What is Medicare?
Medicare is a health insurance program run by the federal government. It provides care for people age 65 and over, as well as some younger people who qualify due to special circumstances.
How to Qualify for Medicare
You qualify for Medicare if you are a United States citizen or permanent legal resident and you or your spouse have earned enough working credits to qualify for Social Security.
Parts of Medicare
Medicare coverage consists of 4 different parts: A, B, C, and D. There is a simple breakdown of each of these parts below, as well as a breakdown of what Medical Supplement Insurance is.
Part A is available at no premium to those that quality. It covers hospitalization, post-hospital skilled nursing care, home health care, and hospice care. However, only semi-private rooms are covered under these provisions.
The amount that Original Medicare will cover depends on the length of your stay. There is a $1,260.00 deductible that you must reach first, then during Days 1-60, you have no co-insurance that you are responsible for. From Days 61-90 you must pay a $315 co-insurance per day. After that, you have 60 “lifetime reserve days” that you may use. There is a $630 co-insurance per day for each lifetime reserve day you use. After you have used all 60 of those days you are responsible for 100% of the costs.
Part B is an optional part of Original Medicare that covers doctor’s services. You can initially enroll during a 7-month period that begins 3 months before your 65th birthday and ends 3 months after your 65th birthday. If you choose not to enroll during this time there is an annual Part B enrollment period that runs from January 1- March 31.
Unlike Part A, Part B has a monthly premium that is determined by your annual income. The average premium is $147 per month. Even though Part B is optional, you need to be aware that if you enroll later than your initial enrollment period you will be subject to penalties. In addition to the premium, you will also have to pay a 20% co-insurance for all services received.
Part C refers to Medicare Advantage Plans from Private Insurance Companies. These plans are available to help cover gaps in the coverage of Parts A and B. These plans are usually HMOs. Many of these plans include prescription drug coverage.
You will still have to pay your Part B premium if you choose one of these plans, however, there are monthly plan premiums as low as $0.
Benefits provided by the plans vary widely and differ according to your location. Wealth Guardian Financial has trained professionals licensed to help you find a plan that best suits your needs.
Part D Prescription Drug Plan
Part D Prescription Drug Plan refers to prescription drug coverage through private insurance companies. Even though it is optional, it is like Part B in that you will receive a penalty for acquiring it after your initial enrollment period. However, if you had qualified prescription coverage from another source, you would not be subject to the penalty.
Medicare Supplement Insurance (or Medi-Gap)
Medi-Gap is another type of coverage from Private Insurance companies to cover the gaps in Original Medicare. This coverage cannot be used in conjunction with a Part C plan.
The federal government has outlined 10 standardized Medi-Gap plans that are identified by a letter of the alphabet. Each insurance company may offer any of the 10 plans and they all must include the same benefits, the only difference to you should be the price.
How Wealth Guardian Financial Can Help
At Wealth Guardian Financial our goal is to help educate you so you are able to make an informed decision. We want to help you find one that fits your needs and your price range. Meet with one of our qualified insurance agents today to get started.
Disclaimer: Medicare has neither reviewed nor endorsed this information.
When Can You Elect New Medicare Benefits? The Medicare Annual Election Period, or AEP, happens each year. It starts on October 15th and ends on December 7th. During this time, you have the chance to change your Part C or Part D coverage. To prepare you for this Annual Election Period we have compiled a list of 5 things every Medicare Beneficiary should know about AEP. 1. The Annual Election Period is Not the [...]
Medicare Misconceptions Medicare misconceptions are dangerous. They can wreak havoc on your retirement and financial plan. This article clears up three common Medicare misconceptions to help you navigate Medicare successfully. 1. Medicare is Free Medicare Part A is free of premium for most people. But Part B has a monthly premium. In 2021, this premium starts at $144.60 a month. In addition to this premium, you are also responsible for deductibles and co-insurance. For [...]