In part one of this two-part blog series, we went over some of the basics on important Medicare coverage for seniors. Offered by the federal government to seniors over age 65, Medicare provides basic health services and insurance coverage to over 60 million seniors in the United States today.
At Avamere at Mountain Ridge, we know many of our assisted living community residents rely on Medicare coverage for their healthcare, and our staff is educated on the important themes therein and will be happy to assist any resident with related questions or concerns. In today’s part two of our series, we’ll go over some additional resources in terms of Medicare coverage as a primer, whether for someone just entering senior age and looking to acquire coverage or for someone already covered and looking for more information.
How to Enroll
One major benefit of Medicare is the fact that for many seniors, enrollment is automatic and requires no action on their part. Such situations generally include:
- Seniors who receive Social Security benefits or Railroad Retirement Board benefits prior to reaching age 65.
- Those under age 65, but who have had a social security disability for 24 months or longer.
- Seniors with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).
For those outside these categories, however, you will have to enroll in Medicare if you’re nearing 65 or have recently turned 65 and are not receiving Social Security benefits. You can call 1-800-633-4227 to do this, or you can sign up online.
Areas Not Covered
In part one of this series, we went over many of the areas covered by Medicare. It’s important as well, however, to be aware of the areas that typically are not covered, which include:
- Eye exams and most types of vision care
- Elective procedures like plastic surgery
- Dental exams and dental care – the exception here will be for medical reasons, like oral surgery required for reconstruction
- Alternative therapy like acupuncture, reflexology and more
- Experimental procedures, off-label drugs and similar areas
These specific details will vary depending on your area and your plan provisions, so be sure to contact a Medicare plan representative to find out what’s covered under your plan.
One important term you might hear during Medicare enrollment is Medigap insurance, which is related. This refers to a family of various supplemental insurance policies to Medicare, helping seniors bridge the space between what Original Medicare covers and other costs they may have. These Medigap insurance policies are offered by private companies, meaning they’ll vary significantly, but usually feature a basic monthly premium and a Part B deductible.