This post is sponsored by Sivan Social. All comments and opinions are my own.
Being my mom's primary caregiver was one of the hardest things I've ever done. It taught me so much about navigating the world as an elderly person, and she was so grateful I was there to help.
I had spent years advocating for my self and my children with doctors, insurance companies, etc. I felt confident that I could manage my mom's medical care. But the complexity of Medicare, Advantage plans, and ultimately hospice were all new to me.
Today, I'm sharing what I wish I'd known about Medicare and some tips to help you navigate, whether you're doing so for yourself or helping a loved one. Medicare Open Enrollment is soon–so let's get started!
What I wish I'd known about Medicare
Original Medicare only includes Part A (hospital coverage) and Part B (medical coverage). That isn't enough coverage for most seniors, and it certainly wasn't for my mom..
What Medicare Part A covers
Since Medicare is broken up into parts, it's good to know what each part covers. In general, Part A covers inpatient hospital services, skilled nursing home care, hospice and home health care.
What Medicare Part B covers
Part B, on the other hand, generally covers doctors visits, labs, durable medical equipment (DME) and ambulance services. You still have to pay co-pays for appointments, other costs and reach a deductible. Part B has a monthly premium, which is typically taken out of your social security check before you receive it.
Medicare doesn't cover long-term care
For my mom, it did provide rehab and in-home health care after her hospitalization for an acute episode. But that was just the medical side of things. Daily living needs are what brought me in–shopping, cooking, bathing, dressing, and transporation to appointments.
What Medicare Part C covers
This is where things got tricky for us. Part C refers to Advantage Plans, which are extra coverage from a private insurance company that also covers Parts A and B. There were a lot of carriers, and each one changes their program each year.
Help is available when picking a plan. There are so many to choose from, depending on your region, and each has pros and cons. You can call QuoteManage using the number at the top of SeniorLiving.org to their free Medicare plan consultation. This is a no-cost, no-obligation call with an expert who helps seniors find the right plan for their needs.
What is Medicare Plan Part D?
I was also surprised to learn that original Medicare did not cover prescriptions! Part D is another program to include and charges a monthly premium. On top of that, you also have co-pays for most prescriptions.
Medicare uses a tiered system–so your co-pay amount depends on where your prescription falls on their tier table. We were always careful to ask doctors for the lowest-tiered drug to be effective. For example, a generic drug may do the same as a name brand drug, and the co-pay would be lower to fill that prescription.
Use the benefits you have
Medicare offers free preventative services like mammograms, flu shots, cardiovascular screenings and other cancer screenings. You've earned your Medicare health benefits, so you don't want to miss out on these important services.
How long is Medicare open enrollment?
Every year, the period for open enrollment is October 15 – December 7. This is the time to enroll in Medicare for the first time, switch plans, drop plans and enroll in Advantage Plans and prescription coverage if you choose.
How can I get a comparison of Medicare plans?
This is where the free service from QuoteManage comes in handy! You can click the button at the top of this page right from your phone. You'll reach an adviser who can help you compare plans to see what coverage you need. This call is completely free, and there is no obligation.
Give yourself time to learn about your options and get your questions answered. Visit the 2022 Medicare Enrollment page on SeniorLiving.org to get more facts about Medicare.