New to Medicare?

Are you or someone you know new to Medicare?  Becoming eligible for Medicare can make health insurance more affordable, but original Medicare alone doesn’t cover the full costs of medical services.  There are doctors’ visits, hospital stays, lab work, – not to mention the costs for outpatient prescription drugs or routine dental, vision and hearing care.  Insurance companies offer a range of plans to add benefits and limit your risk.  We help you choose coverage to reduce these expenses.

Overview of Original Medicare

Medicare Part A is hospital (inpatient) insurance.  You are entitled to Part A at age 65 with no monthly premium if you or your spouse have payed payroll taxes for at least ten years.  Part A covered services include inpatient prescriptions, post-hospital rehabilitation in a skilled nursing facility, and hospice care.

Medicare Part B is doctors (outpatient) insurance.  In 2019 the premium for Part B went up to $135.50 per month for new beneficiaries for those making $85,000 year or less. You may pay more, based on your income.  (See Table below) You are generally eligible to enroll for Part B to begin on the first of the month you turn 65.  Enrollment is typically automatic when premiums are to deducted from Social Security benefits.

If your yearly income in 2017  (for what you pay in 2019) was  


You pay each month (in 2019)

File individual tax return File joint tax return File married & separate tax return
$85,000 or less $170,000 or less $85,000 or less $135.50
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $189.60
above $107,000 up to $133,500 above $214,000 up to $267,000 Not applicable $270.00
above $133.500 up to $160,000 above $267,000 up to $320,000 Not applicable $352.29
above $160,000 above $320,000 above $85,000 $433.40

 

If you are not getting a Social Security check yet, you may need to call Social Security at 1-800-772-1213 or log onto www.socialsecurity.gov to activate Part B up to 3 months prior to your desired effective date.  You will not pay the late enrollment penalty if you delay Part B while you remain on a group health plan as an active employee.  As a retiree, however, you are generally expected to enroll in Part B even if you keep group coverage.  Significant costs with original Medicare alone include:

2019
Part A Deductible Part B Deductible Part B Coinsurance
$1364 per benefit period $185 20% – Unlimited
Benefit period resets 60 days from discharge Every Year Including outpatient surgery, chemotherapy or an MRI

Because of the unlimited financial exposure, (20% coinsurance with no cap), most seniors opt for additional coverage in the way of Supplements or Medicare Advantage Plans.  Medicare Parts A & B do not cover prescriptions, so a Part D plan is recommended as well. Many Medicare Advantage Plans include prescription coverage. Please call to discuss whether a Supplement or Advantage Plan is better for you.

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