Medicare is the federally operated health insurance program that helps those who meet specific requirements. For example, if you are 65 years or older, disabled, worked for one of the many railroad companies or have permanent kidney disease, you may be eligible for Medicare. Having said this, it is essential to realize that the program has undergone, and will continue to undergo, changes as the baby boomer generation reaches retirement.
Applying for Medicare Part B is as easy as applying for Medicare, essentially, with some basic differences. If you already have Medicare Part A (the health plan that helps pay for hospital stays), enrolling in Part B requires some important steps:
- When one initially applies for and receives Medicare Part A, the option to obtain Part B should be automatic; however, this is not always the case.
- In order to be eligible for Medicare (aside from that which is stated above), you must be a citizen of the United States or someone who has legally lived in this country for at least five years.
- Most of the common health care questions on the program can be found in Publication Number CMS-10050, which can be downloaded from the Medicare website.
- Upon receiving your insurance card, you should inspect it; if you have Parts A and B, the card will reflect this information. If you have only Part A, then you will have a period of seven months to apply for Part B. This can also be done by using the Medicare website.
- If you are automatically enrolled in Part B, then your health coverage starts immediately; however, if you wait longer than three months, your coverage will not start until a period of one to three months following your enrollment.
- If you do not take an advantage of enrolling in Part B during the seven months after applying and receiving Part A, there is still a means of applying for Part B. However, you must wait for the next general enrollment period, which starts on January 1 of each year and ends on March 31 of that same year. This is the same as the first quarter of the calendar year.
- However, if you choose not to enroll into Part B during the first year, your premium will increase by 10 percent for each year you waited beyond the first year. This is an important difference between the two parts. Part A does not require the payment of an annual premium. However, when using either portion, it is important to understand that you may be responsible for the differences between what Medicare considers a "fair and reasonable rate" and what is actually charged.
- When you see your health care provider, whether he or she is a physician, physician assistant or nurse practitioner, you will be charged for the visit. Once a year, you will be responsible for a deductible, that has recently increased from $100 to approximately $124. It is highly recommended that you pay this deductible as soon as possible. Beyond that, you will be responsible for approximately 20 percent of the charge for the visit.
- There are specific issues you should keep in mind. First, it is not inconceivable for a physician to "negotiate" with you and accept the payment from Medicare, essentially meaning that the plan will cover the entire visit. Secondly, bear in mind that there are those "unscrupulous" practitioners that will charge one payment for people with Medicare and a different payment for those who pay for their own medical coverage. This is fraud. If you know this has occurred, it is your responsibility to let Medicare know about the incident.
- Remember, when you first enroll (when you meet any of the qualifications), be sure that you also enroll in Part A and Part B. If this is not done automatically, then contact Medicare. If you are computer-savvy, go to http://www.medicare.gov/.
- Also, keep in mind that, because people are generally living longer than ever in recorded history, it is very possible that the enrollment requirements will change. The decreasing number of working people supporting an ever-increasing number of retired people spells a basic problem with regard to Medicare.