Enrolling in Medicare can be overwhelming and confusing.
This video goes through the basics of how Medicare works and how to find the best Medicare coverage for you.
Confused about your Medicare coverage options? Watch our free video: How to Find the Best Medicare Coverage Without Paying More Than You Need To…
What is Medicare?
Medicare is a government program that provides health coverage to people who are age 65 or older and also to people who are under age 65 but have certain disabilities.
Original Medicare has two parts, Part A and Part B. We still refer to those as Original Medicare, as opposed to the new parts: Part C and Part D, which were developed in the early 2000s.
Medicare Part A
Medicare Part A is hospital or inpatient insurance. It doesn’t cover everything at 100 percent. There are deductibles and co-insurance amounts that remain your responsibility with Medicare Part A.
If you worked 40 quarters, which is 10 years, and had Medicare tax taken out through that time, then you will not have to pay a monthly premium for Medicare Part A.
Medicare Part B
Medicare Part B is outpatient insurance. Timing this enrollment is very important because you do have to pay a monthly premium to be enrolled in Medicare Part B.
In 2022, most people have to pay $170.10 per month for Part B. The amount you pay for Part B is determined by your income. More info:https://www.cms.gov/newsroom/fact-sheets/2022-medicare-parts-b-premiums-and-deductibles2022-medicare-part-d-income-related-monthly-adjustment
Because of this monthly cost, you don’t want to enroll in Medicare Part B until you actually need Part B coverage.
For example, if you are going to continue working and be covered by a group employer health plan after you turn 65, you may want to delay enrolling in Medicare Part B. More information on that here:https://youtu.be/xghaDDt8qDE
Original Medicare Problem
One big issue with Medicare Parts A & B: There is no out-of-pocket spending limit with either Medicare Part A or Medicare Part B, so there’s no limit to how much you can end up spending on your medical care with the Part A and Part B deductibles, copays, and coinsurance.
Medicare Part C
Medicare Part C is also known as Medicare Advantage plans. Private insurance companies contract with Medicare and provide plans that will cover your Medicare Part A and Part B coverage.
Instead of having your care managed by Medicare itself, your claims are process and medical costs are covered by the independent health insurance company according to the plan’s contract.
Most Medicare Advantage plans provide coverage for things that Original Medicare doesn’t cover. Benefits vary by plan.
Most Medicare Advantage plans will also include Medicare Part D. Part D is prescription drug coverage. Those plans are known as MAPD plans. There are also some Medicare Advantage plans, known as MA only plans, that do not have the Part D drug coverage included.
MA only plans can be a great option for people who have creditable drug coverage available through another source, like an employer plan, a government program like the VA, or a state pharmaceutical assistance program.
Medicare Part D Standalone Plans
Medicare Part D also offers standalone prescription drug plans. The standalone plans are for people who want Medicare prescription drug coverage but don’t want an MAPD plan.
Like Part C, Medicare Part D plans are offered through private insurance companies that contract with Medicare. All of those plans have to be approved by Medicare before the insurance companies are allowed to offer them to the public.
Medicare Supplements/Medigap
Medicare Supplements are also known as Medigap plans, and they do just that: they fill in the gaps in coverage in Original Medicare to control your out-of-pocket spending.
Medicare Supplements have higher monthly premiums than Medicare Advantage plans, for the most part. But, depending on the particular Medicare Supplement plan letter you choose, there are very few extra costs to you through the year if you need medical care.
Your Options
The two major routes for Medicare coverage chosen by Medicare beneficiaries are either a Medicare Advantage plan that includes Part D drug coverage or Original Medicare plus a Medicare Supplement and a standalone Part D plan, possibly with an extra insurance policy to cover dental, vision, and hearing.
How to choose which is right for you: https://youtu.be/y_mxOGk7xH8
If you have Medicare Supplement questions, please feel free to give our office a call at 877-312-1414 or schedule a free, no obligation Medicare Plan Consultation.
We’re here to help you understand your options and find the best Medicare plan for you!
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