New to Medicare (Medicare 101)
Look no further! We’re your one-stop-shop Medicare Information resource center!
If you’re new to Medicare, you could find yourself overwhelmed with mail and uncertain of the future.
The stacks of envelopes that explain every health, drug and supplement plan compatible with Medicare only make it more stressful.
Furthermore, there are different plans and parts that contain similar letters. Medicare is confusing and because of that, you could be vulnerable to making poor healthcare decisions.
Even if you’re new to Medicare, you should feel confident in your healthcare coverage.
New to Medicare? Understanding Your Medicare Benefits
If you already get Social Security, then you’ll automatically enroll in the federal health program. If you aren’t already taking Social Security, you’ll need to enroll yourself.
Traditional Medicare and Original Medicare are the same things, you’ll notice them used interchangeably throughout your research.
This federal program consists of several parts including Part A, Part B, Part C, Part D & Medigap.
Medicare Eligibility and Medicare Age
One way you could be eligible for this federal healthcare coverage is by turning 65 years old. This is considered the Medicare age.
If you’ve received Social Security benefits for more than 24 months, you could also be eligible.
However, if you’re not a citizen or a legal resident of at least 5 years, you may not qualify.
Medicare Enrollment Process
Many seniors will be automatically enrolled in Medicare. This happens what you’re already receiving Social Security or Railroad Retirement benefits.
If you’re not receiving benefits prior to your 65th birthday, you’ll contact Social Security for enrollment.
It’s extremely important to understand that the only parts of Medicare you’ll sign up for with the Social Security office are Part A and Part B. All other parts, including Medicare Advantage & supplemental insurance, is done through a licensed agent and/or agency.
You can sign up for Medicare Part A & Part B by:
- Visiting the Social Security office
- Call Social Security
- Apply for Medicare online
- If you worked on a railroad, call the RRB
Part A & Part B does not cover everything. In fact, you may be responsible for the Part A deductible more than one time per the calendar year.
Additionally, these parts only cover 80% of your medical costs & prescription medications are not covered. These out of pocket expenses can quickly add up. That’s where supplemental plans come into play.
You can see rates & sign up for supplemental Medicare coverage by:
- Using our online rate form
- Call us at the number above
Working with our resource center is completely free to you, we’re here to answer any questions you have.
Explaining the 4 Medicare Parts
There are four main parts of Medicare Insurance. Parts A-D. This information is easy to digest, and once you’re done, you’ll be an expert.
Covers hospitalization and inpatient services.
Depending on your citizenship and how long you worked in the United States, qualifying for free Part A is possible.
If you’re receiving Social Security benefits, you may notice automatic enrollment in Part A.
When you become hospitalized you must pay the Part A deductible. Costs that exceed the deductible will require your 20% responsibility.
This deductible is ongoing, meaning you could be responsible for paying it several times throughout the year.
Covers outpatient services, doctor visits, and durable medical equipment.
If you don’t enroll in Part B when first eligible, you may incur a Part B late enrollment penalty.
Part B has a premium. However, your premium is most likely deducted from your monthly benefit check.
If your income is above a certain amount, you could be responsible for an Income Related Monthly Adjustment Amount (IRMAA).
There is an annual deductible as well as 20% coinsurance you’ll be responsible for covering.
Once you enroll in this type of coverage, the federal government no longer handles your claims.
The Insurance company that you enroll with will handle claims, determine your eligibility for services and give you a list of required doctors.
Part C plans can seem appealing, most plans include vision, dental, and hearing benefits. Additionally, the low premiums attract many seniors.
However, the limitations on these plans can make getting the care you need difficult.
You can obtain Part D by enrolling in a stand-alone prescription drug plan or enroll in a Part C plan that includes prescription drugs.
Delaying Part D enrollment when first eligible means that you’ll likely pay the Part D late enrollment penalty when you finally join a plan. This penalty will stay with you as long as you have Medicare.
You may not be responsible for a penalty if you have creditable coverage or receive extra help.
Talking with a licensed insurance broker can make finding the right plan for you, simple.
When you apply for Prescription Drug coverage, you’ll need your Medicare Number as well as Part A and B effective dates. The red, white, and blue card will have this information displayed on the front.
New to Medigap
Imagine if you only had to pay a premium and a small deductible; doctor visits, as well as hospital stays, have coverage. This level of coverage exists, it’s called Medigap insurance.
Medigap policies cover the 20% not covered by the federal healthcare program. Depending on the policy you select, you could have coverage on your Part A deductible as well as your Part B deductible.
Many of these policies offer further benefits, such as foreign emergency coverage. If you travel, even just inside the United States, the Supplement is the policy for you.
Employer or Medicare Coverage
If you’re working past the age of 65 then you will likely take a different path than those that retire and take Medicare at 65.
- Is keeping your employer coverage the most cost-effective?
- Would enrolling in Medicare to make it easier when you do retire?
- Could having both employer and Medicare coverage be the best option?
Well, the best choice for you depends on a couple of things. The cost of your employer coverage and the number of employees in your office will help determine what is best for you.
New to Medicare FAQ’s
When was Medicare Established?
Parts A and B were established by law in 1965. Since then, the law has been amended to make more people eligible and expand the benefits offered by Medicare.
The Medicare Modernization Act of 2003 added prescription drug coverage and established the Medicare Advantage program of private Medicare coverage.
What is the Medicare Tax?
To fund the Medicare system, there’s a 2.9 percent tax on every worker’s pay. Your employer pays half the tax, and the other half comes from your pay.
If you make more than $200,000 in wages in 2019, you will pay an additional Medicare tax of .09 percent of your wages beyond $200,000.
Is it Mandatory to go on Medicare when you turn 65?
No, it’s not mandatory to go on Medicare when you turn 65. Keep in mind though, if you don’t enroll when you’re first eligible, you could incur a late enrollment penalty for Part A & Part B.
The late enrollment penalty is 10% for each year you went without coverage and will stay on your premium for the rest of your life.
Can You Sign Up for Medicare Online?
As stated above, yes. If you’re not automatically enrolled you can sign up online.
How do I Register for Medicare?
By visiting the Social Security office, calling Social Security, or applying online through SSA.gov.
What Documents Do I Need to Apply for Medicare?
You will need two, possibly three, documents to apply for Medicare. Those documents include your birth certificate, proof of citizenship if not born in the United States, and your drivers’ license.
Take Advantage of our Expert Advice
Our agents can answer all your questions, educate you on the basics and walk you through the application process. Being new to the crazy world of Medicare can be difficult, having someone in your corner can make the process easier.
Our services are free. You can contact a licensed insurance agent at the number above or you can submit an online rate comparison form.