Medicare is health insurance primarily for those ages 65 and over. It’s a government-funded program that provides a wide range of coverage, depending on which policy is selected. Choosing the right Medicare plan is essential, and our professionals at Senior Insurance Consultants are here to help.
Eligibility
Most people who meet the age requirement of 65 are eligible for Medicare if they’ve paid Medicare taxes for ten years or more. Some under the age of 65 may be eligible, depending on health status and if they have a diagnosis approved for Medicare coverage.
Three months before a beneficiary’s 65th birthday, they’ll receive an enrollment packet. This will detail the different options available and can be extremely helpful when picking out the right plan.
The Parts of Medicare
Medicare is divided into four parts, each corresponding to a separate coverage area. This simplifies billing and allows beneficiaries to choose their areas of coverage.
Parts A and B are considered to be Original Medicare. Medicare Advantage, or Part C, encompasses the same coverage as Original Medicare but provides additional options. Prescription drug coverage is included in Part D.
Is Medicare right for you?
The answer is most likely, yes! Even if you have another form of health insurance, enrolling in Medicare can save you money and give you peace of mind.
If you’re considering enrolling in Medicare, contact an insurance agent who can answer your questions. Working with a professional is the best way to ensure all your paperwork is done correctly and the enrollment process goes smoothly.
What Is Medicare
If you’re wondering what your healthcare will look like during retirement, consider Medicare. It was created to serve seniors and provide the highest quality of coverage. There are many different plans available within Medicare, so it’s essential to research and find the best policy for you.
Original Medicare vs. Medicare Advantage
Medicare is divided into parts, and different coverage areas are assigned to each piece. This makes it easy to understand your policy and make changes if you want to expand your coverage.
Original Medicare includes Parts A and B. It is essential coverage but provides hospital inpatient and outpatient care provisions. Some medical supplies are also covered through Part B.
Medicare Advantage Plans, or Part C, are sold through private insurance companies. With Part C, the beneficiary has more options and can find healthcare coverage that will be best for them. There are many different policies available within Plan C, so working with an insurance agent is the best way to be sure you’re enrolling correctly.
Eligibility
Most Americans ages 65 and older are eligible for Medicare. Because Medicare was created for this age group, many services are tailored to meet everyday needs. Medicare is thoughtful about its coverage and works to ensure everyone has an option that will work for them.
Wanting to enroll?
If you’re considering enrolling in Medicare, contact an insurance agent who can walk you through the process. Insurance decisions don’t have to be complicated or stressful. With the help of our team at Senior Insurance Consultants, you’ll know you’re getting individualized attention from professionals with Medicare experience.
Costs of Medicare
Premiums
Premiums are typically paid monthly and can range depending on the beneficiary’s policy. For those that don’t have premium-free Part A, the monthly premium for 2020 will be $458. Part B premiums typically are around $144.60. Part C premiums can be as low as $0, whereas Part D premiums vary among each plan and company.
Keep in mind that premiums can fluctuate each year.
Deductibles
Deductibles are paid out-of-pocket. Once the deductible has been met, Medicare will partially or entirely cover included medical costs through the benefit period. The 2022 Part A deductible is $1,556.
Deductibles are excellent for those that are anticipating high medical bills. While paying the deductible out-of-pocket might seem expensive, it can save money in the long run and is an excellent option for many.
Coinsurance
Coinsurances are what the beneficiary will need to pay after they’ve paid their full deductible. For most plans, coinsurance is a percentage of the overall cost of a procedure or appointment. In 2020, the Part B coinsurance was 20% of the Medicare cost.
Understanding costs
When selecting a Medicare plan, it’s best to examine all the different features. Understanding the additional costs for each part can help you predict your future bills.
Apply for Medicare
Initial Enrollment Period
The best time to enroll in Medicare is during your Initial Enrollment Period (IEP). Your IEP will begin three months before your 65th birthday and extend three months after it. Initial Enrollment Periods span seven months in total.
Enrolling during your IEP is optimal because there will be no late fees, and you have the widest variety of options. When first enrolling in Medicare, take the time to research and find the best plan for you. It can be complicated to switch between plans, which can only be done at certain times, such as the Annual Enrollment Period (AEP). AEP begins on October 15 and ends on December 7 of each year.
Special Enrollment Periods
Special Enrollment Periods are given to those with another form of insurance when their IEP begins. Because of this, the individual is not required to sign up during their IEP and can postpone enrollment until their employer insurance ends. Special Enrollment Periods can also be granted if an individual has a significant life change, such as moving.
Apply with the help of a consultant
Applying through a consultant is recommended. They can answer your questions and walk you through the process.
Medicare & Employer coverage
Simultaneous coverage
Even if you have employer health coverage, you can still enroll in Medicare. Having two insurance policies can be helpful, as one might pick up where the other leaves off. This is an efficient solution that allows for peace of mind and can also reduce bills.
There are no problems with being enrolled in employer coverage and Medicare simultaneously.
Special Enrollment Periods
If you have employer coverage and wait to enroll in Medicare, you may be granted a Special Enrollment Period. You don’t need to register during your Initial Enrollment Period.
In most cases, you’ll be able to enroll in Medicare once your employer coverage ends. If you want details about your specific case and what Medicare will allow, it’s best to speak with a professional. They can give you insight and walk you through the process.
