in special categories also qualify for benefits.

We thought it might help SCJ readers if we explained some not-so-easy-to-understand parts of the program.  Links are provided to Medicare.gov pages that offer further explanation.  So here goes:

  • You can sign up for your chosen Medicare plan online.  You can only change plans (after you signed up) during the Annual Enrollment Period (specific dates in November and December each year).
  • You can manage your entire Medicare account online. You need to register your account and a password will be sent to you via United States Postal Service. You will receive the password and instructions for finalizing your online account.
  • Seniors who have not worked 40 quarters (about 10 years) and therefore have not paid into the Medicare fund for 40 quarters most likely cannot receive benefits for Medicare Part A (hospital insurance) without paying monthly premiums for this coverage.  Caveat: You may qualify for Part A coverage  via your spouse, if you are 65 or older and your spouse is 62+.  However, you most likely will be able to receive Medicare Parts B and D coverage (B: doctor care, outpatient services, medical equipment; D: prescription drug coverage). This circumstance is a little difficult to decipher, so SCJ recommends you consult your local Social Security/Medicare office if you have questions or concerns about whether or not you qualify for hospital insurance coverage.
  • You must be a US citizen or legal resident who has lived in the United States continuously for five years to qualify for benefits.
  • Medicare is not free. Attending costs change on an annual basis.  Here is a link to an explanation of the costs of Medicare for 2013.
  • Most seniors need health care coverage in addition to Medicare. This coverage is called Medigap benefits, or supplemental insurance.
  • Original Medicare is the same, nation-wide.  However, Part B (doctor & medical care, medical equipment), Part C (Medicare Advantage) and Part D (prescription drug coverage) vary from state to state.  Seniors need to apply for coverage that is available in the state/region in which they live.
  • A number of decisions are required in the process of applying for Medicare benefits.  A look at this Medicare site is helpful in reviewing the options and making decisions that work for you.

SeniorCitizenJournal.com will continue to offer updates as Medicare benefits change and evolve.


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