U.S. citizens of the age of 65 or older are eligible to enroll in Original Medicare. A Medical Advantage Plan called Part C or a Medicare Supplement plan grants individuals additional benefits through private insurance. Original Medicare includes parts A and B.
Martinez said Texans’ biggest misconceptions about enrolling in Medicare is that enrollment is automatic and can be done at any time.
Individuals who fail to sign up for Medicare parts A and B or Part D when first eligible could face penalties in the form of higher premiums.
This interview has been edited for length, style and clarity.
What benefits does Medicare cover?
Part A:
- Inpatient hospital care
- Home health
- Nursing facilities
- Hospice care
- Doctor visits
- Diagnostic and preventative care
- Lab tests
- Mental health care
- Does the plan include all of their Doctors and their prescriptions?
- Will I need referrals to see a specialist?
- Am I covered when I travel away from my area of residence?
- Am I covered if I leave the country?
- Birth certificate
- Proof of U.S. citizenship or legal residency
- Social Security card
- Health insurance information
- Tax information
- Military documents (if applicable)
Yes, if you have Medicare and are a veteran, you are eligible to review all your options. There can be advantages to having both types of coverage.
There can be some definite advantages in having VA benefits and Medicare insurance. Having both types of coverage can give you more health care options. If you only have VA insurance, you are limited to receiving covered care at only VA facilities. But adding Medicare coverage can open up the range of hospitals, doctor’s offices, pharmacies and other types of health care locations in which you may receive covered care. Having both types of coverage can benefit you in the event that an emergency occurs when you are not in close proximity to a VA hospital.
Some individuals may like some of the benefits of their original insurance provider. How may Medigap be a good option for those interested in staying on a private insurance plan?
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn't cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs.
It's important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost.
You and your spouse must buy separate Medigap policies.Your Medigap policy won't cover any health care costs for your spouse.
Rules vary on what changes you can make and when you can make them. Further details can be found at Medicare.gov.
