Senior Healthcare Advisors Blog
Medicare can be a confusing concept, especially when you are new to it. So, we've highlighted what many consider to be important basics to get you started on your Medicare journey.
Knowing These 8 Facts - Can help you save money, avoid complications, and prepare you for your next step with Medicare.
1) Original Medicare Is Not Free
Many people approaching age 65 assume that Medicare is completely paid for because they have been paying into it all of their working years via payroll taxes. However, when you pay into Medicare, you are only paying into Medicare Part A , (which covers hospital stays). If you or your spouse have worked for at least 40 quarters during your working years in the USA, you will earn premium-free Part A.
Part B (which covers doctor visits and diagnostic testing) and Part D (which covers prescription drugs) need to be paid for. Medicare Part B and Part D are based on your household gross income. Some people with higher incomes will pay more in the form of an IRMAA (Income Related Monthly Adjustment Amount). Most people pay the base rate premium for Medicare Part B, which is $135.50 a month for 2019.
The average Part D monthly premium is about $35 for 2019. However, you may find a wide range of pricing for plans in your area.
2) You Still Pay Your Part B Premium If ...
You enroll in a Medicare Advantage or Medicare Supplement plan.
No matter which type of gap coverage you enroll in, you must continue to be enrolled in Part A and Part B. Sometimes people think that if they enroll in a Medicare Advantage plan that they can skip paying Part B. This is not the case.
3) Not Enrolling in Medicare Can Cost You
You have 7 months total to enroll in Medicare when you first become eligible. The 7-month period begins three months before the month you turn 65 and ends three months after the month you turn 65. If you don’t enroll in Medicare during this time and you don’t have creditable coverage to back you up, you will be penalized.
Creditable Coverage - in its most common form is employer health coverage that you decide to keep because you are still working past the age of 65 for a large employer. Employers with more than 20 employees will pay primary to Medicare. This means that individuals with large employer coverage can delay enrollment into Medicare without penalty.
4) Supplement Plans are Standardized by the Government
Medicare Supplement plans also know as "Medigap" plans - Are lettered A through N and each plan provides different coverage that help to fill some or all of the gaps that Original Medicare doesn’t cover.
Medicare Supplement plans have federally standardized benefits across each Plan Letter. For example, a Medigap plan G with AARP/United Health Care has the exact same benefits/coverage as a Medigap plan G with Aetna regardless of which state you live in, with the exception of (MA, MN and WI).
So, once you’ve decided on the Plan Letter that best suits your health care needs, the only decision left is to find the best price in your area.
5) Every Doctor That Accepts Medicare Will Accept Your Medicare Supplement Plan
There are differences between a Medicare Supplement and a Medicare Advantage plan. One of the differences is that any doctor that accepts Original Medicare will accept a Medicare Supplement plan.
BUT ... Not all doctors that accept Original Medicare will accept a Medicare Advantage plan.
A Medigap plan pays after Medicare. Therefore, your doctor never bills your carrier directly; Medicare does. The only question you need to ask your doctor is if they accept Original Medicare. If they do, they will accept your Medigap plan, regardless of which company you bought it from.
6) The Annual Election Period Applies ONLY to Medicare Advantage and Prescription Drug Plans
The Annual Election Period (AEP) begins October 15th and ends December 7th. During this time you are able to make changes to your Medicare Advantage and Part D Prescription Drug plans.
This is not necessarily the customary time to make changes to your Medicare Supplement plan coverage. You are able to change Medicare Supplement plans anytime throughout the year, and unless you are in your Initial Open Enrollment period (the 7 month window of time mentioned in #3 above), have a guaranteed issue window, or live in a specific state with lenient rules, you will have to answer health questions and be subject to medical underwriting to apply for a new Medigap plan.
Note: With a Medicare Supplement plan you are guaranteed coverage with no medical underwriting during your Initial Open Enrollment period.
7) Pay Attention to Your Annual Notice of Change
If you have a Medicare Advantage plan or a Part D drug plan, you will receive an Annual Notice of Change (ANOC). Your ANOC is a letter you get from your carrier in September. This letter will let you know all the changes that will be made to your plan effective January 1st. These may include changes to the benefits, premiums, co-pays, and networks for your current plan.
You will want to review your ANOC thoroughly to decide whether you want to change plans based on their changes. If you don’t review your ANOC and let your plan auto-renew, you could be stuck in a plan that you might not want anymore. You won’t be able to change plans again until the following AEP.
8) Do Some Homework Before You Decide
Consider working with an licensed Independent Medicare Advocate rather than spending all of your time speaking to agents that represent just one or two specific Insurance Companies.
Agents that are employed by specific insurance carriers are substantially limited to the plans, pricing and guidance they can offer you.
Rest assured, Senior Healthcare Advisors (SHA) an established Medicare Advocacy Group that's always available to help you with your Medicare questions and options.
SHA assists thousands of seniors every year to make Medicare choices that are right for them.
After speaking with us and getting a clear plan of action, you'll have the knowledge to choose a plan and confidently put your Medicare decisions behind you. Whether it's a "low cost" Medicare Advantage Plan, a Medicare Supplement Plan that provides 100% coverage or even your Part D Prescription Drug plan, SHA is here to help.
Remember - There is never any pressure to choose a plan and there is never a charge for our services or advice.
When it comes to your Medicare decisions be sure
to have an Advocate by your side!
Senior Healthcare Advisors is a leading resource throughout the country for Medicare knowledge and guidance. Our mission is to educate seniors about their options
and empower them to make the Medicare choices that are right for them.
Our licensed Medicare Advocates will work with you Free of Cost to put your Medicare Plan together for the lowest possible cost in your area .... Guaranteed!
Additionally, we'll review your plan annually to ensure your getting the best
possible coverage for the best price, year after year.
Call 888 357 5020
Senior Healthcare Advisors - Provides Medicare knowledge - guidance - quotes and resources - Specifically designed for Seniors and their continued quality of life.