Although it’s a benefit millions of Americans receive, Medicare is often a complex subject to understand. When you’re new to the program, it can be especially challenging to figure out the enrollment guidelines and how to choose coverage. As such, you’ll want to consult an experienced insurance agent who can explain the process. In the meantime, the following information offers some basic knowledge to help you navigate your options and avoid penalties. 

What to Understand About Medicare 

What Is Medicare? 

Medicare is a federal health insurance program that is designed to cover medical services for those 65 and older and certain disabled individuals. It was created to ensure Americans would continue to have health coverage once they entered retirement and no longer qualified for an employer-provided plan. The program is funded by taxpayer money and premium payments made by Medicare beneficiaries. 

How Does It Work? 

The program consists of four different types of plans, which include:

• Part A: Covers in-patient hospital expenses
• Part B: Covers doctor visits and out-patient testing
• Part C: Coverage provided through private insurers as an alternative to Parts A and B
• Part D: Covers prescription costs 

Most beneficiaries don’t pay for Part A plans. Premium costs for Part B are based on income, and rates for Part C and D vary depending on the plan selected. 

Who Is Eligible? 

Typically, you are eligible for Medicare if you’re at least 65 years old and have been a U.S. resident for five consecutive years. Additionally, if you have been diagnosed with end-stage renal disease or amyotrophic lateral sclerosis, or you have been entitled to collect Social Security disability benefits for a minimum of 24 months, you will qualify for coverage. Similar to Social Security, Medicare is an entitlement program, meaning U.S. citizens earn the right to receive coverage after working and paying taxes for a specified length of time. 

What Is the Enrollment Process?

The open enrollment period begins three months before you turn 65 and ends three months after. If you already get Social Security benefits, you will be automatically enrolled in Medicare Part A when you reach 65. If you don’t, you will need to apply for coverage. Neglecting to enroll during your designated open enrollment time frame can result in penalties that lead to higher premiums. 

If you will become eligible for Medicare soon, know that you don’t have to go through the daunting task of enrolling on your own. The professionals at Toohey Insurance Service are available to answer your questions and provide valuable guidance as you determine which plan is right for you. They have offered the residents of Somerset, KY, high-quality insurance coverage and personalized service since 1983. You can count on their vast industry experience to help maximize your Medicare coverage while minimizing your out-of-pocket expenses. Call (606) 678-0540 to schedule an appointment, and visit them online for more information on their array of insurance solutions.