What You Need To Know About Preparing For Medicare Benefits
Preparing for Medicare can feel daunting, but it doesn’t have to be. Here are the basics you need to know to make the process as smooth as possible.
First, you’ll want to familiarize yourself with the different parts of Medicare and what each cover.
Next, you’ll need to decide when to sign up for Medicare—the initial enrollment period is three months before your 65th birthday, the month of your birthday, or three months after your birthday.
Finally, you’ll need to choose a plan that fits your needs. Read on for more information about each of these steps.
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What is Medicare and who is Eligible for it?
Medicare is a federal government health insurance program for people 65 and some younger adults receiving Social Security benefits for at least 24 months.
To be eligible for Medicare, you must be a U.S. citizen or permanent resident who has been legally residing in the country for at least five continuous years.
You or your spouse must also have worked and paid Medicare taxes for at least ten years.
If you’re not sure you’re eligible for Medicare, you can check with the Social Security Administration.
What does Medicare cover?
Medicare comprises four parts: Part A, Part B, Part C, and Part D.
Part A covers hospital insurance, while Part B covers outpatient health care services, such as doctor’s visits, lab tests, and preventive services.
Part C, also known as Medicare Advantage, is a health insurance plan offered by private insurance companies that cover all of Parts A and B, as well as extra benefits like prescription drugs.
Part D is a stand-alone prescription drug plan that covers the costs of prescription medications.
Finally, you can sign up for Medigap policies to maintain what you earned.
Depending on your needs, you can enroll in any combination of these parts.
How do I Enroll in Original Medicare and what are the Deadlines to do so?
You can enroll in Medicare online, by phone, or in-person at your local Social Security office.
Your initial enrollment period is the three months before your 65th birthday, the month of your birthday, or three months after your birthday.
If you don’t enroll during this time, you may have to pay a late-enrollment penalty.
Once you have received your Medicare card, Integrity Now Insurance Brokers can help you with the next steps in finding Health coverage.
What Happens If You Don’t Enroll In Time?
If you don’t enroll in Medicare during your initial enrollment period, you may have to pay a late-enrollment penalty.
What are the penalties for not enrolling on time?
This penalty is an extra 10% of the premium for each year that you delay enrolling in Part B.
For example, if your Part B premium is $100 per month, you would owe a penalty of $10 per month—or $120 per year—if you delayed enrolling for two years.
The only way to avoid this penalty is to have what’s known as “creditable coverage.”
Creditable coverage is any health insurance that’s at least as good as Medicare Part A and Part B.
This includes employer-sponsored health insurance, COBRA, Medicaid, and certain types of private health insurance.
If you have creditable coverage, you can delay enrolling in Medicare without having to pay a late-enrollment penalty.
You’ll need to provide proof of your creditable coverage when you do enroll.
What if I’m still working when I turn 65?
If you’re still working when you turn 65, you may not need to enroll in Medicare right away.
If you have health insurance through your employer, you can delay enrolling in Part B without paying a late-enrollment penalty.
You’ll need to provide proof of your employer-sponsored health insurance when you do enroll.
What are my Options for Medicare Coverage?
There are a few different ways to get Medicare coverage.
You can enroll in traditional Medicare, which includes Medicare Part A (hospitalization) and Medicare Part B (outpatient care).
When staying on Original Medicare, you will want to buy a Medicare supplement Insurance Policy. This will fill in the gaps not typically covered by Medicare Parts A and B.
If you decide to enroll in a Medicare Advantage Plan, you’re still getting your Medicare benefits from the government.
But instead of getting them through traditional Medicare, you’re getting them through a private insurance company that contracts with Medicare.
Medicare Advantage Plans must cover everything Original Medicare covers, but they can also offer extra benefits like dental, vision, and prescription medications.
How do you Sign-up for Part D Prescription Drug Coverage?
You can sign up for Part D Prescription Drug Coverage through a Medicare Advantage Plan or a stand-alone prescription drug plan.
A stand-alone prescription drug plan is a private insurance plan that covers only prescription drugs.
You can also get Part D coverage through some Medicare Advantage Plans.
If you keep your Original Medicare coverage with a Medicare Supplement Plan G, you may join a Part D plan that covers drugs alone.
However, if you move from Original Medicare to an Advantage plan and get your health insurance products, you must exclusively utilize the Part D coverage provided by the plan.
What is the Difference Between Original Medicare and Medicare Advantage?
Original Medicare is made up of Part A (hospitalization) and Part B (outpatient care).
Medicare Advantage is offered by private insurance companies providing a Medicare health plan that covers all of Parts A and B, as well as extra benefits like prescription drugs.
What are the benefits of enrolling in Medicare Advantage?
Medicare Advantage plans typically have lower premiums than Original Medicare.
They also often include additional benefits, like dental, vision, hearing aids, and prescription drug coverage.
What are the benefits of enrolling in Original Medicare?
Original Medicare typically has lower out-of-pocket costs than Medicare Advantage plans when coupled with a Medigap Plan G.
It also gives you more flexibility in choosing your doctors and hospitals who accept Medicare without HMO plan network restrictions.
You can also add a prescription drug plan to your Medicare plan coverage.
Please contact our office if you have any questions about how to prepare for Medicare or need help with your Medicare enrollment. We would be happy to help!
What are the Different Parts of Medicare, and what do they Cover?
