A full 18.7% of the population of New Hampshire is 65 or older, so there are a lot of questions surrounding how Medicare works and who qualifies. This federal health coverage program helps those who are 65 or older, and it ensures that those with specific health conditions get the healthcare they need.
You might have questions about how to sign up for Medicare, if you qualify, and how much Medicare costs. This guide will answer the common questions we hear about Medicare in New Hampshire. Of course, you can always contact us with specific questions as well.
Original Medicare includes
These coverages will follow you no matter where you are in the country, and most doctors are enrolled in Medicare and accept assignment. However, some providers don’t accept Medicare, so make sure you double-check before you get medical care from a new provider.
Medicare is a program designed to help those who cannot get health insurance through their jobs. That means it applies to those of retirement age (65 and older) and those who are permanently disabled or have specific health conditions.
To qualify for Medicare in New Hampshire, you need to be a U.S. citizen or permanent resident who has lived in the country for at least five years.
Additionally, at least one of the following conditions must apply for you to be eligible for Medicare:
If you’re eligible for Medicare, it’s important to take advantage of this wide-ranging coverage.
If you qualify for Medicare, you might be automatically enrolled in Original Medicare Parts A and B. Many people are automatically enrolled when they reach their 65th birthday or hit the threshold of disability payments.
However, it typically is not recommended that you go forward with automatic enrollment for several reasons. First, automatic enrollment does not include optional coverages like Part D for prescription drugs or Medigap to help you afford costs. Secondly, you have specific enrollment privileges during your initial enrollment period that don’t come again, like guaranteed approval into a Medigap plan.
Finally, if you want to enroll in a Medicare Advantage plan, you’ll need to select that specifically. Many people enjoy Advantage plans because they offer additional benefits that Original Medicare does not, like vision and dental coverage.
If you are not automatically enrolled, you’ll need to take action to ensure you get Medicare coverage. You can enroll by:
To enroll manually, you’ll need specific documentation such as your citizenship status, social security number, birth date, and work history.
Different parts of Medicare have different costs, so we’ll look at each one individually.
Medicare Part A is premium-free for most Americans, meaning you won’t pay for it each month. If you have an inpatient hospitalization, you’ll have a deductible of $1,556 for 2022. For days 1 - 60 of hospitalization, you’ll pay a $0 coinsurance. For days 61-90, you’ll pay $389 per day.
If you have to stay in the hospital for more than 90 days in a year, you’ll need to either pay the full cost or use your lifetime reserve days. You only have 60 of these in your lifetime. The coinsurance for a lifetime reserve day is $778 in 2022.
Medicare Part B has a premium of $170.10, or it may be higher if you have a higher income. If you need medical care, you’ll have a deductible of $233 each year. After that deductible, you’ll pay 20% of the Medicare-approved amount for care, and Medicare will pay the rest.
Medicare Part D is sold by private health insurance plans that have a contract with Medicare. As a result, the monthly premium and copayment amounts will vary. Also, different Part D plans will cover different drugs and different in-network pharmacies, so be sure you review the plan carefully to ensure it covers what you need.
Medicare Part C, known as Medicare Advantage, is a full replacement for Original Medicare and often includes drug coverage. We’ll talk more about Advantage plans in the next section.
Wondering if you can get Medicare Advantage in New Hampshire? You can! There are almost 800 hundred thousand people enrolled in Medicare Advantage in New Hampshire. Private insurers sell Medicare Advantage plans, and you can contact them or speak to a licensed insurance agent to compare plans and get the best deal for your needs.
Medicare Advantage plans are required to cover at least as much as Original Medicare, so you won’t be missing out. Most of the time, Advantage plans offer benefits that you can’t get with Original Medicare. For example, you might be able to get vision and dental coverage, discounts on gym memberships, wellness visits, and more.
What’s important to keep in mind is that each Advantage plan will have its own medical provider network, which includes pharmacies and durable medical equipment providers. These are often focused in your local area, and you may not be able to get non-emergency coverage outside the network.
As a result, if you travel often or spend a lot of time in other states, it might be a better idea to keep Original Medicare and get a Medigap policy to help cover your out-of-pocket costs. If you’re not a frequent traveler, however, you may find that an Advantage plan is perfect for your needs.
There’s no one answer for this because no one’s situation is exactly the same as someone else’s. The key is to review the medical network, drug coverage, and additional benefits to find a plan that fits your requirements.
Some Medicare Advantage plans are available with no additional cost beyond your Part B premium, but others have an additional monthly premium. You’ll also want to look at the deductible, copayments, and coinsurance before you commit to a plan.
Often, talking to a licensed insurance agent is the best way to get clear on your needs and compare plans accurately. We’re available for you anytime!
This guide answered the most common questions about Medicare in New Hampshire, but you may still have specific questions based on your circumstances. Or, you might want to connect with a licensed agent to compare plans and choose the best option. Either way, contact us today!
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