4 Things To Remember About Medicare


1. Will You Be Working When You Turn 65 Or Not?

If you are planning on continuing to work when you turn 65 and your employer has more than 20 employees, signing up for Medicare Part A is all you need to do. You can do this up to 3 months before the month of your 65th birthday. The easiest way is by going to ssa.gov, or by calling Social Security @ 1–800–772–1213. If you are not going to work, you do not have group retirement insurance or your employer has fewer than 20 employees you will need to sign up for both Medicare part A and part B. If you are already drawing Social Security retirement benefits, you will be automatically enrolled and should receive your Medicare card approximately 3 months before you turn 65.

2. Learn The 4 parts Of Medicare

Medicare has 4 parts.

Part A, is the hospital benefit under Medicare. It is a paid up benefit obtained by working and paying in a minimum of 40 quarters. Medicare Part A has a deductible that increases yearly and needs to be met before any benefits will be paid.

Part B, is the medical benefit under Medicare. Part B is not a paid up benefit and there is a premium that you pay monthly if you are drawing social security and quarterly if you are waiting till full retirement age to draw social security. The premium increases each year and you pay more if you are a high income earner. Medicare part B has a deductible that needs to be met before Medicare will pay for medical expenses. Medicare pays 80% of approved services after you meet the annual deductible.

Part C, is also known as Medicare Advantage or as I call the “Joe Namath Plans”. Nothing wrong with a little humor, right?. Part C bundles Part A,B and, most often times D (drug coverage)together under one umbrella with the addition of some “extra” benefits that traditional Medicare does not cover. Staying within the plans network of providers is important to make sure you are covered. 

Part D, is the Stand-Alone prescription drug benefit. These plans are administered by private insurance companies contracted with Medicare. As of this writing, there are approximately 28–32 different plans available in any given county across the US. Plans vary by premium, deductibles, covered drugs and co-payments . Plan recommendations, by Medicare insurance professionals, are based on the particular medications that a person takes.

3. Learn The Differences Original Medicare And Medicare Advantage.

A person that chooses to stay on original Medicare will normally get an additional Medicare Supplement insurance policy, also known as Medigap and a Stand Alone Part D drug plan. The Medicare supplement policies fill most of the gaps in original Medicare leaving the out of pocket costs very low for Medicare approved services. They generally pay 20% after the Medicare part B deductible is met and Medicare pays 80%. There are 10 different plans available to choose from, however, most companies only offer a few different plans. The most popular plans today are plans G and N. 

Medicare Advantage are bundled plans. Many people will join these plans being “drawn” by the offer of “free stuff” and the “zero premium” plans that are offered. What I mean is, many Medicare Advantage Plans do not have a premium in addition to the Medicare part B premium. They do however, have deductibles, co-payments and maximum out of pocket costs associated with your medical care. Another general characteristic, is most plans require you to stay within a network of contracted providers. I believe Medicare Advantage plans have their place if someone cannot afford the extra premiums for Medicare Supplement and a Stand-Alone drug plan. But, if someone can afford it, and really wants the freedom to see any physician with coverage offering minimal out of pocket costs, original Medicare is the way to go.

4. Choose How You Want To Enroll

You can read, educate yourself and decide whether it will be original Medicare with Medigap or Medicare Advantage. Then, call all of the insurance companies and compare all of the different plans available in your area and enroll directly with the company of your choice bypassing an agent. You will pay the same price though. You will need to do this comparison each year to make sure your drug costs are kept under control. The reason for yearly review is, Medicare Advantage and Part D drug plans change annually. It can be a costly mistake if you miss something. My recommendation, since it doesn’t cost you anything extra is to do business with an independent agent that is licensed with all of the top companies and has made a career out of helping people with their plan choices. Make sure this agent gives ongoing service year after year, is reliable and has INTEGRITY.

I hope this helps someone to understand Medicare better. I am always happy to help and give my services to anyone who wants to call, or email. 

Please call me @ 800–230–3211 or email: billclark@seniorschoiceinsurance.com