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Are you confused about Medicare?

If you are feeling just a bit overwhelmed by this whole new world called MEDICARE, don’t worry, you are not alone. As a Medicare advisor and as an agent we have been assisting clients for nearly forty years. We work with both medical providers and with clients, just like you, to navigate the complexity and confusion with Medicare and the various programs and plans that are available. Here are just a few of the questions most of our clients have:

How do I enroll in Medicare?
What are the Benefits of Medicare?
What doesn’t Medicare Cover?
What if I am still Working and on Employer Group Coverage
What about COBRA?
When Should I Apply?
What about my retiree pension medical benefits?

Yes, this can be a mine field and we are here to help. I encourage you to attend one of our online Medicare 101 Webinars. This will be a great start in pointing you in the right direction and answering most of your questions. We always follow up with a one on one conference call and all of this at absolutely no charge. We can do this because whatever plan is best for you they have built into the plan payment for our services. Approximately $225 for the year. No, this does not increase your premium.

So don’t travel this road alone. Allow our experienced Medicare Advisors walk you through the process.

Intro Video to Medicare 101 Webinar

Meicare heatlh insurance card

What is Medicare?

Medicare is made up of four parts as defined below:

PART A: HOSPITAL INSURANCE

Part A covers not only your Hospital admission and services but also your care in a Skilled Nursing Facility, Hospice and Home Health. There is a per admission deductible. There is no premium.

PART B: MEDICAL INSURANCE

Part B covers outpatient medical services such as physicians, durable medical equipment, labs, and radiation. Preventative services are also included. There is an annual deductible. There is also a premium paid monthly to the Medicare Trust Fund and deducted automatically from your Social Security check. There is a penalty for late enrollment.

PART C: MEDICARE ADVANTAGE

Includes all services in Part A and Part B and may include Part D as well. Run by Medicare Advantage approved insurance companies, that comply with all Medicare regulations. They administer your Medicare benefits and may include extra supplemental benefits such as annual physicals, vision, dental, transportation and gym membership.

PART D: MEDICARE PRESCRIPTION DRUG COVERAGE

Helps cover the costs of outpatient prescription drugs. Part D is run by Medicare approved insurance companies. There is a penalty for late enrollment.

For more detailed information please click the button below.

WHEN AM I ELIGIBLE TO ENROLL?

The Social Security Administration handles Medicare applications. Some people get Medicare part A and B automatically and other people will need to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.

There are several different ways that people become eligible for Medicare.

  • Early enrollment prior to age 65 due to permanent disability under Social Security guidelines. Medicare will start after 24 months of disability.
  • Age In at age 65. This is the most common way that people enroll. Eligible if they or their spouse has worked 40 quarters.  Enrollment is quick and easy online at https://www.ssa.gov/benefits/medicare/,or if you prefer, you can sign up at your local Social Security office.
  • If you’re covered under an employer group plan and you enroll late because you’re still working, there is an additional form required to avoid late enrollment penalties (call or email a request for this form). This form verifies that you have been continuously covered under employer group coverage since turning age 65.  We highly recommend that you hand deliver this to the local Social Security office. DO NOT MAIL OR FAX. If it is lost or placed at the bottom of some pile of paperwork only you are the one to suffer.
  • If you’re getting benefits from Social Security or Railroad retirement, at least 4 months before you turn 65 you will automatically be enrolled into Medicare parts A and B.

Remember, everyone begins their coverage on the first of the month unless their birthday is on the first, then it is the first of the prior month.  We always encourage our clients to begin this process at least three months prior so that there is a smooth transition between private medical and Medicare.  Again, please contact our team or attend a workshop for more information. We will take you through everything from start to finish.

What if you have COBRA? Call us to avoid Part B penalties.

Lastly, remember that Part B and Part D have some nasty penalties if you do not sign up in a timely fashion.  Give us a call we can help or contact your local Social Security office (866-606-8093).

WHAT ARE THE LATE ENROLLMENT PENALTIES WITH MEDICARE?

Part B Penalties:

In most cases, if you don't sign up for Part B when you're first eligible, you'll have to pay a late enrollment penalty. You'll have to pay this penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it. Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B. Coverage will start July 1 of that year.

Part D Penalties:

The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.

Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($33.19 in 2019) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

The national base beneficiary premium may increase each year, so your penalty amount may also increase each year.

HOW MUCH ARE PART B PREMIUMS?

Part B premiums can vary each year. In 2019 for most people it is $135.50 per month.  However, if your income is higher than $170,000 for a couple you could pay more. Go to this link to get more information: https://www.medicare.gov/your-medicare-costs/part-b-costs

Feeling just a bit overwhelmed? Not sure what to do next?

Don’t worry, we are here to help….call (866) 606-8093

HealthCare Options NW

Phone: (866) 606-8093

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