What is Medicare?
Wisconsin Medicare is really no different than the rest of the country. True there are different Wisconsin Medicare Supplement Plans and Wisconsin Medicare Advantage Plans but the basics of Medicare are the same. For answers to all your Medicare in Wisconsin questions or a free Medicare supplement quote call 920-545-4884 anytime, there is never a fee for our services. Continue reading for details on just what is Medicare.
The mid 20th century faced an economic paradox of longevity. Life expectancy was going up, but as an aging population left the workforce and entered the fixed income retirement life, their medical bills also began to rise.
And so, in 1965, President Lyndon Johnson signed Medicare into law as an honest solution to a very real problem: the near impossibility for senior citizens to find affordable health care. It’s origins are one thing, but for those nearing retirement age, Medicare can be a confusing jumble of parts, plans, forms, and red tape. You too may be searching for the answer to a question as simple as what is Medicare?
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In its simplest terms, Medicare is a federally funded program to provide health insurance to the following U.S. populations:
- Those of age 65 or greater
- Those under 65 who also receive social security disability insurance (or SSID)
- Those suffering from End-Stage Renal Disease
Medicare consists of two basic categories: Original Medicare and various Medicare Advantage Plans. Original Wisconsin Medicare includes insurance services which are directly managed by the federal government.
Medicare Advantage Plans, also known as Medicare Part C, involve receiving health insurance from a private company that contracts with the federal government.
Both categories come with their share of advantages and disadvantages. Original Medicare is accepted almost universally, while the Advantage Plans are subject to network restrictions common to private insurance providers.
However, Advantage Plans can sometimes offer better pricing structures, as well as coverage for dental and vision health, which is excluded from Original Medicare.
Making Sense of Medicare Parts
In addition to being categorized according to the Original or Advantage Plans, Medicare is also divided into different parts (A, B, C and D). Each part of Wisconsin Medicare covers different aspects of healthcare and adheres to different policies.
Medicare Part A
Medicare Part A, also known as hospital insurance, offers coverage for visits to the hospital, skilled nursing facilities, as well as some hospice or home health care services. Part A requires a monthly premium if you have not paid Social Security taxes for at least 10 years. Otherwise, it is free to those eligible for Medicare.
Medicare Part B
Medicare Part B, or medical insurance, provides for preventative health care, lab work, x-rays, outpatient services, medical equipment, and mental health care. Part B always involves a monthly premium.
Medicare Part C
Part C is really just the portion of Medicare policy that permits private insurance companies to offer Medicare benefits through the Medicare Advantage Plans. These private companies must offer the same benefits covered by parts A and B, but they may do so at their own rates and limitations, rather than those set by the federal government. Part C plans require a monthly premium that is paid on top of any premiums that you pay for Parts A and B.
Medicare Part D
Part D provides coverage for prescription drugs and is paid for with a separate premium from parts A and B. Most Medicare Advantage Plans also include Medicare Part D.
Wisconsin Medicare | Three Things you need to Know.
Now that you know the basics, let’s take a look at some of the most important—and also the most commonly overlooked—elements of Medicare.
Medicare Isn’t Free
Even though monthly premiums have already been mentioned, it bears repeating: Medicare comes with a cost. The only exception is Part A, which has no monthly premium if you paid Social Security for at least 10 years. In addition to monthly premiums, you will likely also have to pay deductibles, copays, and coinsurance according to your specific plan.
You Might Not Be Enrolled Automatically
If you are already receiving Social Security benefits, you don’t need to do anything to sign up for Medicare Parts A or B (though you can decline Part B). If you are not collecting Social Security, you need to sign up before the deadline to avoid costly penalties for late enrollment. The sign up window stretches for three months before and after your 65th birthday, so make it your birthday present to yourself to enroll in Medicare.
Medigap Can Help Keep Costs Reasonable
Even though monthly premiums for Original Medicare are relatively low, out-of-pocket costs can quickly drain the wallet of those living on a fixed income. That’s where a Wisconsin Medigap comes in. As the name implies, these supplemental insurance plans exist to fill the “gap” left by Medicare and provide peace of mind that you won’t get overwhelmed by unpredictable deductibles and copays.
Get the Medicare Help You Need
Navigating Wisconsin Medicare can be intimidating. Which parts do you need? What’s the difference between Medigap and the Medicare Advantage Plan? Can I have both? The list of questions goes on and on.
If you’re confused and confounded—or just need the help of an experienced professional to find the right option for you—call the experts on the Medicare Solutions Team at (920) 545 - 4884 or contact us through our website at your convenience.
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