Everything You Wanted to Know About Medicare… But Maybe Didn’t Know to Ask / Genevieve E. George

08/01/2019 — Download

If you are about to turn 65, your healthcare coverage — at least your primary coverage — will be provided by the U.S. government through a plan called Medicare. The following Q&A answers many of the key questions about Medicare and explains some of the associated options.

WHEN CAN YOU APPLY?

Your initial enrollment period begins three months before you turn 65, includes the month of your 65th birthday and ends three months after you turn 65 (seven month period).

WHAT ARE THE PARTS?

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. Most individuals do not pay a monthly premium for Part A because they paid Medicare taxes while they were working.

Medicare Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies and preventive services. Everyone pays a monthly premium for Part B. The premium varies depending on your income and when you enroll in Part B. Most people will pay the standard premium amount of $135.50 in 2019.

Medicare Advantage Plan (Part C) is an “all in” monthly alternative to Original Medicare. This plan is offered by private companies approved by Medicare. If you join a Medicare Advantage plan, then you still have Medicare. These “bundled plans” include Part A and Part B and usually Medicare prescription drug Part D as well. You can enroll for this plan during your seven month initial enrollment period. Your coverage will begin according to the following table.

Medicare Prescription Drug Coverage (Part D) is an optional benefit for prescription drugs available to all people with Medicare for an additional charge. You enroll for this plan during your seven month initial enrollment period and your coverage will begin according to the following table.

Medicare Enrollment Chart

Medicare Supplemental Insurance (Medigap) policies help pay some of the health care costs that original Medicare does not cover, such as co-payments, co-insurance and deductibles. Some policies even cover medical care when you travel outside the U.S. These policies are sold by private companies. You must have Part A and Part B to qualify. They are NOT the same as Medicare Advantage (Part C). Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your original Medicare benefits.

HOW DO I SIGN UP FOR PARTS A AND B?

If you are not getting benefits from Social Security at least four months before turning 65, you’ll need to sign up with Social Security to get part A and Part B.

  • Apply online at Social Security Administration website: https://www.ssa.gov/benefits/medicare/. If you started your online application and have your re-entry number,you can go back to the website to finish your application. In most cases, the online application will take 10 minutes and there are no documents required or forms to sign. Social Security will process your application and contact you if they require additional information. Otherwise you will received your Medicare card in the mail.
  • Visit your local Social Security office.
  • Call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778).

HOW DO I SIGN UP FOR MEDICARE PRESCRIPTION DRUG COVERAGE (PART D)?

Consider using an agent to assist in your decisions for supplemental policies, especially if you have specific prescriptions or health needs. While this is an optional benefit, if you decide not to get Medicare drug coverage when you are first eligible, you’ll likely have to pay a late enrollment penalty if you buy it at a later date. You’ll not incur a penalty if you have prescription coverage under another policy. There are two ways to get this coverage: (1) choose a Medicare Part D plan, or (2) choose a Medicare Advantage Plan that offers drug coverage.

WHERE TO FIND A PART D POLICY

  • Visit the Medicare website to start your search. You can either search generically by your zip code or login for a tailored search.
  • Under the General Search, add your zip and select “find plans.”
  • Next page has three questions regarding your current Medicare coverage and drug preferences. Select “yes” to the question regarding drugs to see the prescription plans available.
  • From here, you can enter any medications you need your plan to consider.

HOW DO I SIGN UP FOR MEDICARE SUPPLEMENTAL INSURANCE (MEDIGAP)?

Consider using an agent to assist in your decisions for supplemental policies, especially if you have specific prescriptions or health needs. Supplemental plans range from type A to type N, with F currently being the most comprehensive. Some plans include the prescription coverage while others do not, so you may need Part D and Medigap. In addition, some plans, like type F, may offer high deductible options.

WHEN TO ENROLL

The best time to buy a Medigap policy is the six-month period that starts the first day of the month you’re 65 or older and enrolled in Part B. After this enrollment period, your option to buy a Medigap policy may be limited, and it may cost more.

WHERE TO FIND A MEDIGAP POLICY

  • Visit the Medicare website to start your search.You can either search generically by your zip code or login for a tailored search.
  • Under the General Search, add your zip and select “find plans.”
  • Next page has 3 questions regarding your current Medicare coverage and drug preferences.
  • From here, you can enter any medications you need your plan to consider.

OTHER ITEMS TO CONSIDER

Complete an authorization form if you would like your family or friends to call Medicare on your behalf. Medicare cannot give personal health information about you to anyone without this written permission on file.

The historical and current information contained in this document is a summary of information obtained from or prepared by other sources, including your account statements prepared by the custodian. It has not been independently verified, but was obtained from sources believed to be reliable. HBKS Wealth Advisors does not guarantee the accuracy of this information and does not assume liability for any errors in information obtained from or prepared by these other sources. The information included in this document is for general, informational purposes only. It does not contain any investment advice and does not address any individual facts and circumstances. As such, it cannot be relied on as providing any investment advice. HBKS® Wealth Advisors is not a legal or accounting firm, and does not render legal, accounting or tax advice. You should contact an attorney or CPA if you wish to receive legal, accounting or tax advice.


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