/// Posted byAviva Sapers & Peter Stoner
Whether your 65th birthday is fast approaching or decades away, it pays to understand the basics of how Medicare works and what it does and does not cover—and then plan accordingly for any additional coverage that you may need in retirement.
Enrolling in Medicare can be more complicated and frustrating than many might expect, and the rules and regulations are changing.
Parts A & B (Original Medicare): Applying for Medicare A/B is handled through Social Security and can be administered on-line rather than going to a Social Security office. An on-line Social Security account will require setting up a username and password and may require the answering of “security questions” based on credit bureau information—some of which can be very specific and based on older data they have on record. Unfortunately, this can sometimes result in failed attempts and needing to go to a Social Security office to complete the enrollment process.
Medicare Part A is used for hospital insurance and covers inpatient stays at medical facilities, as well as costs of hospice care, home health care, and nursing homes (which are limited). If you will be spending the remainder of your life in a nursing home, Medicare will not cover it. Part A has a per “benefit period” deductible of $1420 in 2020. A new benefit period begins after a beneficiary has been released from the hospital for at least 60 days, meaning the deductible can be incurred multiple times throughout a year.
Part A has a $0 premium for most people, but will only pay for a maximum of 100 days of nursing home care (after certain conditions are met). After 20 days of full coverage, a significant daily co-pay is required for days 21-100 at skilled nursing facilities.
Medicare Part B provides medical insurance to help cover the costs of physical therapy, physician visits, durable medical equipment costs, and other medical services, such as lab tests, and screenings.
Part B requires a monthly premium based on income level, along with an annual deductible of $197 in 2020. It also requires a co-pay of 20% of costs.