Medicare

Depositphotos_13854407_originalWhat is Medicare?

Medicare is a federal government program for people over age 65. It is an 80/20 coinsurance system where you, the patient, are responsible for 20% of all of your medical costs, as well as annual deductibles, per day copayments and up to 15% excess charges from doctors.

For example, if you were in the hospital for 5 days and the bill came to $100,000, Medicare would cover $80,000 and you would be responsible for $20,000.


Medicare Part A

Part A of Medicare covers Hospital Stays, Emergency Services and limited skilled nursing and home health care for rehabilitation after your annual deductible has been met. For 2015 the Medicare Part A deductible is $1,260.

Most people will not pay a premium for Medicare Part A as long as they or their spouse have worked for 40 quarters in their lifetime.

Medicare Part B

Medicare Part B covers doctor visits, outpatient care, some medical supplies and preventative services.

Most people will pay $104.90 per month for Part B coverage in 2015.

You must pay a deductible of $147 per year before Part B coverage takes effect.

Is there a way to defray the costs of what Medicare does not cover?

Yes. Most people take out either a Medicare Supplement or Medicare Advantage policy to help lower their medical costs.

Does Medicare Pay for Prescription Drugs?

Medicare Parts A and B do not cover the costs of your prescription drugs. You can purchase a Medicare Part D or Prescription Drug Plan to help with these costs. Many Medicare Advantage plans include prescription drug coverage. You will need to purchase a stand-alone prescription drug plan if you choose to purchase a Medicare Supplement policy.

What is Medicare Supplement or Medigap Insurance?

A Medicare Supplement or Medigap policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. These types of plans help make it possible to predict your annual medical costs and lower your out-of-pocket spending.

What is a Medicare Advantage Policy?

Medicare Advantage Plans are offered by private insurance companies who contract with Medicare to provide you with all of your Part A and Part B benefits

 

Depositphotos_5697426_originalApplying for Medicare

Will I be automatically enrolled in Medicare Part A and B when I turn 65?

If you are already receiving Social Security benefits, you will be automatically enrolled in Part A and Part B of Medicare six months prior to your 65th birthday.

If you are not currently receiving Social Security benefits, you will need to apply for Medicare Part A and Part B.

When Should I apply?

You can sign up for Medicare three months before reaching age 65, even if you plan to keep working and delay receiving social security benefits. While filling out the online application, you can opt out of receiving retirement benefits now. You can then apply online when you are ready to start receiving your social security benefits.

How should I apply?

You can apply online at Medicare.gov. The process takes about ten minutes. Otherwise, you can make an appointment at your local Social Security office and apply in person. You will need a valid picture ID and your birth certificate in order to apply in person.

What if I don’t apply?

You should apply for Medicare before turning 65, even if you don’t plan to retire and take social security benefits yet. Failing to apply for Medicare when you are first eligible will result in a 10% increase in premium for each 12 month period you were eligible but did not apply, unless you have a group health plan.

What if I want to keep my employer health insurance?

You should apply for Medicare Part A before you turn age 65 even if you plan to keep your employer health insurance. You will be able to sign up for Medicare Part B under a special enrollment period during an 8 month period following the last month of group coverage.

What happens after I apply?

Once you have applied online, you will receive a receipt that you can print and keep for your records. You will also receive an application number which will allow you to check the status of your application online. The Centers for Medicare and Medicaid Services will review your application and contact you if they need any more information or documentation. They will then verify that you are eligible to enroll and send your Medicare card to you in the mail.

Contact Us

The best way to find out how much a Medicare Supplement or Medicare Advantage policy will cost is to get a rate comparison from the top rated insurance companies to see who will offer you the best coverage at the most affordable price. We can help with that. Give us a call at 1-888-321-6361 to request your free rate comparison.

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