MEDICARE 101

By Denise Terry Walker

Maybe you’re getting close to 65 yourself or simply want to understand how Medicare works so that you can help a family member or friend. Some people who sign up for Medicare are retired; others are still working. Medicare is the United States’ national health insurance program for citizens and some permanent legal residents. Generally, you qualify for Medicare when you turn 65, based on your employment record or that of your spouse. People under 65 with qualifying disabilities are also covered by Medicare.

Understanding Medicare may seem difficult and intimidating. It’s true that it’s a huge government program with lots of rules, time windows for signing up, and choices to make. Although Medicare is big and covers millions of Americans, let me break it down a bit for you.

The Medicare program is administered by The Centers for Medicare & Medicaid Services (CMS), a division of the US Department of Health and Human Services (HHS) .

There are 4 parts to Medicare:
Part A covers hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B is for medical insurance needs such as doctors’ services, outpatient care, medical supplies, and preventive services.
Medicare Part C relates to Medicare Advantage Plans, which are offered by private companies that contract with Medicare to provide Part A and Part B benefits. Most Medicare Advantage Plans also include prescription drug coverage.
Medicare Part D adds prescription drug coverage to specific Medicare plans.

What can be confusing for many, though is which plan is right for them. The answer to that question is: everybody is different. Everybody has different needs, different health situations, and different financial situations. So what might be good for one person might not be good for the person down the street. What might be good for one spouse might not be good for the other spouse.

Because deciding what is best for you when it comes to going on Medicare can be so confusing for many, something that I do on a fairly regular basis is give Medicare one-on-one seminars to help people understand what is covered with Medicare, how to get their Medicare and if they even need to apply for Medicare. All of this is at no charge to the person. I also will meet with people in their homes to discuss their options when first becoming eligible for Medicare or if they already have a plan and are looking to get something different. Most people think that they can only change plans during open enrollment. However, did you know that a Medicare supplement can be changed at any time during the year? Of course, there are some rules for changing a Medicare supplement. And it might not always be in the best interest for someone to do so.

I’m a licensed insurance agent in both North Carolina and in Virginia and I’ve been selling insurance for those who qualify for Medicare going on my ninth year, now. I’m also an independent agent and so I have many products from different companies to offer.

Open enrollment is coming up from October 14th through December 7th. If you have any questions or concerns about your current plans or you have parents or family members or you know of anyone who might be aging in or maybe you just have some general questions about Medicare feel free to give me a call!!

Denise S. Walker
dsw.insurance@gmail.com
434-531-5674

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