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What You Should Know About Medicare Including How It Works

Learn everything you need to know about Medicare, including how Medicare
works, what it covers, and the out-of-pocket fees you must pay. Contact Legit
Medicare to find out more.

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Setting Up Your Medicare Coverage

There are only two steps to setting up Medicare coverage:

Step 1: Sign Up

Start by contacting Social Security or the “Railroad Retirement Board” to sign up for hospital insurance (Part A) and medical insurance (Part B).

Step 2: Choose How To Get Your Medical Coverage

There are several options to choose from, including original Medicare or Medicare Advantage Part C to cover your healthcare. If you select Original Medicare then you can also choose drug coverage Part D, as well as supplemental coverage such as Medigap. Unless you choose a Medicare Advantage Plan, you will have Original Medicare.

How Does Medicare Work?

Medicare is not like private insurance plans that offer different coverage for couples or families, and you don’t have to choose the same plan as your spouse. You sign up only once for Part A and B, and each year you can select your health insurance options by switching or adding coverage.

While you can get Medicare at 60, the current age for eligibility is 65. To get Medicare at age 60, you must collect SSDI for at least 24 months or have ESRD or ALS.

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What We Offer

Original Medicare

Original Medicare includes Hospital Insurance (Medicare Part A) and Medical Insurance (Medicare Part B). If you want to add drug coverage, you can sign up separately for the Part D Medicare plan.

This Medicare covers most of the approved health care costs for supplies and services. After meeting your deductible, you pay a share of the costs for supplies and services as needed. Unless you carry other coverage such as Medicaid, Medigap, union, or employee coverage, there isn’t any limit to out- of-pocket yearly costs.

Your share of costs reduces if your health care provider or doctor accepts the approved Medicare amount. But, you will have to pay the full cost if you use a service not covered by Medicare.

Thus, Original Medicare allows you to go to any hospital and see any doctor in the U.S. that accepts Medicare. It also allows you to join a separate Part D Medicare drug plan to get drug coverage and buy a Medigap Medicare Supplement insurance policy to help reduce your share of costs for services.

Medicare Advantage (MA) Part C

Medicare Advantage is an alternative to Original Medicare. These are bundled plans that include Part A, B, and at most times Part D. Medicare Part C, out- of-pocket costs may be lower than Original Medicare costs. They may also offer extra benefits not covered by Original Medicare, such as dental, vision, hearing, and more.

Plans are offered by private Medicare-approved companies that comply with Medicare rules. Each plan may have different service rules, such as requiring a referral to see a specific physician or specialist. Costs for services and monthly premiums vary depending on the plan you join. Plans cover all urgent and emergency care, along with almost every medically necessary service that Original Medicare covers. Some plans customize benefits packages to meet the needs of those with specific conditions.

Flex Card Used By Seniors on Medicare

Flex cards are like debit cards used with qualifying health plans to buy medical equipment and other healthcare items. These cards are issued by private insurance agencies, linked to flexible spending accounts, and only available with specific plans.

In addition, they have different spending limits depending on the carrier and plan. Qualifying medical expenses for Flex Cards include medical equipment, diagnostic devices, prescription, and OTC Medications, copayments and deductibles, vision, dental, and hearing care, and medically necessary expenses.

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What Medicare Covers

Some of the most commonly asked questions about this government insurance plan are whats covered by Medicare, does Medicare cover eye exams, and what are the fees? In this section, we will address all the above and more.

Medicare covers many items, tests, and services, including preventive services, such as shots and screenings. Services covered by Medicare vary by location, but there are certain things that every state covers, including those that are medically necessary.

To search for services covered by your plan, you can use the Medicare fee schedule lookup tool or talk to your doctor about covered services, items, and tests. They can discuss other options available to you if Medicare doesn’t cover specific recommended tests or services.

Does Medicare Cover Vision?

Routine vision exams and glasses are not covered by Original Medicare. However, if you had an eye injury, have an eye condition due to a normal and common part of aging, or have an eye disease, medical insurance Part B will cover certain services related to vision. But vision care coverage with Part B is limited to those with eye problems who require medically necessary treatment.

Like Part B, MA plans provide medically necessary vision care coverage and some corrective lenses, and routine eye exam coverage.

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What does Medicare cost?

With the Medicare Advantage Part C, you may pay a premium in addition to a Part B monthly premium or your premiums may not cost you a thing. Plans may also help pay a part or all Part B premiums. For non-urgent or non- emergency care, you will need to choose a doctor from the plan’s network and you cannot use or buy separate supplemental coverage such as Medigap.

Each time you use a covered service, you pay a monthly premium and part of the costs for Medicare coverage. There is no annual limit for how much you pay unless you have a Medicare Advantage Plan or Medicare supplemental coverage insurance such as Medigap.

If you have limited resources and income, and can’t afford medical costs and Medicare premiums, you may qualify for state benefit programs that pay Medicare premiums, coinsurance, and/or Medicare deductibles.

Have More Questions About Medicare Coverage?

If you still have questions about your coverage, we can help. Contact Legit Medicare to get answers from our professional, friendly staff.