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Medicare Basics
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When you reach 65, the health insurance landscape changes. You become eligible for Medicare, the U.S. federal health insurance program for people age 65 and older. Most people will want to apply for Medicare a few months prior to reaching age 65.  After you are approved you still have many decisions to consider including prescription drug coverage and out of pocket expenses for covered medical procedures. 

 

Medicare coverage starts with Parts A and B.

  • Part A is referred to as hospital insurance. This is free for most people because they spent their working years paying into Medicare.

  • Part B is referred to as medical insurance. It covers additional services and supplies needed to treat medical conditions as well as some preventative services. You pay a monthly premium for Part B.

Medicare Parts A and B comprise what is referred to as Original Medicare. 

With Original Medicare, as with most other insurance plans, you still have deductibles, co-pays, and coinsurance expenses as well as prescription costs. That’s where Medicare Parts C and D come in—offering additional coverage you can purchase.

  • Part C is called a Medicare Advantage Plan, or Medicare Health Plan. It is private insurance that provides coverage in a single plan that includes Medicare Parts A and B, and may also include prescription drug coverage (Part D). Medicare Advantage plans may also include extra covered services like vision, dental, and hearing.

  • Part D refers to prescription drug coverage that you can add to your basic Medicare Part A and B benefits. 

When enrolling in Medicare you will have to decide if you want Original Medicare or a Medicare Advantage Plan. Your location, budget, amount of travel you do, and care providers will all need to be considered when making this decision.

Am I eligible for Medicare?

To be eligible for Medicare you must have:

  • Age 65 and older

  • US citizen or permanent resident that meets work history requirements

  • People under age 65 with certain disabilities, and people of any age with permanent kidney failure.

How much does it cost to enroll in Medicare?

Medicare Part A - Most people don’t have to pay a monthly premium for Medicare Part A because they or a spouse paid Medicare taxes while working in the United States, and have 40 or more quarters of Medicare-covered employment. If you don’t automatically get premium-free Part A, you may still be able to enroll, and pay a premium. For those that do not qualify for the entitlement to Part A, the premiums are as follows:

  • $437, for individuals or their spouses that paid less than 30 quarters in Medicare taxes and,

  • $240, for individuals or their spouses that paid 30-39 quarter in Medicare taxes.

Medicare Part B - For those enrolling in Medicare in 2019, you will pay the standard Medicare Part B premium of $135.50 per month unless your modified adjusted gross income is greater than $85,000 for single filers/$170,000 for joint filers. Medicare Part B and D premiums are means-tested so if your income exceeds these amounts you will pay a higher premium. 

Medicare Part C - Premiums for Medicare Advantage Plans vary. You can use Medicare's online plan finder tool to search your location and see estimated premiums and benefits.

Medicare Supplement Policies - If you go with Original Medicare it is likely you will want to purchase a Medicare Supplement policy, sometimes called "Medigap" policies. Premiums vary depending on the plan and insurance carrier that you choose

Most important--Original Medicare is not sufficient to pay for your medical needs. Because of gaps in Original Medicare you will be left with sizable bills without the help of a Medicare Advantage or Medigap policy. Before making a decision, make sure you completely understand your Medicare benefits and the benefits of any supplemental policy you may enroll in.

Request a call from a licensed agent to discuss your options. click here >>>

Did you Know?

 

 

  • 7 in 10 baby boomers say they have a fair or poor understanding of Medicare*

  • 1 in 5 Medicare beneficiaries describes Medicare as confusing*

  • Most can’t identify what Medicare Parts A, B, C and D cover*

  • 62% of those eligible have never shopped for Medicare coverage to fit their needs*