Medicare is a government-run insurance program designed to provide vital health care to disabled workers and those over 65. While these policies offer vital coverage at discounted prices, the program isn’t free and may not cover everything. Understanding how this program works will ensure you get the health care you need if you’re approaching retirement age.

Who Is Covered?

In addition to Americans over the age of 65, Medicare also covers those receiving Social Security Disability and people with severe kidney disease. For some, enrollment in some parts of Medicare is automatic, but most must sign up by specific deadlines.

The Parts

Medicare coverage is divided into several parts, each providing different types of coverage. If you’re receiving Social Security when you turn 65, you’ll automatically be enrolled in Part A, which covers in-patient hospital visits, and Part B, which pays for hospital visits and preventive care.

Medicare Part D covers prescription drugs that can be very expensive. Many private insurance companies offer Medicare Advantage plans that provide the same coverage as Parts A and B, with some policies including prescription drug coverage.

How to Sign Up

If you aren’t automatically enrolled when you turn 65, you can sign up through the Social Security Administration’s website. For most people, it’s best to sign up during the seven-month window around your 65th birthday. If you miss the deadline, you’ll be charged a monthly penalty for the life of your policy, which can add up to thousands of dollars.

Many private insurance companies also offer Medicare Advantage plans, designed to provide the same coverage as parts A and B, along with prescription drug benefits for some plans. Some programs even include coverage that's excluded in the Medicare program, like vision and dental services.

Is It Free?

If either you or your spouse has paid Medicare taxes for the past 10 years, you won’t be charged for Medicare Part A. Premium amounts for part B are based on your income, starting at $148.50 per month with a $203 annual deductible. Once you’ve paid that amount, Medicare covers 80% of your medical expenses. Medicare Advantage plans typically have more generous coverage, so they might be the more cost-effective option for those with special medical needs.

If you’re nearing retirement or qualify for disability, Right Choice Insurance and Taxes Inc will guide you through the confusing Medicare system. With offices in Nogales and Tucson, they offer assistance in English and Spanish for customers throughout Santa Cruz, Pima, Cochise, and Pinal counties. Visit the website for details on their services, or call (520) 264-8500 to discuss your options and request a quote.