Medicare is a Federal health insurance program that falls under the Social Security Program. It provides benefits primarily for people age 65 or older, but people younger than age 65 can qualify for Medicare, including those who have certain disabilities and those with permanent kidney failure.
While Medicare helps with the cost of health care, it does not cover all medical expenses or the cost of most long-term care. Since the Medicare program is complex, we’ve put together a sampling of our clients’ top frequently asked questions.
How do I enroll in Medicare coverage?
Most people assume you contact Medicare, the CMS (Centers for Medicare and Medicaid Services), to enroll in the Medicare program. This is not the case. Your first point of contact is the Social Security program, although you do not have to be receiving Social Security benefits to enroll in Medicare. If you are already drawing Social Security before the age of 65, you are automatically enrolled in Medicare’s Part A and Part B. Your Medicare card is sent to you approximately 3 months before you turn 65. If you will not be receiving Social Security benefits at 65, you have to contact Social Security to enroll in Medicare – they will not contact you.
Is Medicare free?
Medicare consists of several parts, and only Part A is free for most citizens:
- Part A – Hospital Insurance – free when the individual qualifies for social security benefits.
- Part B – Medical Insurance – The cost is a monthly premium
- Part C – Medicare Advantage (Parts A and C combined) – The cost is a monthly premium
- Part D – Prescription drug coverage – The cost is a monthly premium
While the costs of the coverage may be free or involve premiums, there are often co-pays and additional costs for health care similar to standard insurance policies.
Does everyone qualify for Medicare when they turn 65?
Every U.S. citizen qualifies for Medicare Part A when they turn 65. Even those who do not qualify for Social Security benefits qualify for Medicare Part A, but there may be a premium involved if either you or your spouse worked for less than ten years.
Does Medicare cover long term care?
No! Medicare only offers extremely limited coverage for long term care. While it may cover up to 20 days in a nursing home, a large co-pay amount comes into play after that time. The bottom line determining coverage normally is whether the care offered is medically necessary or strictly custodial, which means the care provided assists with the activities of daily living (ADL).
Part of a comprehensive estate and retirement plan is understanding the Medicare program and planning for the expenses and coverage that it does and does not offer senior citizens.