Demystifying Medicare

By: Jan Paul C. Ferrer

 

The life expectancy for Americans has been marching upwards for decades, reaching 77.8 years in 2020.1 Today, a 65-year-old man will live an average 18 more years, and a 65-year-old woman has an average life expectancy of more than 20 years,2 and many people will live well past those averages.

With this increase in longevity, your retirement may be a lot longer than that of the generations that came before you. And, as you get older, your health care expenses are likely to increase. Proactive planning for unforeseen health care expenses can help protect the retirement you’ve worked so hard to achieve. Understanding how Medicare works is an important fi rst step.

The Basics of Medicare

Once you turn age 65, you qualify for Medicare. Medicare is health insurance funded by the U.S. government. It’s available to you and your spouse if either one of you has worked and paid Medicare taxes for at least 10 years.3

Keep in mind that Medicare is diff erent from Medicaid, another type of U.S. government insurance. Medicaid is designed for people with low income and assets. It is funded by state and federal governments, and diff erent states have diff erent eligibility requirements.

Medicare consists of four parts:

Part A. This covers hospitals, including a semi-private room, meals and other general services. It does not cover a private room, private nurse or other extras. Medicare Part A also covers the cost of a skilled nursing facility, but only after a hospital stay of at least three days. It also covers home health care prescribed by your doctor, including part-time nursing, medical equipment and services such as physical and occupational therapy. Finally, Medicare Part A covers hospice care and any blood you might receive while you’re in a hospital or skilled nursing facility. Medicare Part A is free, but only pays benefi ts during a benefi t period that begins when you enter the hospital and ends when you have gone 60 consecutive days without inpatient hospital care or skilled care at a skilled nursing facility.4

Part B. Like Medicare Part A, you are automatically enrolled in Medicare Part B if you are receiving Social Security benefi ts and are at least 65 years of age, or are disabled and have been receiving Social Security benefi ts for 24 months. However, unlike Medicare Part A, Medicare Part B requires a monthly premium which is based on your taxable income. Medicare Part B can help to off set the cost of doctors’ fees, emergency room visits and other outpatient services.5 Keep in mind that you do not have to accept Medicare Part B if you do not want it. You always have the option of purchasing private health insurance or, if you are still working, opting for your employer’s health coverage. Note: this varies by employer plan. Some employer plans make Medicare the primary.

Part C. More commonly known as Medicare Advantage Plans, Medicare Part C combines Part A and Part B with other services that may include vision, hearing, dental and some prescription drug coverage. Unlike Medicare Part A and Part B, Medicare Part C is off ered by private insurance companies and generally requires a monthly premium.6

Part D. Introduced in 2006, Medicare Part D is the newest of the Medicare programs. Like Medicare Part C, Medicare Part D is issued by private companies. Medicare Part D plans vary in the medications they cover, the co-pay or co-insurance arrangement they make available, and the monthly premiums they require.7

With so many moving parts, Medicare can be overwhelming. Your health care needs will vary depending on a variety of factors, including your medical conditions, the medications you are taking and even your preferences for medical care.

For full details of Medicare plans and coverages, please visit www.medicare.gov.

Footnotes

1, 2 https://www.cdc.gov/nchs/data/vsrr/VSRR10-508.pdf

3 https://www.medicare.gov/what-medicare-covers/your-medicare- coverage-choices/whats-medicare https://www.medicare.gov/what-medicare-covers/your-medicare- coverage-choices

4 https://www.medicare. gov/what-medicare-covers/whatpart- a-covers

5 https://www.medicare. gov/index.php/what-medicare-covers/ your-medicare-coverage-choices/ whats-medicare

6 https://www.medicare. gov/what-medicare-covers/ your-medicare-coverage-choices

7 https://www.medicare. gov/drug-coverage-part-d

Important Disclosures:

Article by Morgan Stanley and provided courtesy of Morgan Stanley Financial Advisor. Jan Paul C. Ferrer is a Financial Advisor in Chicago, IL at Morgan Stanley Smith Barney LLC (“Morgan Stanley”). He can be reached by email at janpaul.ferrer@ morganstanley.com or by telephone at 312 312-419-3535

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