Dental, Vision, & Hearing
Original Medicare
Original Medicare, which consists of Parts A and B, doesn’t include a few coverage areas. While Original Medicare is sufficient for many, others prefer to extend their range. Dental, vision, and hearing coverage can all be added to Medicare Advantage and not to Original Medicare. However, there are a few exceptions that are worth noting.
Dental work may be covered if it is related to jaw surgery or done in an emergency. There are no guarantees, which may vary depending on the case.
Vision checks and glasses are not covered under Original Medicare. If glasses are required as part of recovery from cataract surgery, they may be substituted. It may be included if a vision check occurs during a covered appointment.
Medicare Advantage
Medicare Advantage, or Part C, can be tailored to the beneficiary’s needs. Dental, vision, and hearing coverage can all be included. This is excellent for individuals anticipating using a specific area of coverage. If you want to enroll in an Advantage plan, you’ll need to do so through a private insurance company. You can make an appointment with us today, and we’ll be happy to discuss all your options.
Medicare Under 65
While Medicare is primarily intended for those ages 65 and up, some exceptions are made. Individuals under 65 enrolled in Medicare can access various healthcare and insurance coverage.
Qualifications
While enrolling in Medicare as early as possible is best, specific qualifications must be met to ensure eligibility.
If the individual has been getting disability benefits from Social Security or the RRB for at least 24 months, they are most likely eligible to enroll in Medicare. Once the 24 months have passed, they may be automatically enrolled in Original Medicare.
Meet the qualifications previously listed and are automatically enrolled in Original Medicare. You can still sign up for Plan C. Advantage Plans are an excellent option for those with complex medical needs.
Medicare Supplement Plan Comparison
With twelve Medigap options, it can be overwhelming to figure out which will be best for you. You can ask a few questions to help plan a comparison and lead you in the right direction.
What Medicare Service did you spend the most money on last year?
Looking at your past insurance bills is an excellent way to plan for the future. Did you spend more on Medicare Part A or B costs last year? Was the majority of that deductibles?
If you can understand why your bills were heightened in the past, you can make informed decisions when selecting a Medigap policy for the future.
Are you anticipating certain medical costs?
When selecting a Medigap plan, consider what you might need in the future. If you’re anticipating increased outpatient or hospital inpatient care, that should be factored into your decision.
Do you travel?
If you travel, you may want to select a plan which covers foreign travel exchange.
Medicare Supplement Plans
Plan Variety
There are ten different types of Medicare Supplement insurance plans. They each provide additional layers of coverage and have unique selling points.
Each plan has its letter and varies in comparison to the others. The plans are labeled as A, B, C, D, F, G, K, L, M, and N. What plan an individual decides upon is a very personal decision and can be made quickly through the help of an insurance professional.
Which Plan is right for you?
Picking a plan may seem complicated or overwhelming, so it’s always best to work with an insurance agent. They’ll be able to guide you through the process and provide the peace of mind that comes from knowing you have the advice of a professional.
Medigap plans can lower medical bills and provide some financial relief. If you’re questioning which Medigap policy is right for you, feel free to reach out, and we’ll help you find the plan you need.
Medicare Supplements
Medicare Supplements have many different plan options, allowing the individual to select the one best for them. Supplements reduce Medicare bills. They do this by covering some of the costs associated with Medicare and are not available for those enrolled in Part C.
Some plans may partially cover deductibles, while others have out-of-pocket limits. These limits benefit those anticipating large medical bills in the coming insurance period.
Consider your options
If you’re considering a supplemental Medicare plan, consider talking with an insurance consultant who can offer you some guidance. So many options are available, but choosing one doesn’t have to be overwhelming.
Medicare Part A
Medicare Part A is hospital insurance. Part A is included within Original Medicare and is often paired with Part B.
Eligibility
You’re eligible for Part A if you meet Medicare enrollment’s age and tax requirements. Many people are automatically enrolled in Original Medicare and will receive Part A when they turn 65.
Part A costs
If you’ve been paying Medicare taxes for ten years or more, you’ll most Likely receive Part A premium-free. While there may be other costs that will be the beneficiary’s responsibility, Part A is typically a very Financially sound option.
Part A covers:
-
- Inpatient care in a hospital
- Skilled nursing facility care
- Nursing home care
- Hospice care
- Home health care
Is Part A right for you?
Part A is an excellent option for hospital insurance. It would help if you always considered different possibilities when selecting an insurance plan and researched to find the best option. Many people choose Plan A because of its affordability. If you have more questions about Part A, please get in touch with us, and we’ll have one of our professionals be in touch.
Medicare Part B
Medicare Part B is one of the two parts which make up Original Medicare. Part B covers a wide variety of services and is highly recommended.
Eligibility
Eligibility guidelines for Part B are the same as those for Medicare enrollment. Qualifying for Medicare generally depends on age and tax history, though some exceptions are made for those with specific disabilities.
Medicare Part B covers:
-
- Medically necessary services
- Preventative services
Medically necessary services include various things, from durable medical equipment to ambulances. Some prescription drugs may also be covered, as well as clinical research.
Medicare’s dedication to its beneficiaries can be seen in its emphasis on preventative services. Being proactive is essential when it comes to health. So many different services are covered under Part B.