What Is Medicare?
Medicare is a federal health insurance program for people who are: age 65 or older, also for certain people under age 65 with disabilities, and also for people with End Stage Renal Disease.
Medicare Part A B C D
There are 4 Parts of Medicare – Part A, Part B, Part C, and Part D.
Medicare Part A Covers:
Part A is for inpatient coverage when you’re in the hospital. It includes your room and inpatient hospital care. It also covers skilled nursing facility stays, hospice, and home health care.
Medicare Part B Covers:
Part B of Medicare covers outpatient medical. This includes Dr visits, lab work, tests, surgeries, durable medical equipment, and preventive services.
Medicare Part C Covers:
Part C of Medicare is called Medicare Advantage. Part C covers everything that Part A and B covers. Most of the time Part D Rx is inclused in the coverage as well. These plans are optional and they are a bundled all in one type of plan.
These plans are typically HMO or PPO Network type plans that may work similar to what you’ve had while working.
A Part C Medicare Advantage Plan is not a Medigap plan. You can choose either a Part C Plan or a Medigap Plan, but not both. Plan choices will vary depending on the area where you live. Be sure to contact us if you need help finding a Plan.
Medicare Part D Covers:
Medicare Part D helps to cover the cost of prescritpion medications including shots and vaccines. Part D plans are run by private insurance companies but are still regulated by the government. There is prescritpion drug assistance through the Extra Help program. We explain the program in detail in our Extra Help For Medicare Part D video.
Cost For Medicare
The cost for Medicare will vary for beneficiaries. It is based on income and other factors.
How Much Does Medicare Part A Cost?
For most people, there’s no cost for Part A. You can get premium – free Part A if you receive retirement benefits from Social Security, the railroad retirement Board or if you’re an active or retired federal employee.
If you’re eligible for the retirement benefits mentioned above, but haven’t filed for it yet, then you shouldn’t have to pay a monthly premium for Part A.
If you or your spouse worked at least 40 quarters in your lifetime and paid taxes, Part A is considered paid up and you’ll pay zero $0
Those under the age of 65 can get premium –free Part A if receiving Social security or railroad retirement disability benefits for at least 24 months or if have End Stage Renal Disease.
If you don’t qualify for premium – free Part A, then you can buy it. The cost will depend on how long you or your spouse worked and paid Medicare taxes. If you have to buy Part A, then you’ll want to make sure to avoid a penalty. If you you don’t sign up for Part A when you’re first eligible for Medicare then you could faec a late enrollment penalty.
There’s a deductible associated with Part A and this amount can change every year.
How Much Does Medicare Part B Cost?
Most people will have to pay a monthly premium for Part B.
The cost for Part B will be based on your income reported on your tax return two years prior. Most people will pay the standard premium amount. If you are in a higher income bracket then you may pay more. This is called the Income Related Monthly Adjustment Amount or IRMAA.
Certain people with lower incomes may qualify for assistance that covers the Part B premium for them, so be sure to watch our video about the Medicare Savings program to see if you might qualify.
The premium payments for Part B will be deducted automatically from your Social Security, Railroad retirement or federal employee benefits.
If you don’t receive any benefits yet then you will get a bill for Part B. You can send in quarterly payments, use online bill pay, or set up a monthly payment with Medicare Easy Pay.
Signing Up For Medicare
If you don’t sign up for Part B when you’re first eligible then you may have to pay a late enrollment penalty.
Some people will get Part B automatically and some people will have to sign up for Part B.
Medicare Automatic Enrollment
If you receive Social Security benefits, Railroad retirement, or have disability for 24 months, then you’ll be signed up for Part B automatically. If you’re not receiving retirement benefits yet, then you will have to sign up for Medicare Part A & B.
Delaying Medicare Enrollment
In some situations, you may want to postpone your initial Medicare open enrollment until a later date. You could do this without incurring any penalty. An example of this scenario would be if you’re still working and have employer group insurance, or insurance through your spouse.
You may be able to delay signing up for Medicare and save the cost of your Part B premium.
Individuals already receiving Social security or Railroad retirement benefits at least 4 months before their eligibility date for Medicare will automatically be signed up for Part A & B.
For those receieving retirement benefits and have other coverage may not want to enroll in Medicare yet. If you have coverage through employer group insurance or have Veterans benefits then you’ll have an option to refuse Part B. You would not have a penalty, as long as you currently have Creditable coverage in place.
You’ll need to notify Social Security before your Medicare coverage has started. You’ll receive your Medicare card in the mail about 3 months before your 65th birthday, and there will be instructions for you to opt out.
You can also call Social security and ask to decline Part B. You could face a late enrollment penalty if you enroll in Part B late or outside of your enrollment window. Check with the benefits administrator to make sure your insurance is considered creditable coverage. If it’s creditable coverage then you would not have a penalty for delaying your Part B enrollment.
How To Sign Up For Medicare
If you have to sign up for Medicare there are a couple of ways you can do it. You can Sign up for Medicare online, you can call Social Security, or go in person to your local Social Security office. Keep in mind that you may have to make an appointment so call them first.
You know Medicare is great coverage that you’ve paid into your whole life, but it doesn’t cover everything 100%.
Original Medicare Parts A and B pays up to 80% of your medical costs. There are also deductibles and other out of pocket costs with basic Medicare coverage.
So you should get some type of supplemental coverage in addition to your basic Medicare Parts A & B. Whether it’s a Medicare Advantage Plan, or a Medigap Plan. You must sign up for Medicare Parts A and B in order to enroll in Part C or a Medigap Plan.
If you need help finding a Plan or have questions then give us a call at (800) 783-5901 and we’ll happy to help you.