Policy & Law

Top 4 Important Things To Understand About Insurance

2 Mins read
  • There are many important things to understand about insurance to get proper coverage and care. Here are a few things to know

When it comes to Medicare, the enrollment process can be a little tricky. That’s why it’s important to understand the relevant health insurance terminology, know what the important dates and deadlines are, understand the different parts, and know the eligibility requirements. Below you’ll find the top four important things to understand about insurance.

1. Keep Important Dates and Deadlines in Mind

The first thing to understand about insurance such as Medicare is that there are important dates and deadlines to keep in mind. For example, you can enroll for Medicare three months before you turn 65, but if you continue to work past age 65, you can wait and sign up for Medicare within eight months of leaving your job or group health plan. If you have a Medicare Advantage plan — a plan that includes the benefits of Original Medicare as well as other perks — you can switch plans from January 1 to March 31 every year.

2. Know Common Terminology

If you want to find the best policy for you, it’s important that you understand some of the common health insurance terminology. Some of the terms you might hear include the following:

  • Coinsurance: The amount you pay for a health service, which could include a prescription or a doctor’s appointment.
  • Deductible: The amount you have to spend before your insurance starts to pay its portion of your medical care.
  • Exclusions: Healthcare services or medical equipment your health plan won’t cover, which could include things like travel immunizations or cosmetic surgery.
  • PCP: This acronym stands for primary care physician. When you join a healthcare plan, you’ll be asked to select a primary care physician who will manage your care.
  • In-Network: A list of doctors, hospitals, and specialists who’ve agreed to accept a certain rate for members of a certain healthcare plan. These providers are “in-network” and won’t cost you extra money like an “out-of-network” provider.

Knowing what these terms mean can help you decide which healthcare plan is the right one for you.

3. Understand the Different Parts of Medicare

Before you enroll in a Medicare plan, make sure you know all about the different parts of Medicare and what they cover. There are four parts: Parts A, B, C, and D. Take a look at what each part covers:

  • Part A: Covers hospital stays, some skilled nursing care, hospice care.
  • Part B: Covers doctor’s appointments, diagnostic screenings, lab tests, ambulance transportation, medical equipment, and other outpatient services.
  • Part C: Also called a Medicare Advantage plan, Part C includes the benefits of Parts A and B as well as dental and vision care. In some cases, you may be eligible for transportation to and from doctor’s offices, meal delivery, shower grips for your bathroom, or wheelchair ramps.
  • Part D: Covers prescription drugs and is often referred to as a Medicare supplement plan.

Parts C and D are available from private, Medicare-approved insurance companies.

4. Know the Eligibility Requirements

You can only enroll in Medicare if you’re eligible. Most people qualify when they turn 65, but some people don’t. You’ll be eligible for Medicare if any of the following applies to you:

  • You’re 65 or older and eligible for Social Security
  • You’re under 65, permanently disabled, and you’re getting disability benefits from the Railroad Retirement Board or Social Security
  • You have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s Disease
  • You have end-stage renal disease (ESRD)

Once you know you’re eligible, find out when you can enroll. When you’re ready, you can apply for Medicare online or over the phone.

Finding the Right Healthcare Plan and Provider

Applying for health insurance, especially Medicare, can be a tedious process. You have to keep important dates and deadlines in mind, know at least some health insurance terminology, understand the different types of plans available, and know the eligibility requirements. Once you’ve done your research and learned as much as you can about Medicare, you can feel confident knowing you’ve got all you need to make a great decision about your healthcare provider and plan.

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