What you may not know about Medicare

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Almost everyone knows that Medicare is a medical insurance program for retired and disabled people, run by the government. But there are probably some things you don’t know about Medicare — and should. Some people are only covered by one type of Medicare; others opt to pay extra for more coverage. Understanding Medicare can save you money. Here are some things you should know about Medicare.

There are four parts to Medicare: Parts A, B, C and D. Part A helps pay for inpatient hospital care, skilled nursing care, hospice care and other services. Part B helps pay for doctors' fees, outpatient hospital visits, and other medical services and supplies that are not covered by Part A. Part C allows you to choose to receive all of your health care services through a provider organization. These plans may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C. And Part D is the Medicare Prescription Drug Program. Part B is the one we get the most questions about, so here are some things to know about it.

Most people don’t pay a premium for Part A because they have worked and paid enough in Medicare taxes on wages over the years. However, there is a monthly premium for Medicare Part B; in 2012 the standard premium is $99.90. Some high-income individuals pay more than the standard premium. Part B is a good value for people who need medical insurance, but you need to enroll during your initial enrollment period, or when you first become eligible, unless you want to pay a penalty in the form of a higher premium. Most people first become eligible for Medicare at age 65.

There are exceptions to this rule. For example, you can delay your Medicare Part B enrollment without having to pay higher premiums if you are covered under a group health plan based on your own current employment or the current employment of any family member. If this situation applies to you, you can sign up for Medicare Part B without paying higher premiums:

  • Any month you are under a group health plan based on your own current employment or the current employment of any family member; or
  • Within eight months after your employment or group health plan coverage ends, whichever comes first.

If you are disabled and working (or you have coverage from a working family member), the same rules apply.

Remember: If you don’t enroll in Medicare Part B when you first become eligible to apply and you don’t fit into one of the above categories, you'll have to wait until the general enrollment period, which is January 1 through March 31 of each year. At that time, you may then have to pay a higher Medicare Part B premium because you could have had Medicare Part B and did not take it.

For more information about Medicare Parts A, B, C, and D, visit the Center for Medicare & Medicaid Services (CMS) Medicare website at www.medicare.gov.

 

 

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