7 Medicare Facts You Need To Know

Medicare Fact Number 1: Medicare Is National Healthcare.

Whether you like it or not—Medicare is national healthcare for those 65 and over or on Social Security Disability Income.

Back in 2014 when the Affordable Care Act was introduced, and I arrived in someones home to meet with them about their Medicare options, before I could even put my bag down, almost every person asked me the same question…”What do you think about ObamaCare?”

My answer: “Well, we’ve had national healthcare since 1965 and it’s called Medicare and you are on it…how’s it working for you?” To which most replied, that it was working fine.

Now, don’t get Medicare confused with ObamaCare. They are not same. ObamaCare has some serious issues and has caused some serious issues…which I will not go into. And, it doesn’t mean that I support “Medicare For All” currently.

But, the bottom-line is…Medicare is indeed national healthcare for a select group of people. Oh wait, Medicaid is a national State-based healthcare for another select group of people. And sometimes, people have both Medicare and Medicaid.

Medicare Fact Number 2: Medicare DOES NOT COVER Long-Term Care.

Medicare covers only Skilled Nursing for up to 100 days…and many times they want cover you that long if they deem it not necessary.

Medicare Fact Number 3: Medicare DOES NOT have a limit on what can come out of your pocket.

Whereas most traditional healthcare insurance offers a limit called a MOOP (Maximum Out Of Pocket), traditional Medicare does not. That means, if you develop a serious health or medical issue, your 20% co-insurance and potential hospital copays could cost you tens of thousands of dollars. Unless you have the right level of Medicaid, this is why you need to seriously consider either a Medicare Supplement policy or a Medicare Advantage plan.

Medicare Fact Number 4: Medicare IS NOT FREE.

For years while you were working you and your employer paid thousands of dollars in Medicare taxes to help fund your future Medicare costs. Then, once you get Medicare you will have to pay the Medicare Part B monthly premium. If you qualify for Medicaid, then Medicaid does pay your Medicare Part B premium.

What’s unfortunate about the thousands of dollars you and your employer have paid into Medicare is the fact that if you were to pass away prior to turning 65 or obtaining Medicare… then NONE of that money is returned to your heirs or the employer. Whereas, at least with Social Security, if you pass away prior to 65, then your spouse can receive part of your Social Security benefit.

Medicare Fact Number 5: You need to qualify to receive Medicare.

Meaning, you have had to worked 40 quarters (10 years) or you had to be married to someone who worked 40 quarters and paid into Medicare while working during those 40 quarters.

What options do you have if you don’t automatically qualify based on working 40 quarters? Then, you do have the option to purchase both Part A and Part B for a premium for each. See this: https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance

Medicare Fact Number 6: You do not need to accept or have Medicare Part B.

You have every right to decline Medicare Part B if you so desire. It would not be wise to do so unless, you have the right Retiree Healthcare coverage or perhaps live overseas and have access to healthcare there. You can enroll in Part B later, but, you may end up incurring a late enrollment penalty for doing so.

If you are nearing retirement and have the option for continued group or retiree healthcare coverage, be sure to do a good comparison and note what the potential benefits and risks are of choosing to stay on group or retiree coverage. It’s important to remember, just because your company offers you retiree coverage now, does not mean they won’t discontinue it at some point in the future (which many have done since 2014). Losing group coverage later while at the same time having Medicare Part B could limit you from all of your Medicare options.

Medicare Fact Number 7: Medicare does not cover you while traveling or staying overseas.

But, if you have a Medicare Supplement policy or a Medicare Advantage plan, then you do get some “emergency” coverage while traveling abroad and only for a limited time. If you travel outside the United States and it’s territories, then you better get good travel insurance that covers medical care that may arise while traveling in a foreign country.