A look at Medicare: The Social Security (SS) system no longer automatically enrolls individuals in MediCare at 65!
Want to enroll at 65 or later when coming off an employer plan? First step - call the local SS office to meet with a retirement person.
Note: Surveys report errors when people call SS's 800#! Best to meet with a person.
The Local office may want to complete the enrollment over the phone when you call. However, asking for an in person appointment is important. Indicate you want to meet with someone to understand the options to pay your share of Part B.
Second step - call my Google Voice # today — (860) 451-9793 — there is no cost to meet to increase understanding. More than 50% of people, close to 65, are confused about MediCare! You can also send a Text. The meeting focus will be to simplify MediCare so your coverage selection is less stressful.
MediCare Part B:
80% of the amount MediCare approved for each outpatient service is paid to the provider! Thus, since so much treatment is outpatient today, its important to cover your 20% share by buying one of two types of Medicare Health Plans.
First: A Medicare Supplement: You can receive medical treatment from any provider in any state who accepts MediCare's payment.
Note: Supplements, which are purchased from a private company, are often called MediGap plans. Some points:
- Supplements have "lettered' names. A has the least coverage. B, C, etc. have more. Coverage in any plan, with the same letter, offered by any company is the same however, their monthly cost can vary considerably.
- Supplement N's cost from one company is over $100 a month lower than their full coverage F. Why? Because the person who enrolls pays Part B's deductible each year [$188 in 2017], a $20 co-pay for any office visits, and a $50 co-pay if any emergency room visits.
- 9 out of 10 people are happy with their Medicare Supplements.
What about prescriptions? Outpatient prescription medications are not covered by MediCare's Part A or Part B. Nor by Supplement Plans. Thus, to cover part of the cost of medications MediCare's Prescription Drug Plan (PDP) is available. A PDP is MediCare's Part D and enrolling is not optional even if you don't take any medications. Why? A penalty is applied for each month after 65 unless you have "credible" prescription coverage such as through an employer plan.
Second: A Medicare Advantage (MA) plan. Some points about MA plans, which are MediCare's Part C and purchased from private companies:
- They are available based on the County where you live. MA coverage is of interest to many since they include a full physical each year, more no cost to you preventive care, and at least the same benefits as original MediCare.
- You pay a co-pay or cost sharing for different types of medical treatment received through the companies network of providers. Your cost sharing over the year is capped by the plan's Maximum Out of Pocket (MOP) provision.
- Companies, which offer MA plans, have a yearly contract with MediCare and are paid a fixed monthly payment for each person who enrolls. Individuals also pay the company a monthly cost, which varies, based on the level of co-pays, cost sharing, and the plan's MOP.
- Most MA plans include a Part D plan for prescription expenses and are then a MAPD plan. Many MAPD options are more economical than a MediGap plan plus a Part D plan.
Another option to lower the monthly cost of your 20% risk protection plan is to select MediCare' High Deductible plan. ($2,200 in 2017) It's lower monthly cost and limited cost sharing, together with a separate Part D plan, results in your overall cost over the year being less than with a MAPD plan. This Supplement is only available from a few companies here in CT.
Call my Google Voice # today or send a Text — (860) 451-9793 — for a no cost discussion to take away the confusing parts and:
- Review some options and the value of a Medicare Supplement in Connecticut or Medicare Advantage in Connecticut plan.
- Review your interests and budget and select the best option for your situation.
Call my Google Voice # today or send a Text — (860) 451-9793 — to set up a time to talk.
Under 65 and Interested in coverage for a short time?
Short Term Medical (STM) plans are economical since they do not meet the requirements of a qualified health reform plan. They also do not cover any pre existing conditions. What can they do?
- Provide coverage for any unexpected medical situations during the couple months before a new employer plan begins.
You can view STM plans and costs on the Parker Agency page on HCC Medical Insurance Services. HCC is rated A+ (Superior) by A.M. Best.
You can look here for network providers.
Questions on short term plans? Send a note to - John@Parker.agency