What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
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Original Medicare FAQ
Who is eligible for Original Medicare?
To be eligible, you must be turning or have already turned 65 years old, and have paid federal taxes for at least 10 of your working years. Those under 65 may qualify if they have a disability.
When can I enroll?
You can enroll in Original Medicare during the Initial Enrollment Period. The Initial Enrollment Period is the 7 months surrounding your 65th birthday (3 months before, the month of, and 3 months after your birthday).
If you miss the Initial Enrollment Period, you can sign up during the General Enrollment Period, which is between January 1st and March 31st. Unfortunately, you have to wait until July 1st for your coverage to begin. Additionally, you could pay higher premiums when you purchase supplemental coverage from a private insurer.
If you or your spouse are currently over 65 and have health coverage through your employer, you can get Original Medicare during the Special Enrollment Period. The Special Enrollment Period will begin once your employer-based coverage expires.
How much does it cost?
For Part A, or hospital care, most pay $0 if they have paid Medicare taxes for at least 40 quarters. If you buy Part A, you'll pay up to $437 each month. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $437. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $240.
+ $1,364 deductible for each benefit period
+ Days 1-60: $0 coinsurance for each benefit period
+ Days 61-90: $341 coinsurance per day of each benefit period
+ Days 91 and beyond: $682 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
+ Beyond lifetime reserve days: all costs
For Part B, or doctor's office care, most pay about $135.50 per month or higher depending on your income. However, most people who get Social Security benefits will pay less than this amount ($109 on average).
The deductible is $185 each year. When using doctor's-office-related services, you will have to pay 20% of costs out-of-pocket.
Learn more about Original Medicare here.
How do I enroll?
You can apply online at socialsecurity.gov, on the phone at 1-800-772-1213, or visit your local Social Security office.
IMPORTANT
Original Medicare only pays for a fraction of your health care. Many, especially those with medical conditions, are financially burdened by out-of-pocket costs, including deductibles and co-pays. Original Medicare also provides very little prescription drug coverage. It is recommended you purchase a Medigap or Medicare Advantage Plan, along with a Medicare Prescription Drug Plan, to protect you from mounting medical expenses.
Medicare Supplements
Why enroll in Medicare Supplemental?
With Original Medicare it doesn't cover all services at 100% so there will be "gaps" that need to be filled. Supplementing your coverage with a Medicare Supplement Plan can reduce the amount you pay out-of-pocket when using the benefits.
Some Medigap Plans also provide you with additional coverage, such as emergency health care when you are travelling internationally, and nursing-facility care that may not be covered under Original Medicare.
Who is eligible?
To be eligible, you must be enrolled in Original Medicare Parts A & B.
How much does it cost?
Medigap policies monthly premiums are paid by you as Medicare doesn't pay any of the costs for a Medigap policy. Insurance companies decide how they will price the plans. They can be priced or "rated" in 3 ways:
+ Community-rated (also called “no age-rated”)
+ Issue-age-rated (also called “entry age-rated”)
+ Attained-age-rated
* Disclaimer: The cited source is not endorsed by Medicare. It is an independent publication. Data is used for illustration purposes only. The relationship between a plan provider and the source of information is not established on this website.
When can I enroll?
You must enroll during the Medigap Enrollment Period which begins 6 months after you turn 65. Remember, you must have Original Medicare to finish enrollment.
If you miss the Medigap Enrollment Period, you can still get a plan. However, insurers are not required by law to accept your enrollment as when you are first eligible, and can deny you coverage based on preexisting conditions.
How do I enroll?
To begin, just enter your contact information. We help figure out your eligibility. You can also call 954-256-5356 to speak to an agent.
Medigap, also known as Medicare Supplemental Insurance, is offered by private insurance companies to fill the health care coverage "gaps" left open by Original Medicare. There are 10 types of Medigap Plans. They are Plans A, B, C, D, F, G, K, L, M and N. Not every insurer offers all 10 plans, and prices can vary, but the benefit coverage is the same across companies as they are standardized plans.
Medicare Advantage (Part C)
Why get Medicare Advantage?
Most find Original Medicare does not provide enough coverage. Medicare Advantage Plans can greatly reduce the amount you pay out-of-pocket when using medical services. Many plans also provide prescription drug benefits, or coverage that is lacking with Original Medicare.
Am I eligible?
If you are eligible for Original Medicare Parts A & B, then you will be eligible for Medicare Advantage Plan.
When can I enroll?
There are three enrollment periods for Medicare Advantage.
First is the Initial Enrollment Period which is around your 65th birthday (or younger if you are disabled). Specifically, the Initial Enrollment Period is the 7 month period surrounding your 65th birthday -- 3 months before, the month of, and 3 months after your birthday.
Second, is during the Open Enrollment Period. This year's Open Enrollment Period begins on October 15 and ends on December 7. If you already have a plan, but would like a new one, this is also the time where you are permitted to change plans.
And third, is during the Special Enrollment Period. The Special Enrollment Period is only open to those who recently had a major life change, such as if you recently moved or lost health coverage.
Since Special Enrollment is limited, it is important that you do not miss the Initial or Open Enrollment Periods. Your coverage can be greatly delayed and you could face a penalty for not having coverage.
How much does it cost?
Monthly premiums for Medicare Advantage Plans greatly vary based on the plan you choose and the state you live in. Some plans cost $0 per month, others much more. It just depends on the plan that you choose.
How do I enroll?
You will generally reach out to your local Medicare certified agent or Insurance carrier to enroll. To begin, just enter your information and tell us about yourself. You can also call 954-256-5356 to speak to an agent.
Medicare Advantage Plans (also known as Medicare Part C) enable you to receive the same Original Medicare benefits through private insurers, along with the additional medical benefits that Original Medicare does not provide. These include coverage for out-of-pocket expenses including deductibles and co-pays.
Medicare Advantage Plans can also come with a Prescription Drug Plan (also known as Part D). Original Medicare provides very little coverage for prescription drugs.
What all of this means is that with Medicare Advantage, you can get hospitalization, doctor's office, and prescription drug coverage all conveniently under a single plan. The plans are HMO and PPO plans that are very similar to what you may have had previously through an employer.
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*Not connected with or endorsed by the United States government or the federal Medicare program.
Medicare has neither reviewed nor endorsed this information. This website and its contents are for informational purposes only.
