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Facts on the Part D Donut Hole and More!

Many people will always tell you that you should put your health first, but how often do you listen to that? It’s important to not only take care of your health by eating healthy and exercising, it’s also important to have yourself insured for the future of your health. The best way you can do that is by investing in some health insurance for yourself. To learn more about health insurance, especially Medicare in particular, here are all the facts that you need to know.

Why Do I Need Health Insurance in the First Place?

Regardless of what state your current health is in, you should always make sure that you have health insurance. Health insurance is something that is never to be ignored and you should consider it as an investment in yourself.

People are under the assumption that health insurance is expensive, however that is actually the exact opposite.

Health insurance aims to help you make more savings while keeping your health in check. By paying for the premium fees, you automatically end up making so much savings in the long run.

Obviously if you are sickly, you may want to get some health insurance. However people who don’t get sick often tend to ignore getting health insurance.

However, you never know what could happen so it always best to make sure that you already insured for your health.

The doctor isn’t limited to illnesses either, because people can get into accidents that would require doctors assistance.

Senior citizens tend to require more healthcare than others, which can rack up a huge bill over time. For instance, they might require prescription drug coverage to help them save money because those drugs can cost a lot over time.


What Is the Purpose of Medicare?

Medicare is meant to help Americans save money while getting the healthcare that they need. It is no secret that hospital bills and doctor visits are quite costly in America, and the prescription drug costs alone can be quite overwhelming.

This is why many people should turn to Medicare if possible to help them save money while maintaining their health.

Medicare is mandated for seniors who are 65 and older and have worked for more than 10 years and have been getting the benefits of their social security.

However, keep in mind that they are required to get Medicare Part A, which is for hospital visits.

Thankfully though if the senior qualifies for it, it is absolutely free to get that health insurance plan. If they choose to not get it, then they will have to refund the cost of the Medicare part A.

However, senior citizens aren’t the only ones who can get Medicare. People with certain disabilities who are younger are eligible to enroll for Medicare.

Additionally, people with end stage renal disease can also apply. End stage renal disease is a form of kidney failure that requires dialysis and/or kidney transplants.

You should learn if you can qualify for these options if you aren’t a senior but want health insurance.

What Are the Parts of Medicare?

Surprisingly, Medicare isn’t actually just one kind of health insurance. Medicare offers four different parts that people can choose from to suit their needs.

The first kind is Medicare Part A which is the one mandatory for people over 65 year old. It is a type of in hospital health insurance.

This means that anything that is in the hospital or hospice care would be covered for or partially covered by your health insurance. Keep in mind that the days are limited and once you use up all of those days, you will have to pay for the hospital bills on your own.

Medicare Part B is a common form of health insurance that many people get which is for out hospital coverage.

Therefore, things such as check ups with the doctors and X-rays will be mostly covered by Medicare. Keep in mind that this will only apply to clinics, hospitals, and doctors that are affiliated with Medicare.

You will also have to pay a deductible fee for a certain period of time until the effect of Part B comes in, however it is definitely worth it. You’ll be saving 80% of your bill for any service that you get from a Medicare doctor.

Medicare Part C is considered the all-around package and it is also referred to as Medicare Advantage. This combines all the packages into one but you would still also have to pay for premium for some other aspects.

For instance, if you were already enrolled in Part B and want to get Part C, you will still have to pay for the premium for part C. This is a good choice for almost every person since it can help you save the most money in the long run.

Part D is the prescription drug coverage health insurance plan, which is also called the donut hole. Medicare donut hole helps people pay for their prescription drugs, which can add up to a lot in the long run if you don’t have health insurance.

If you are on brand name drugs, you’ll know how expensive it is paying for all these medicine. So Part D is here to help you.

Part D works as a stand-alone health insurance plan but you could probably get it with the other Medicare parts. The coverage gap that Part D offers you is the part that is called the donut hole.

You will have a drug plan that you can use to help you cover most of the drug expenses that you need to pay for. However once you reach your limit, you’ll have to pay for it on your own until the time for the yearly limit is up.

Once it is up, you can move on and use the Part D benefits again to help you pay for the medicine that you need.

You should also remember that Medicare is very different from Medicaid. Medicaid is funded and provided by the Federal government.

While it is also a form of health insurance, it is specifically targeted to households with lower incomes and people who cannot work due to their disabilities.

However if you find that you fit the criteria for Medicaid, you can see if you can enroll for that program as well.

Be Aware of the Costs

While health insurance helps you save money, many people seem to be under the assumption that health insurance is usually free. In certain circumstances they are, but there are normally costs associated with health insurance.

However, these costs are usually small in comparison to what you would have to spend if you did not have health insurance.

Premiums are one of the first expenses that you might notice is involved with health insurance. Typically, the premium fees can really vary on what kind of Medicare Part you are getting. In addition to that, it will change based on what your income level is.

Therefore if you earn a high income, you should expect to pay a higher fee. You would pay a lower premium fee if you earn less income.

Deductibles and coinsurance costs are also another thing that you should be aware of. Each deductible will vary based on what kind of Medicare Part and plan you are getting, so be sure you are aware of it before getting a plan, otherwise you might be in for a big surprise.

However if you are a senior with a lower income, Medicare may help you cover some of the expenses that deductibles can cause.

Timing Matters

Surprisingly, just because you are eligible for Medicare for free as a senior of 65 and above with social security benefits, doesn’t mean you can take your time in getting Medicare.

It actually matters a lot on when you enroll, otherwise you can actually face a penalty. Part A is something that you can enroll for anytime you would like, however Part B is a different story.

There is a very specific period of seven months that you have to sign up for part B. It’s three months prior to turning 65, the month that you turn 65, and the three months after you turn 65. You’ll get a late sign up penalty if you try to apply any time after that.

It’s important to make sure you know what you can get and what you are eligible for when getting health insurance. If you are 65 and above with social security benefits, you should definitely get Part A for free and get Part D to save money on medicine today!