Medicare Part A
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Medicare Part A, also known as hospital insurance, typically covers expenses related to inpatient hospital stays, hospice care, skilled nursing care, and some home healthcare services. In addition, there are usually out-of-pocket costs, such as deductibles, coinsurance, and copayments, associated with this coverage.
Medicare Part A is insurance for individuals 65 years or older or those with a disability or end-stage renal disease (ESRD). It is also known as "hospital insurance" and helps cover the costs of inpatient hospital stays, hospice care, and some home health care services.
Medicare Part A covers the following services:
- Inpatient hospital care: This is care received after you are formally admitted into a hospital by a physician. A general hospital stay of up to 90 days throughout each benefit period is covered, in addition to 60 lifetime reserve days. Medicare also includes up to 190 lifetime days in a Medicare-certified psychiatric hospital.
- Skilled nursing facility (SNF) care: Medicare pays for lodging, food, and services offered in a skilled nursing facility, such as medication management, tube feedings, and wound care. If you are eligible for coverage, you are protected for up to 100 days throughout each benefit period. To be eligible, you must require skilled nursing or therapy services and have at least three consecutive days as a hospital inpatient within 30 days of admission to the SNF.
- Home health care: Medicare will pay for those services if you are confined to your home and require skilled care. Your insurance covers up to 100 days of daily care or an infinite number of intermittent care sessions. You must have been a hospital inpatient for at least three consecutive days within 14 days of obtaining home health care to be eligible for Part A payment. (Note: If you don't fit the criteria for Part A coverage, you can still receive home health care under Medicare Part B.)
- Hospice care: This is the care you may elect to receive if a provider determines you are terminally ill. You are covered as long as your provider verifies that you require care.
You may be eligible for Medicare Part A if you are 65 years or older and a citizen or permanent resident of the United States.
Medicare Part A eligibility requirements for people under 65 years of age include those collecting Social Security Insurance (SSI) or Railroad Retirement Board (RRB) for 24 months due to a disability.
Additionally, there are specific guidelines for those under age 65 who suffer from either end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). The first month after becoming eligible for SSI benefits, people with ALS can start receiving Medicare Part A.
Coverage will also kick in during the month of a kidney transplant or earlier if a person requires hospitalization two months before a kidney transplant to prepare for the procedure.
It might be time to switch insurers whenever your existing insurer's service doesn't meet your needs. For example, it might be time to consider other options if you have poor claims experience or an unexplained rate increase.
If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.
Contact us today to help you with multiple options to choose from.
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Medicare Part B
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Unlock a world of medical coverage with Medicare Part B - from doctor visits to diagnostic tests; it's the key to maintaining your health and well-being.
Medicare Part B, also known as medical insurance, is a component of Original Medicare and covers medically necessary services and supplies for treating an individual's health condition. This includes doctor visits, lab tests, diagnostic screenings, medical equipment, ambulance transportation, and other outpatient services.
The federal government set the Part B monthly premium of $170 in 2022. However, it may be higher if your income is more than $88,000.
A yearly deductible will also apply to you; it is $203 for 2022. Additionally, you will be responsible for 20% of the cost of all outpatient services, including doctor visits. The monthly fee will be taken from your monthly benefit if you receive Social Security.
Can I delay enrolling in Medicare Part B?
Some people may get Medicare Part A "premium-free." Still, most people have to pay a monthly premium for Medicare Part B. Because Medicare Part B comes with a monthly premium, some people may choose not to sign up during their initial enrollment period if they are currently covered under an employer group plan (either their own or through their spouse's employer).
If you are still working, you should check with your health benefits administrator to see how your insurance would work with Medicare.
Suppose you delay enrollment in Medicare Part B because you already have current employer health coverage. You can sign up later during a Special Enrollment Period without paying a late penalty. You can enroll in Medicare Part B at any time you are still covered by a group plan based on current employment. After your employer's health coverage ends or your employment ends (whichever comes first), you have an eight-month special enrollment period to sign up for Part B without a late penalty.
