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Medicare Benefits

Independent Medicare Insurance Brokers

 

A broker can offer you plans from many insurance carriers, based on your needs and preferences. We work for you, and our advice is free.

Does the alphabet soup of Medicare Parts A, B, C and D have your head spinning? We have helped thousands of folks just like you understand the basics of Medicare.

Keep Calm — We're Here to Help!

Not sure what to do during the Annual Enrollment Period for Medicare? Whether this is your initial enrollment and your head is swimming with all your options, or you just want to discuss your current plan, reach out to one of our certified sales representatives.

We can meet with you privately in our office, work over the phone, or online. We’ll review your health history, medications, options, and choices to design a plan that fits your goals and budget.

Our advice is free, your peace of mind is priceless. 

 

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WHAT IS MEDICARE?

Medicare is the federal health insurance program run by the Centers for Medicare and Medicaid (CMS) to provide health insurance for individuals. Each person must qualify for Medicare, choose what plan suits them best, and must enroll individually. There are four basic parts of Medicare (A, B, C & D) and each part helps pay for certain health care services.

MEDICARE ELIGIBILITY & REQUIREMENTS – WHO QUALIFIES FOR MEDICARE?

American citizens and legal residents meeting these requirements:

  • Age 65 or older
  • Paid 40 quarters into Social Security — non-working spouse included
  • Younger than 65 with a qualifying disability
  • Any age with a diagnosis of end-stage renal disease or ALS

To qualify as a legal resident, you must have lived in the US for at least five years in a row.

WHEN — AND HOW — DO I ENROLL IN MEDICARE?

You Initial Enrollment Period (IEP) for Medicare is determined by your birth date.

 

If you already get benefits from Social Security or the Railroad Retirement Board (or will be getting benefits at least 4 months before you turn 65), you’ll get Medicare Part A and Part B automatically when you’re first eligible and don’t need to sign up. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.

Medicare will send you a Welcome to Medicare packet along with your Medicare card three months before you turn 65. You’ll still have other important deadlines and actions to take, so read all of the materials in the packet.

You don’t need to sign up for Medicare each year. However, each year you’ll have a chance to review your coverage and change plans during the Annual Enrollment Period October 15 – December 7.

If you’re turning 65 in the next 3 months and NOT already getting benefits from Social Security or the Railroad Retirement Board, you’ll need to sign up with Social Security to get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You won’t get Medicare automatically.

Click here to apply for Medicare online with the Social Security Administration.

WHAT IF I WORK PAST AGE 65?

We can help you figure out how Medicare works with your employer’s coverage. When you are ready to leave your group coverage you will need to enroll in Medicare Part B if you have not already. Leaving employer group coverage qualifies you for a special enrollment period with Medicare and you can choose additional coverage at this time.

WHAT ARE MY COVERAGE OPTIONS?

Original Medicare is Part A Hospital Insurance & Part B Medical Insurance

Part A comes to most people at no cost – if you or your spouse has worked for 40 quarters (about 10 years) you have paid into Social Security for this.

Part A Hospital coverage includes

  • Inpatient hospital care
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Part B Medical Coverage has a monthly premium. Each year Medicare sets the premium amount. For the year 2020 most people pay $144.60, however it is based on income and can be higher.

Part B Medical covers

  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment – like wheelchairs, walkers and other equipment
  • Many preventive services – like screenings, shots and vaccines and a yearly wellness visit

An important thing to know is that Medicare insurance does have deductibles and only covers 80% of your bills. You are responsible for the remaining 20% after the deductible. This is known as The Gap – but we can help with that.

Plan for The Gap

Medicare Supplement Insurance also called MediGap is sold by private insurance companies and helps fill the gap of Original Medicare to pay the remaining out of pocket costs – like the 20% coinsurance. With these plans you can choose to see any doctors or visit any hospital that accepts Medicare.

Part C is also known as Medicare Advantage plans and are also sold by private insurance companies. These plans can have as little as $0 monthly premium and have copays and coinsurance based on what your medical needs may be. All Medicare Advantage plans must have a yearly limit so you know the maximum of what you would pay on out of pocket for Part A & B covered services. Many of these plans also include Part D prescription coverage and added benefits such as vision, dental, post hospital meals and transportation. With Medicare Advantage plans you must use a network of providers.

Part D is Prescription coverage purchased thru private insurance companies that follow the rules of Medicare.
The cost of plans vary by coverage and carrier.

So you can see – there are lots of options for you! We can help you understand the alphabet soup of Medicare.

Meet our Medicare Benefits Team

Reach out to our Team with any questions or to set up a consultation:

 

Medicare@TheAshleyGroup.com | call 419.897.1001

 

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