Medicare is made up of four parts: Part A, Part B, Part C, and Part D.
Medicare Part A of the plan covers hospitalization., The Part B portion of the program covers outpatient services., Part C is a private health insurance plan that covers all of Parts A and B, as well as extra benefits like prescription drugs, and Medicare Part D is a prescription drug insurance plan.
Depending on your needs, you can enroll in any combination of these parts.
Please contact our office if you have any questions about your Medicare enrollment. We would be happy to help!
How much will I have to pay for Medicare Premiums, Deductibles, and Copays each year?
Medicare Part A of the plan covers hospitalization and has no monthly premium for most Americans but includes a deductible.
The Part B portion of the program covers outpatient services and has a monthly premium and co-payments. Deductible and coinsurance of 20% of the medical bill.
Medicare Part C private health insurance plans may charge an additional monthly premium that varies depending on the insurer. Still, all plans must cover all of Parts A and B, as well as extra benefits like prescription drugs.
Part D prescription drug insurance plans also have premiums that vary by insurer, with the average premium being around $30 per month.
Do Medicare Premiums, Deductibles, and Copays Increase Every Year?
Medicare premiums, deductibles, and copays are subject to increase yearly.
For example, the Part B standard monthly premium increased from \$134 in 2018 to \$144.60 in 2019. Part B premiums in 2022 are now $170.10
The Part A deductible also increased from $1,340 in 2018 to $1,408 in 2019.
It’s worth noting that these annual hikes should be considered while budgeting for your healthcare expenses.
The annual increases typically follow inflation rates and the rising cost of healthcare.
What should I do if I'm already enrolled in a Medicare Advantage Plan but want to switch to a different one later on down the road?
If you’re already enrolled in a Medicare plan but want to switch to a different one later on down the road, you can do so during the Medicare Open Enrollment Period.
This period runs from October 15 to December 7 each year.
You can make changes to your existing coverage or sign up for new coverage during this time.
To switch plans, choose a new one that meets your needs and then cancel your old one.
It’s important to note that you can only make changes to your coverage during the appropriate Medicare Enrollment Periods.
If you try to make changes outside of this period, you may be subject to penalties.
If I sign Up For A Medicare Advantage Plan Can I Switch Back To my Original Medicare And Get Approved For A Medigap Policy?
Yes, and Maybe.
Yes, you can switch back to your Original Medicare at any time.
However, Medicare beneficiaries may not be able to get a Medigap plan if they have had a Medicare Advantage plan for more than 12 months without going through full underwriting by the Medicare insurance company.
If you have had a Medicare Advantage plan for less than 12 months, you may be able to get a Medigap plan under guaranteed issue rights as long as you meet the eligibility requirements.
Some US States have removed the underwriting requirements to obtain a Medicare supplement plan outside the guaranteed issue period, but most have not.
What should I do if I'm already enrolled in a Medicare Advantage Plan but want to switch to original Medicare later on down the road?
Suppose you’re already enrolled in a Medicare Advantage Plan but want to switch to Original Medicare at some point. In that case, you can do so during the Medicare Advantage Open Enrollment Period.
This period runs from January 1 to March 31 each year.
During this time, you can disenroll from your Medicare Advantage Plan and switch back to Original Medicare.
It’s important to note that you can only make this change once yearly.
Please contact our office if you have any questions about switching Medicare plans. We would be happy to help!
How can I get more information about Medicare and its various plans?
The best way to get more information about the various Medicare plans is to contact one of our Medicare insurance agents. Our Medicare insurance agents are trained professionals who can help you understand your Medicare options and enroll in the plan that best meets your needs.
As independent insurance agents, we provide unbiased information and can help you compare plans from different insurers to find the one that best meets your needs.
Please contact our office today if you would like to speak with one of our Medicare insurance agents. Our team would be happy to answer any of your questions!
How do I choose a Medicare Plan?
Choosing a Medicare plan depends on your needs and budget.
You can enroll in Part A and B if you want basic coverage. However, you will be left with unlimited out-of-pocket expenses without obtaining a Medigap Policy.
If you want more comprehensive coverage, buy a Medicare supplemental insurance policy to help cover costs not covered by Original Medicare, such as deductibles, copayments, and coinsurance.
You can also join a Medicare Advantage Plan (Part C) or get a Part D prescription drug plan included with a single Medicare plan.
Not all Medicare plans are the same. Even if you’re not purchasing anything soon, it’s a good idea to research what alternatives are available.
Talk to one of our Medicare insurance agents to help you decide what kind of coverage is right for you.
Can I enroll in Medicare if I'm not 65?
You can enroll in Medicare at any age if you’re eligible.
If you have a disability or end-stage renal disease, you may qualify for Medicare before you turn 65.
To see if you’re eligible, visit the Social Security website.
What is the Difference Between Medicare and Medicaid?
Medicare is a health insurance program for people 65 and over, people under 65 with specific disabilities, and people of any age with end-stage renal disease.
Medicaid is a health insurance program for low-income individuals and families.
For more information about Medicaid, visit the Centers for Medicare and Medicaid Services website.
Now that you know the basics of preparing for signing up for Medicare, it’s time to take the next step. Give us a call, and we’ll walk you through signing up for Medicare.
We’re here to help make this transition as smooth as possible for you. With over 20 years of experience, our team of Medicare insurance agents is ready and waiting to assist you in making the best decision for your health care needs.
