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Understanding Medicare Coverage

Understanding government-funded programs like Medicare can feel a little overwhelming, but this resource might be invaluable if you find yourself in need of quality care. Millions of Americans over 65, as well as some disabled individuals under the age of 65, are eligible to receive Medicare benefits—and sometimes that coverage is crucial to receiving the medical attention you need. But how do you know if Medicare covers what you need?

Frequently Asked Questions

What is Medicare?

Medicare is a federal healthcare insurance program available to all Americans once they turn 65. Those who are disabled and under 65 may also be eligible to enroll for Medicare. Medicare coverage can cover inpatient hospital stays, care in a skilled nursing center, hospice care and some home health care.

While this can be a wonderful resource for seniors in need of short-term care solutions, it might not be the best option if you have long-term care needs. The best way to know how Medicare can work for your individual circumstances is to speak to a specialized representative who can give you the most reliable advice possible.

What will Medicare pay for?

Medicare does not cover independent living and usually doesn’t pay for assisted living expenses. However, it can cover certain expenses like short-term care in a skilled nursing facility, depending on your eligibility.

Medicare’s different parts help cover specific services:

Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing center, hospice care and some home health care.

Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies and preventive services.

Medicare Part C (Medicare Advantage Plans)
This is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Most Medicare Advantage Plans offer prescription drug coverage too.

Medicare Part D (Prescription drug coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans.

Source: Medicare.gov

How can I figure out what kind of coverage I have?

Check your red, white and blue Medicare card.
Check all other insurance cards that you use. Call the phone number on the cards to get more information about the coverage.
Check your Medicare health or drug plan enrollment.
Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048

Learn More About Medicare Coverage

You can learn more by visiting medicare.gov or calling 1-800-MEDICARE.

Tips for Annual Medicare Enrollment

Because healthcare needs can change so quickly, you want to make sure you have the right kind of Medicare coverage so you’ll be covered in the event of an emergency or unexpected medical event. That’s why it’s more important than ever for seniors to keep their Medicare coverage up to date.

Medicare includes an annual enrollment period, which gives you the opportunity to make changes to your coverage. To ensure maximum coverage, you should explore and research the advantages of each type of coverage.

A Few Helpful Tips

Keep in mind that even if your short or long-term care needs haven’t changed, there’s a chance that your Medicare benefits have. To make sure all your needs are being met, here are a few more things you want to do leading up to and during the enrollment period:

Make sure your physicians and medications are still covered. It’s not uncommon for Medicare policy changes to impact these areas of your current coverage.
Recalculate the cost of your medications and make any necessary changes to your coverage if the numbers no longer work for your budget.
Look into your long-term care plans. If there is a chance that you may require the services of a long-term medical care facility, like a skilled nursing center, you want to be sure you have adequate coverage. You may also want to explore supplemental insurance options to cover all your bases.
Examine all your benefits. Your insurance policy may include access to preventive health programs and counseling. Look for benefits that offer services like free wellness programs and smoking cessation programs.

_{* Information on this page is for general purposes only and is not intended to be a substitute for financial, legal, tax, accounting or other professional advice.}

Non-Government Options to Pay for Senior Living

You might not be in a situation where you can pay for senior living through government programs like Medicare and Medicaid, but there are still plenty of options out there. From personal funds like retirement accounts and investments to aid and assistance programs, you may be surprised to learn that you’re only a few steps away from making your senior living community dreams come true.

Helpful Financial Resources