What is Medicare?
Medicare is a Federal health insurance program comprised of four parts: A, B, C, and D. Original Medicare is a fee-for-service health plans comprised of parts A (hospital insurance) and B (medical insurance). Medicare Advantage (Part C) plans are offered by private insurers and provide additional benefits and coverage. Medicare Part D covers prescription drug plans.
Who is eligible?
Individuals are eligible if they meet any of these criteria:
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People age 65 or older
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Certain individuals under age 65 with disabilities
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People of any age that have End Stage Renal Disease (Kidney failure that requires dialysis or a transplant)
When does my coverage start?
Medicare coverage may start on the first day of the month that you turn 65. For example, if your birthday is 07/15/1957, your Medicare coverage will start on 07/01/2022.
If your birthday falls on the first day of the month, your coverage will start one month before on the first. For example, if your birthday is 07/01/1957, your Medicare coverage will start on 06/01/2022. You may also delay your Medicare coverage and select a different start date.
When can I enroll?
If this is your first time enrolling in Medicare:
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The three (3) months before your turn age 65
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The month you turn 65
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The three (3) months after your turn 65
Example: If your birthday is 07/15/1957 and you turn 65 on 07/15/2022, you can enroll from April-October 2022.
Important: To avoid coverage gaps, we recommend enrolling in Medicare at least one month prior to the month that you turn age 65. If you wait until the month you turn 65 to enroll, your coverage may be delayed. Additionally, if you do not enroll in Medicare Part B when you are first eligible, you may be subject to a late enrollment penalty.
What does Medicare cover?
Medicare Part A covers:
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Inpatient hospital care
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Skilled nursing facility care
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Hospice care
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Home health care
Medicare Part B covers services from providers outside of the hospital such as:
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Outpatient doctor and other health care provider visits
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Outpatient care
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Home health care
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Durable medical equipment (DME) such as wheelchairs and walkers
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Preventive care such as screenings, vaccines, and imaging
Although Medicare pays for much, it does not cover all healthcare costs. We offer Medicare supplement insurance (Medigap) policies that can help you cover additional costs like copayments, coinsurance and deductibles.
How much does Medicare cost?
For most individuals, Medicare Part A is free ($0 premium) if they (or another qualifying person such as a current or former spouse) worked 40 quarters (10 years) and paid Medicare taxes. Medicare Part A (hospital coverage) includes a deductible of $1,556 (for 2022) that you must meet before it pays.
Medicare Part B (outpatient and DME) has a monthly premium that is based on your earnings. The standard premium for Medicare Part B in 2022 is $170.10/month. This monthly premium is paid even if you do not receive services. Medicare Part B includes a deductible of $233 per year (for 2022) that you must meet before it pays. Medicare Part B includes a 20% co-insurance. This means that you will pay 20% for Medicare-approved medical expenses after your deductible is met.
We offer additional plans such as Medigap that covers the costs and fees not covered by original Medicare (parts A and B). These plans can help bridge the 'gap' for services and fees not covered such as copayments, coinsurance and deductibles.