Medicare Requirements: A Beginner's Guide to Health Insurance

It can a challenge to wrap your head around Medicare requirements, coverage options, and eligibility requirements. Fortunately, getting the medical care you deserve doesn't have to be a complicated and frustrating struggle.

This guide will explain what Medicare is, what the current coverage options are, and how to qualify for Medicare. We'll also discuss the best way to apply for Medicare. If you're unfamiliar with this process, then keep reading. This guide could help!

What is Medicare?

Medicare is a federally run health insurance program designed for individuals of retirement age. However, some younger individuals with disabilities may also qualify for and receive Medicare throughout their lives. 

The most notable difference between standard private health insurance policies and Medicare coverage is eligibility. Those who opt for Medicare are still expected to pay premiums and meet deductibles, just as with standard plans.

Still, there are quite a few benefits of Medicare that are worth noting.  

Medicare Insurance Benefits

Medicare has two primary benefits: hospital care and medical care. While it may seem like these things are the same, they differ in some distinct ways. These differences come down to the multiple parts of any Medicare plan.

To help you better understand these differences, let's take a quick look at what Medicare offers. Once you know how Part A, Part B, and Part C differ, you can ensure that you make the right choice that satisfies your healthcare needs.

Original

The original Medicare plan is typically referred to as Part A and Part B. While applicants don't necessarily have to apply for both of these plans, it is recommended.

Otherwise, individuals may need to pay a late fee for delayed Part B enrollment. Avoiding this is as simple as opting for both at the same time, typically when you turn 65. Of course, you can begin your Medicare planning long before this age.

Up to three months before turning 65, you can apply for Part A and Part B. Both of these forms of coverage can help you receive medical care during your retirement years.

Part A generally covers hospital costs. If you ever require hospitalization of in-patient treatment at a nursing facility, this part of your Medicare coverage will kick in. Part A benefits may also extend to some out-patient medical costs or hospice services.

Part B is designed to help seniors and retirees pay for annual appointments and some types of medical equipment. Individuals who rely on hearing aids, blood pressure monitors, or glucose meters can benefit from this coverage.

Advantage

The Advantage Plan, also known as Part C, is an upgraded version of the original plan. It offers all of the benefits included in Part A and Part B, but it also offers improved prescription medication coverage.

Additionally, an Advantage Medicare Plan typically offers vision and dental insurance. Of course, there are also a couple of additional coverage options that can help fill gaps between benefits or financial assistance. 

Additional Coverage Options

There are two additional coverage options available to applicants. The first one is Medigap, a program designed to help individuals cover expenses related to deductibles and copayments.

The second potential additional coverage option is Medicare Part D. This beneficial extra can help cover the costs for prescription medications, relieving some financial burden from the shoulders of beneficiaries and patients.

What Are the Medicare Eligibility Requirements?

There is one primary requirement for Medicare eligibility and that is age. To qualify for Medicare, you generally need to be 65 years of age. Still, applicants may apply for coverage three months before their 65th birthday.