Remember that retiree coverage and COBRA are not considered health coverage based on current employment and would not qualify you for a special enrollment period. If you have COBRA after your employer coverage ends, you should not wait until your COBRA coverage ends to sign up for Medicare Part B. Your eight-month Part B special enrollment period begins immediately after your current employment or group plan ends (whichever comes first). This is regardless of whether you get COBRA.
What services are not covered by Part B?
Part B only covers some services. You'll need to pay for them out of pocket. Some examples of these include:
- Routine physical examinations
- cosmetic surgery
- Dental care, including dentures
- Vision care, including eyeglasses or contact lenses
- Hearing aids
- Alternative health services like acupuncture and massage
- Long-term care
- Most prescription drugs
When can I apply?
- Initial enrollment period: Around the time you turn 65, you have a 7-month opportunity to enroll in Medicare. It starts three months before your birth month, includes your birthday month, and lasts for three months following. You are not charged a fee to sign up for any aspect of Medicare during this time.
- Open enrollment period (October 15–December 7). You can move from original Medicare (parts A and B) to Part C (Medicare Advantage) or vice versa. You can also add, withdraw, or modify a Part D plan. You can also swap Part C plans.
- General enrollment period (January 1–March 31): If you didn't sign up for Medicare during your original enrollment period, you could do so now.
- Special enrollment period: You can re-enroll in Medicare later during a special enrollment period if you postpone signing up for it for a valid reason. After your coverage expires or work ends, you have eight months to enroll without incurring fees.
- Medicare is not easy to understand, and you need to consider many factors before finalizing which is the right fit for you. Our experts can help guide you. Talk to us today to know more.
It might be time to switch insurers whenever your existing insurer's service doesn't meet your needs. For example, it might be time to consider other options if you have poor claims experience or an unexplained rate increase.
If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.
Contact us today to help you with multiple options to choose from.
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Medicare Part C
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Medicare Advantage (Medicare Part C) is the private health insurance alternative to the federally run original Medicare. Consider Advantage as an all-in-one Medicare plan that integrates several aspects of Medicare.
Another option for getting your Medicare Part A and Part B coverage is through Medicare Advantage Plans. Medicare-approved private businesses that are required to abide by the restrictions established by Medicare offer Medicare Advantage Plans, often known as "Part C" or "MA Plans."
You must enroll in Parts A and B and pay the Part B payment even if you choose a Medicare Advantage (or MA) plan. You must also select a Medicare Advantage plan and join a private insurance company.
Most Medicare Advantage Plans cover prescription drugs (Part D). Read the plan descriptions carefully because not all of these insurance policies include the same supplementary benefits.
You qualify for Medicare Advantage Plan (Medicare Part C) if you already have Medicare Part A and B and if you live in the service area of the Medicare Part C provider you are considering.
In 2021, people with end-stage renal disease (ESRD) were eligible to enroll in a broader range of Medicare Advantage plans due to a law passed by Congress.
The cost of a Medicare Advantage Plan plan will depend on a variety of factors. The most common costs within your plan will be:
- Your Part B monthly premium, which may be covered by your Part C plan
- Your Medicare Part C costs, which include a deductible and monthly premiums
- Your out-of-pocket costs, which include co-payments and coinsurance
It might be time to switch insurers whenever your existing insurer's service doesn't meet your needs. For example, it might be time to consider other options if you have poor claims experience or an unexplained rate increase.
If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.
Contact us today to help you with multiple options to choose from.
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Medicare Part D
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Medicare Subset D is a prescription drug benefit program available to those 65 and older, some younger people with disabilities, and those with end-stage renal illness as a part of the more extensive Medicare government health insurance program. Anyone with Medicare can get Part D, an optional benefit handled by commercial insurance firms.
