MEDICARE AND YOU

You probably never thought about Medicare until you started to get close to age 65. (Don’t worry, no one does!)

But making the right Medicare coverage choices might be among the most important decisions of your life.

What is Medicare?​

Medicare is the federal health insurance program for people who:
  • Are age 65 and older, or
  • Are younger than 65 but have specific disabilities, or
  • Have end-stage renal disease (permanent kidney failure require dialysis or a transplant)
Medicare parts A & B cover 80% of the cost of Medicare covered services. The remaining 20% is your responsibility. In the table below we have summarized your main options to receive coverage. Our team is here to help educate you on Medicare and answer your questions. Our service is free to you. Talk to a member of our team.
Medicare Part A

(Hospital Insurance)

PART A COVERS:

  • Hospital stays
  • Skilled nursing facilities
  • Hospice care
Medicare Part B

(Hospital Insurance)

PART B COVERS:

  • Doctor services
  • Outpatient care
  • Prevententive services
  • Medical supplies
Medicare Part D

(Prescription Drug Plans)

PART D COVERS:

  • Prescription Drugs not included in Part B
Medicare Part C

(Medicare Advantage)

PART C COVERS:

  • Everything covered by Part A & B
  • Additional benefits not covered by Medicare (may include Dental, Vision, and Hearing)
  • Typically included prescription drug coverage

Medicare timeline - when can I enroll?

Usually you should enroll in Medicare three months before your 65th birthday. You could also be entitled to special enrollment periods.

The signup period for Medicare begins three months before the month you turn 65, during the month of your 65th birthday and for three months after…a total of seven months.

If you are eligible to receive premium-free part A coverage you will be notified by mail 90 days before your 65th birthday. To receive part B coverage you have to apply for it.

If you apply for Social Security during this time period you will automatically be enrolled in Medicare parts A & B.

If you don’t enroll when you first become eligible, you may have to wait until later in the year and may incur a penalty. In some cases you can delay your part B enrollment without a late enrollment penalty. You might do this if:

  1. You are still covered by your Employer Group Plan
  2. You are still covered by your spouse’s Employer Group plan
  3. You have retiree coverage and your employer has more than 20 employees

 

Medicare plans are often more cost-effective than an employer group plan. You should consult with a licensed insurance agent, however, before deciding to either delay your part B enrollment or leave your employer’s group plan. We also recommend you speak with your Group Insurance Administrator to make sure there are no disadvantages to leaving your employer’s group plan.

For example, if you have non-Medicare eligible dependents on your employer group plan their coverage would be terminated along with yours and they would be left without coverage.

If you haven’t received your Medicare information by your enrollment period, contact the Social Security Administration directly. You can also visit their website to do so. We can also help answer your Medicare questions or guide you through the steps to get you Medicare coverage. Our service is free to you. Talk to a member of our team

What are my different Medicare options after turning 65?

You have two options to receive your Medicare coverage. Both require that you have Medicare Part A and Part B.

Original Medicare
Medicare Advantage
Original Medicare Parts A & B Original Medicare & Medicare Supplement PPO HMO
SUMMARY Covers 80% of Medicare Approved Services Fills gaps in Original Medicare Out of network benefits Predictable costs
PREMIUM ***ESTIMATED COST Monthly Part B premium (*$144.60) Monthly Part B premium (*$144.60) and cost for **Medigap Plan Monthly Part B premium (*$144.60) and plan premiums starting at **$0 Monthly Part B premium (*$144.60) and plan premiums starting at **$0
PRESCRIPTION DRUGS Not covered Requires a PDP at additional cost Typically included Typically included
NETWORK Providers that accept Medicare Assignment (no referrals) Providers that accept Medicare Assignment (no referrals) Provider network and out-of-network options at higher cost (no referrals) Must use provider network (referrals may be required)
ADDITIONAL BENEFITS None Limited Benefits Dental, Vision, Hearing, OTC, Gym, and more Dental, Vision, Hearing, OTC, Gym, and more
SUMMARY

Covers 80% of Medicare Approved Services

PREMIUM ESTIMATED COST

Monthly Part B premium (*$144.60)

PRESCRIPTION DRUGS

Not covered

NETWORK

Providers that accept Medicare Assignment (no referrals)

ADDITIONAL BENEFITS

None

SUMMARY

Fills gaps in Original Medicare

PREMIUM ESTIMATED COST

Monthly Part B premium (*$144.60) and cost for **Medigap Plan

PRESCRIPTION DRUGS

Requires a PDP at additional cost

NETWORK

Providers that accept Medicare Assignment (no referrals)

ADDITIONAL BENEFITS

Limited Benefits

SUMMARY

Out of network benefits

PREMIUM ESTIMATED COST

Monthly Part B premium (*$144.60) and plan premiums starting at **$0

PRESCRIPTION DRUGS

Typically included

NETWORK

Provider network and out-of-network options at higher cost (no referrals)

ADDITIONAL BENEFITS

Dental, Vision, Hearing, OTC, Gym, and more

SUMMARY

Predictable costs

PREMIUM ESTIMATED COST

Monthly Part B premium (*$144.60) and plan premiums starting at **$0

PRESCRIPTION DRUGS

Typically included

NETWORK

Must use provider network (referrals may be required)

ADDITIONAL BENEFITS

Dental, Vision, Hearing, OTC, Gym, and more

*2020 Part B monthly premium. This amount can be higher based on income.
**This is the monthly premium for the health coverage.
***These costs vary per plan. Speak to a Connie Advisor for details.

Learn more about Medicare

Visit our Medicare Resource Center which provides helpful articles on everything you need to know about Medicare.

Have questions? We're here to help!

Call us at 623-223-8884 (TTY: 711)