Medicare

Who?  Anyone age 65 or older who has participated in Social Security, Railroad Retirement System or employees of Federal, State or Local Governments or who spouse has participated.

 Individuals under age 65 that have been awarded Social Security or Railroad Retirement Disability after 24 months.

 Those disabled due to ALS (Lou Gehrig’s Disease).

 Individuals with End Stage Renal Disease (ESRD).

What? Original Medicare (part A & part B) Medicare coverage requires copays, coinsurance and deductible payments that are the responsibility of the individual. Which is why you need to  get additional coverage.

 Medicare Advantage, Part C, healthcare coverage with a private insurance company. Premiums range from $0-100/mo. Typically, they include Part D in the plan. Plans vary from  county to county and may require you to use a network of providers.

 Medicare Supplement, commonly called "Medigap", healthcare coverage with a private insurance company. Acts as secondary to Original Medicare. Premiums vary greatly by plan  and also by county.

 Part D (stand-alone Prescription Drug Plans) each plan has a list of drugs, called a formulary, which tells you how the plan will cover each drug. Your prescriptions, including the  dosages, frequency taken, and even where you fill the prescription is THE BIGGEST driving force to what plan you will choose. The premiums vary by county. Each year the         formulary can change. If you don't review your PDP every year, chances are you're spending too much for your prescriptions!

When? Initial Enrollment Period (IEP) 7-month period when your turn 65 and first become eligible for Medicare. 

 Annual Enrollement Period (AEP) Oct 15-Dec 7^th the 1 time of year every senior can make a change to their plan for the next year. Coverage begins Jan 1

 Special Enrollment Periods (SEP) Dates are specific to the individuals situation. Most common SEP's occur when someone moves outside of the plans service area, or loss of        employer coverage due to a spouse or themselves retiring.

Where? Clients sign up for Medicare at SSA.gov, call 1-800-772-1213, or make an appointment at the local office. 

 When it's time to add additional coverage we can get together via Zoom, phone, my office, or your house.

Why?  People work with us for many reasons. The biggest reason is our knowledge and experience, 14+ years. A close 2^nd is that we're independent. What this means is, we are not beholden to one company over another, we find the right company and plan based on our clients need. We also do NOT charge for our time, we get compensated by the companies we decide to place the business with. We get paid the same whether we sell a $0 premium plan or the most expensive, so we will not try to upsell or over-insure you. We are big believers that you can spend your money better than the insurance companies can. The last major reason why clients decide to work with us is because we're local, not an 800 number, you'll see me in the grocery store or at the movies. My contact information is to my cell phone. 

FAQ: 

1. How much does Medicare cost?

 Typically, Part A, doesn't have a monthly cost. As long as you, or your spouse, paid into social security for 10+ years there's no premium, otherwise it could be as much as $506/mo.

 Part B has a standard premium for 2023 of $164.90. However, if your income in 2021, was above $97,000 individually or $194,000 married-filing jointly you will pay more for your part B premium, it could be as much as $560.50/mo.

2. What are the late enrollment penalties (LEP) I've heard about?

 If you do not sign up for Part B & D when you are first eligible, and you should have, you could face a LEP. LEP for part B is 10% for each 12-month period. i.e. You should have signed up last year, but didn't. Instead of paying $164.90/mo, you will pay an additional $16.49 (or 10%) every single month, for the rest of your life! 

 Part D LEP is 1% for every month you weren't enrolled and should have been!

3. I'm going to continue to work past 65, do I still need to sign up for Medicare?

 The short answer is, it depends on your situation. If you, or your spouse, will continue to work past 65 you need to make sure that Medicare considers your health coverage as creditable. If it's not creditable coverage and you sign up for Medicare 2 years later, you could face 20% LEP for part B and 24% for part D. You need to consult with a professional about your situation to see what your responsibilities are.

4. I don't take any prescriptions; I don't need to sign up for part D, right?

 Wrong. Even if you don't take any medications, you still should sign up for a part D plan to avoid LEP's down the road when you do need the coverage. There are inexpensive options, or it might even be included in your Medicare Advantage plan.
 

5. Do I have to have the same plan as my spouse/significant other?

 No. When we are working, we are used to being on the family or employee + spouse plan, where you do have to have the same exact coverage. That's a silly approach to your healthcare because you each have different health histories and risks, so you might have different needs too. When you age onto Medicare, it switches to individual coverage. You could have completely different coverage, or the same, depending on what each of you needs.