Medicare Part D is an entirely voluntary outpatient prescription drug benefit for Medicare recipients offered through commercial companies with federal government approval. A Medicare Advantage prescription drug plan (MA-PD), primarily an HMO or a PPO, covers all Medicare benefits, including prescription medications, or a stand-alone prescription drug plan (PDP) to augment regular Medicare. Of the more than 60 million individuals insured by Medicare in 2020, 46 million are enrolled in Part D programs.
Both Medicare Advantage and Part D provide coverage for prescription medications. A part of the more extensive Medicare, a federal health insurance program, is Medicare Part D.
Even though Medicare covers many medical procedures, Part D is dedicated to lowering prescription costs for Americans 65 and older.
Medicare Part D is often elective for those who currently have Medicare coverage. However, if you want to do so, you will be responsible for paying the exact costs associated with regular insurance plans, including monthly premiums, yearly deductibles, and copays. In return, you receive more prescription medication coverage than what is already provided by the general Medicare program. For this reason, it’s up to you to choose whether subscribing to Medicare Part D makes economic sense, given your health needs and financial circumstances.
You’ll make these payments throughout the year in a Medicare drug plan:
- Premium
- Costs if you get Extra Help
- Costs if you pay a late enrollment penalty
- Yearly deductible
- Copayments or coinsurance
- Costs in the coverage gap
It might be time to switch insurers whenever your existing insurer's service doesn't meet your needs. For example, it might be time to consider other options if you have poor claims experience or an unexplained rate increase.
If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.
Contact us today to help you with multiple options to choose from.
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Medicare Supplement Insurance
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You can get supplemental coverage if you have trouble paying for out-of-pocket Medicare expenses. However, Medicare can be confusing with the various options it has. Contact us today for any questions about Medicare and its options.
Medicare is a federal health insurance program aimed at retirement-age Americans. It helps make health coverage more affordable and less costly than private health insurance. Many people even get part of it premium-free. However, Medicare beneficiaries still have to pay for some health care costs — like deductibles and coinsurance — on their own. Medicare Supplement Insurance, also known as a Medigap plan, can help cover these expenses.
Medicare Supplement Insurance plans help people enrolled in Original Medicare pay out-of-pocket health insurance expenses, like copays, coinsurance, and deductibles. Original Medicare is comprised of Medicare Part A and Medicare Part B.
Part A is insurance for hospital care, and Part B covers doctor and outpatient insurance. You cannot get a Medicare Supplement policy if enrolled in Medicare Part C, a private alternative to Original Medicare.
Your specific coverage varies depending on what Medicare supplement plan you buy. Ten standardized Medigap plans are identified in most states by letters: A, B, C, D, F, G, K, L, M, and N. (Massachusetts, Minnesota, and Wisconsin standardize their Medicare Supplement plans differently.)
They help people pay for their share of the costs of health care services covered by Medicare. Those costs include:
A set amount is called a deductible you pay before Medicare starts paying. Medicare has two deductibles:
One for Part A, which covers hospital services, and
One for Part B, which covers medical services.
Hospital expenses are applied after you meet your Part A deductible. Medicare pays your expenses for the first 60 days you’re in the hospital.
A portion of the cost of most services after you meet your Part B deductible. Medicare pays 80 percent of your expenses. You pay the other 20 percent.
With most Medicare supplement plans, you can go to any doctor or hospital that accepts Medicare. You’ll give them your Medicare card and your supplement plan ID card.
Original Medicare will pay its share. Your supplement plan will pay your share of the costs, depending on what the plan covers. It may also coordinate payment with Medicare and your health care providers. That means you won’t have to bother with claim filing or paperwork.
Medicare and the options around it can get confusing. So connect with us today if you have any questions about Medicare and Medicare Supplement Insurance.
It might be time to switch insurers whenever your existing insurer's service doesn't meet your needs. For example, it might be time to consider other options if you have poor claims experience or an unexplained rate increase.
If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.
Contact us today to help you with multiple options to choose from.
Request a Quote
Get personalized Medicare Supplement Insurance
