If you're approaching or over 65 or disabled, Medicare is an important part of how you get your healthcare. Understanding what's included and how to make the most of it is important!
Medicare is health insurance provided by the U.S. government for eligible people turning 65 or retiring. There are certain times people can sign up for Medicare and depending on the circumstances, some people may be enrolled automatically while others must apply manually. The first time you can enroll will be a 7-month period usually beginning 3 months before the month you turn 65, the month you turn 65, and will end 3 months after the month you turn 65. It is important to note that if you do not apply when you are first eligible for Medicare, you may have to pay a Part B late enrollment penalty, and have a possible gap in coverage if you decide to enroll in Part B later.
What Medicare Plans are There, and Which
One is Right for Me?
Medicare includes two plans based on the needs of the person applying for insurance. Medicare Part A is hospital insurance and covers inpatient hospital stays, care in nursing facilities, hospice care, and some home health care. Medicare Part B is Medical Insurance which includes certain doctor’s services, outpatient care, medical supplies, and preventative services. It is recommended that most people enroll in Part A when they turn 65, even if they have previous health insurance.
Medicare Part A Plan:
This Medicare plan is targeted towards people who need hospital insurance. Talk to a doctor about your need for certain services or supplies and if Medicare will cover the cost of them for your care. Medicare coverage is based on federal and state laws, national coverage decisions made by Medicare, and local coverage decisions made by companies in each state on whether something is medically necessary and should be covered in your area.
Medicare Part B Plan:
Medicare Part B is targeted towards people who need Medical Insurance. Medicare Part B covers a “Welcome to Medicare” preventative visit within the first 12 months of your enrollment. If your doctor or health professional accepts assignment, you will pay nothing for this visit, and the Part B deductible does not apply. This visit is not a physical, but a time for your doctor or health care provider to get to know you and your needs. Medicare Part B is designed to prevent diseases and disabilities based on your current state of health and possible risk factors. Your health care provider will ask that you fill out a questionnaire called a “Health Risk Assessment” to help formulate a personalized prevention plan for you to maintain a healthy status.
The visit includes:
· A review of your medical and family history
· Developing and updating a list of current providers and prescriptions
· Height, weight, blood pressure, vision test, and other routine measurements
· Screening of any cognitive impairment
· Screenings for flu and pneumococcal immunization
· Discussion on advance directives and screenings for potential risk of depression
· Personalized health advice
· A list of risk factors and possible treatments options for you
· Advance care planningIt is important to note that any additional tests or services your health care provider performs in the same preventive visit may include a co-insurance or co-payment, and a Part B deductible may apply.
Medicare Part C Plan:Also known as Medicare Advantage.
Medicare Part D Plan:
Prescription drug coverage.
Yearly Medicare Wellness Visits
If you’ve had Medicare Part B for longer than 12 months, you should schedule a yearly “Wellness” visit to update your health record and personalize a prevention plan. The wellness visit is designed to keep you healthy and prevent disease. Yearly Medicare Wellness visits also include a screening schedule for appropriate preventative services.
Preventative Services Include:
- Cardiovascular- Done every 5 years
- Breast Cancer Screening- Done every 12 months
- Cervical and Vaginal Cancer Screening- Done every 24 months
- Colorectal Cancer Screenings
- Fecal Occult Blood test- Done every 12 months
- Flexible Sigmoidoscopy- Done every 48 months
- Screening Colonoscopy- Done every 120 months
Annual wellness visits are an important way to keep healthy and should be part of your fall prevention plan. 1 out of 3 seniors fall in their home each year, but with a Medical Care Alert Fall Detection System seniors can have peace of mind that help is on the way in the case of an emergency. Medicare generally does not pay for a Personal Emergency Response System, but some Medicare Advantage Plans do...check with your provider.