It is estimated that the average couple will spend about $285,000 for healthcare-related costs during their retirement years. Enrolling in Medicare is a major financial decision that can also impact your quality of life and whether or not you get the right care when you need it. 

Medicare is the main form of health insurance for retired people. It is split into four parts, or Medicare plans: A, B, C & D. Each plan plays a unique role in paying for healthcare services. Part A covers care received inside of a hospital, such as meals, the hospital room, and attentive nurses. Part B pays for preventative care that is received outside of a hospital, such as doctor visits, x-rays, mammograms, blood tests, and outpatient procedures. Part C plans are supplemental plans that are available through private insurers to cover “gaps” in healthcare coverage in Plans A and B. Some of these plans include dental, vision, and hearing coverage. These are also known as Medicare Advantage Plans. Part D plans cover prescription drugs and are also only available through private insurers.

Part B And Medicare Supplement Plans

Your Medicare Plan B only covers 80% of your outpatient expenses, and that’s after you have already paid your deductible. What do you do about the other 20%? If you want to choose a Medigap plan in the future, otherwise known as a Medicare Advantage plan, then you need to already be enrolled in Medicare Plan B. It’s also important to know what deadlines you have to meet, and which options are irreversible. To learn more about what plan is best for you, call the South Florida Medicare Specialists and speak to someone who can guide you to the right choice for you.

What does Part B cover?

As explained earlier, Medicare Part B plans cover doctor visits and outpatient services. If it is care that is received outside of a hospital, then it is very likely to be covered under this plan. But more specifically, Part B covers:

  • Home health services
  • HIV screenings
  • Flu shots
  • Podiatry services for diabetes patients
  • Kidney dialysis
  • Colon cancer screenings
  • Durable medical equipment
  • Annual physical exams
  • Chemotherapy
  • Chiropractic care
  • Speech, occupational, and physical therapy
  • Health services in rural areas
  • Smoking cessation
  • Telehealth
  • Outpatient mental health services

Your part B premium is taken directly out of your Social Security benefits each month so you don’t have to think about it. 

How To Qualify For Part B

In order to qualify, you must be a U.S citizen or have been a legal permanent resident for at least five continuous years. You must also be age 65 or older, although you can qualify if you’re younger and have been receiving benefits from the Railroad Retirement Board or Social Security within the last two years. You can also qualify if you have end-stage renal disease or Lou Gehrig’s disease. 

If you meet these requirements then you will need to pay close attention to when you can sign up for coverage. If you are eligible based on age then your initial enrollment will begin three months prior to your 65th birthday and will last for seven months. However, if you were already receiving disability benefits, then your enrollment begins three months prior to the 25th month that you’ve been receiving disability benefits from either Social Security or the Railroad Retirement Board. If you or your spouse are still working and you want to delay your enrollment to continue with your group health coverage, then you can enroll later during a Special Enrollment Period.  If specific questions about your enrollment eligibility, call the South Florida Medicare Specialists!