Medicare Parts A and B
What’s up with all these “parts?”
Those who enroll in Medicare are eligible for free or subsidized medical coverage, in the event it is needed.
The national health insurance program offers coverage for those 65 and older, along with a select group of younger people with certain conditions. Medicare has several “Parts,” but in this blog, we’re going to focus on Parts A and B.
Signing Up For Medicare
As you get closer to age 65, you should start preparing to enroll in Medicare. However, the enrollment period is limited. Each individual has their own initial enrollment period that spans 3 months prior to turning 65, the month of, and the following 3 months. For help with working out your enrollment period, there are plenty of resources and calculators online.
You should sign up for Part A, but you may be able to delay Part B as we outline below.
Parts A and B
Part A is hospital insurance; offering cover for inpatient care along with some hospice or nursing costs. Alternatively, part B offers medical insurance, covering services performed by professionals such as doctors and other health care providers.
Part A is “free” if you qualify. That is, you’ve been paying into Medicare throughout your working life. There is no premium once you enroll. However, if you or a spouse have not worked or qualify, there is a premium.
Part B always has a premium regardless of work history and starts at $148.50 in 2021 (again, based on income).
What do each of the “Parts” cover?
Your hospital insurance covered in part A may cover:
Your medical insurance covered in part B may include:
Medically necessary services that treat your condition
Preventive health screening and treatment
Clinical research
Mental health treatments
Ambulance services
Medical equipment
There are many services that are not covered by Medicare Parts A or B. It is often assumed that it will cover long-term nursing home care, but it does not. There are also numerous requirements for Medicare to kick in and pay for some short-term care such as a hospital stay requirement, etc. It is important to understand what Medicare will and will not cover. This blog is intended as an overview and not a comprehensive list.
Long-term care (also called custodial care )
Most dental care
Eye exams related to prescribing glasses
Dentures
Cosmetic surgery
Acupuncture
Hearing aids and exams for fitting them
Routine foot care
When You Can Delay
If you are still working when you turn 65 (or your spouse is), you may be able to delay enrolling in Medicare Part B. Part B is a paid-for plan that is based on your income. Many new retirees see a higher premium because of previous income, but you can request a waiver of this increase!
If you are retired or plan to, you have 8 months to sign up for Part B, otherwise, your premium will be penalized and it is permanent.
Workplaces that offer group health insurance and have over 20 employees must offer older employees the exact same benefits as younger employees. They may offer to cover your Medicare as well. Check with your HR department for details.
It is important to note that even if you have both policies running, if a payout is required then your employer’s will be the primary account. Therefore, you may be paying for premiums without any return from Medicare.
In situations where the workplace is less than 20 employees, the employer has the legal right to decide who to enroll (if anyone) in workplace medical insurance. Check with your workplace, but you will typically be required to sign up for Medicare in this situation.
To get more information on whether Medicare will cover what you need, it’s best to talk to a specialist. Unfortunately, Medicare coverage is subject to change between states, as local coverage and services are decided by different local companies. If you’d like to discuss Medicare options, schedule a call with me here. We can also help set you up with an independent Medicare agent to help sort through all the Parts and Plans.