Nearing Sixty-Five? Start Thinking About Medicare

Medicare, the federally run health insurance exclusively for people age 65 or older, as well as people with permanent kidney failure or who are under 65 with certain disabilities, can help provide you with affordable health care both in and out of hospital. It can, if you choose, include medical insurance, hospital insurance, prescription drug coverage and, in some cases, other services such as dental and vision. The coverage you receive all depends on the choices you make when selecting your plan.

There are primarily three categories of health plans for you to consider when choosing your Medicare: Original Medicare plans, Medicare Advantage plans, and other Medicare plans. Within each category, you can select various options to further help you to customize your coverage.

In the Original Medicare Plan, you are able to receive hospital insurance and medical insurance, as well as join a prescription drug plan. You can also buy a Medical Supplement Insurance, or Megagap, policy, in order to cover some of the areas your hospital and medical insurance may miss. You will automatically be enrolled in the Original Medicare Plan, receiving hospital and medical insurance, if you receive benefits from Social Security or the RRB. You can then choose to purchase the additional coverage. While you will likely need to pay a premium for your medical insurance, a premium for the hospital insurance is not usually necessary.

In Medicare Advantage Plans, such as HMOs, you can select a privately run (Medicare approved) health plan. Like the Original Medicare Plan, these health plans cover hospital and medical insurance and provide the option of prescription drug coverage. They also offer additional coverage for services like vision and dental. They can, however, charge copayments, coinsurance, and deductibles for all parts of your coverage. Moreover, they may limit the doctors and hospitals available to you in your plan.

Other Medicare health plans are available in specific areas of the country and work in a way comparable to Medicare Advantage Plans. They include Medicare Cost Plans, demonstrations and pilot programs, and PACE. Each type of plan has a specific set of rules and, in some cases, certain stipulations for joining, so if you think you might be interested in one of these other Medicare health plans, you should contact the ones you are considering to find out more, or visit www.medicare.gov.