MEDICARE INSURANCE

You have your medicare card... Now What!?

Senior couple hugging

Maybe you just turned 65. Maybe you have had Medicare for a while. Either way, it's confusing, isn't it? There are so many options available. You are concerned that maybe you aren't making the right choice. No two people are alike. A great plan for your neighbor might not be the best choice for you. Sit down with a licensed agent. Review your unique situation including doctor preferences, current prescriptions, pharmacy choices, medical history, income, & more. Give me a call to receive unbiased advice at no charge.

Original Medicare

Original Medicare includes 2 parts: Part A and Part B. Medicare is the United States’ federal health insurance program for people age 65 or older.  Certain people younger than 65 with disabilities or people with End-Stage Renal Failure can also qualify.

The four parts of medicare.

Medicare Part A

(Hospital) Part A covers inpatient hospital stays, skilled nursing facility, hospice care, and some home health care.  You enroll through the  www.medicare.gov site or by phone.

Medicare Part A (Hospital Insurance) Costs

Part A monthly premium:

Most people don’t pay a Part A premium because they paid Medicare taxes while working. If you don’t get premium-free Part A, you pay up to $499 each month.

Hospital stay

In 2022, you pay

■ $1,556 deductible per benefit period

■ $0 for the first 60 days of each benefit period

■ $389 per day for days 61–90 of each benefit period

■ $778 per “lifetime reserve day” after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)

 

Skilled Nursing Facility stay In 2022, you pay

■ $0 for the first 20 days of each benefit period

■$194.50 per day for days 21–100 of each benefit period

■ All costs for each day after day 100 of the benefit period

For additional information on Medicare costs click HERE

Medicare Part B

(Medical) Part B covers a portion of doctor and provider services,  durable medical equipment, home health services, ambulance, preventative care, x-rays, lab tests, & doctor administered prescriptions. Part B has a monthly premium and yearly deductible. They both change yearly according to the government. The monthly premium is decided by the government & determined by your income. Social Security and Medicare handle the enrollment of this program also. 

Medicare Part B (Medical Insurance) Costs

Part B monthly premium Most people pay the standard Part B premium amount ($170.10 in 2022). Social Security will tell you the exact amount you’ll pay for Part B in 2022. You pay the standard premium amount if:

■ You enroll in Part B for the first time in 2022.

■ You don’t get Social Security benefits.

■ You’re directly billed for your Part B premiums.

■You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $170.10 in 2022.) If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard Part B premium and an income-related monthly adjustment amount.

Part B deductible—$233 per year

For additional information on Medicare costs click HERE

Medicare Advantage / Part C
Prescription / Part D
Medicare Supplement / Medi-Gap

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare. It is provided by private insurance companies contracted by Medicare to fulfill the basic coverage of Original Medicare but with additional benefits that can sometimes be provided at no additional cost to you. This is possible because Medicare actually pays the insurance company a set amount for providing your healthcare coverage. These plans have a network of doctors and hospitals that you must to use. Many Medicare Advantage plans have prescription plans built into them. Part C plans have an enrollment period and can only be changed during certain times of the year. You enroll in these plans through independent insurance agents.

Medicare Part D is Medicare’s prescription drug benefit that provides outpatient drug coverage. Part D is provided through private insurance companies contracted with the federal government and approved by medicare.  If you want Part D coverage, you have to either buy a standalone plan or get it through a Medicare Advantage plan. Part D Prescription plans also have a limited enrollment period.  Unless you have had a major life-changing event, you can only change plans during the Annual Election Period of October 15-Dec 7th each year. You also would contact an independent health agent to assist you with enrollment in a Part D plan. 

Medicare Supplements (also known as Medi-Gap Plans) are offered by private insurance companies and they offset the out-of-pocket costs that Medicare doesn't cover, thus reducing unexpected expenses like deductibles and co-pays. These plans work alongside original Medicare (part A and B). You pay a monthly premium for these plans.  You can visit any doctor that accepts Medicare and you are not limited by networks.  Medicare Supplements may be purchased throughout the year, but are subject to underwriting. They can be purchased through an independent insurance agent. People that have a medicare supplement would need to purchase a stand-alone drug plan since they are not included in these plans.    

Medicare Supplement Plan Options

Medicare supplement plan options graph