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Altura Benefits is a great place to begin your journey of understanding the nuts and bolts of Medicare. We help our clients shape a clear picture of what Medicare covers – including what it doesn’t – and more importantly, a clear and comprehensive understanding of your benefit options.
Partners in Strategy
As your partner in Medicare planning, Altura Benefits strives to understand your personal needs. We have built solid relationships with various insurance companies, allowing you to feel confident in the choice you make.
To be on Medicare in Utah, you must meet the following requirements:
Certain younger people with disabilities or End-Stage Renal Disease may also be eligible. For example, if you have been diagnosed with Lou Gehrig’s Disease, you automatically qualify for Medicare Parts A & B.
For most people, this means you have been a working taxpayer for at least 10 years. If you don’t have enough work credits, you can pay a small premium and still gain access to Medicare, which is significantly more affordable than the cost of a private individual health insurance policy.
This requirement exists to prevent people from expatriating to the United States purely for healthcare reasons, which could cause shortages and back-ups, and make healthcare more expensive for everyone.
What is Medicare?
Original Medicare can be divided into two main parts. Medicare Part A covers things like inpatient hospital care, and Medicare Part B covers things like doctor services and outpatient care. (There is also a Part C, commonly referred to as Medicare Advantage, which allows users to gain expanded Medicare coverage using private carriers, and Part D, which deals with prescription drug coverage.)
What is a MediGap Plan?
A MediGap plan is a supplementary plan that works in partnership with Original Medicare (Medicare Parts A & B). It covers costs that would not normally be paid by Original Medicare and minimizes your out of pocket cost. We recommend that all clients strengthen their coverage by either adding a MediGap Plan or converting to a Medicare Part C Plan.
When can I enroll in Medicare?
You can enroll in Medicare during an enrollment period. The Initial Enrollment Period begins 3 months before the month of your 65th birthday and ends 3 months after the month of your 65th birthday (a 7 month window of time). There is also an Annual Enrollment Period when qualifying individuals can enroll or change their coverage. Some people will also qualify for Special Enrollment Periods due to retirement, relocation, or other loss of qualified health coverage
I already have private insurance through my job. Can I use Medicare?
Medicare cannot be used in conjunction with a private insurance plan, but you can delay your Medicare enrollment until your current qualified insurance plan ends.
Can I have Medicare and Medicaid at the same time?
Yes. If you are over age 65, or otherwise qualified for Medicare, you can also apply for Medicaid based on your income. If you are found eligible for Medicaid, your Medicare costs could be paid for by the Medicaid Program.
How exactly does Medicare work?
Medicare is very similar to private insurance in terms of function. Essentially, when you receive care, the provider will work with Medicare to determine who pays what. One of the main differences is that you will pay smaller premiums, or no premiums at all, with Medicare. Don’t be fooled, it’s not free. But during your working years you essentially pre-paid your premiums in the form of Medicare taxes.
What doctors can I use with Medicare?
Coverage under Original Medicare (Medicare Parts A & B) is different from private insurers in that, you can typically use any doctor or facility that accepts Medicare patients. Unlike private insurance, which typically requires you to use a specific network of doctors. This is particularly useful if you travel a lot or want to try new doctors.
If you have a Medicare Part C plan (Medicare Advantage), your plan will offer stronger benefits but you will be required to stay within a specific network.
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