Ask PacMed about Medicare

Ask PacMed

Patients often ask…“I’m turning 65 next year. What do I need to know about Medicare?”

Medicare is a great program, but it’s different from the commercial insurance you might be used to. You need to apply for Medicare within three months either side of turning 65—or you can’t join until the next enrollment period, and you’ll pay a penalty.

Basic Medicare includes Part A for hospital stays and Part B for outpatient services. Most people get Part A for free and pay a monthly premium for Part B. You can optionally add Part D for prescription drug coverage.

It’s important to remember, Medicare alone won’t cover all your health care costs. Medicare pays only 80% of items it covers, and it doesn’t cover long-term care, eyeglasses, dental care, hearing aids or extra perks.

To cover some of these extras, you have two options to add to Medicare. One is a Medicare supplement known as Medigap, which pays the extra 20%—only for services that Medicare covers. You’ll pay an extra premium for a Medigap policy.

The other option is Medicare Advantage. These plans may cover vision, dental, hearing aids and long-term care, along with other perks like gym memberships, massage or acupuncture. However, you will likely still pay a portion of the extra 20% for covered services with Medicare Advantage. Some of these plans charge a premium and others do not.

You can’t have both Medigap and Medicare Advantage; you have to choose one or the other.

For help with your individual situation, PacMed offers free services, including Medicare information sessions and a hotline where you can ask questions or schedule a consultation. Just call 1.877.315.3279.

Health care decisions are important for your quality of life as you age. Please let us know if we can help.

Submit your question to StayHealthy@pacmed.org, and you may see it answered by a PacMed expert in the next Healthy Today.