This website was developed to help you understand your Medicare options.
We want to make sure that you are making informed decisions and with that knowledge our sincerest hope is that you will Love Your Medicare.
Love Your Medicare
Love Your Medicare
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B
A
Medicare Part A
Medicare Part A
For those turning 65 - Medicare Part A is offered from Social Security when you turn 65 and helps pay for inpatient hospitalization. It also offers some limited benefits for a skilled nursing facility or home healthcare after a hospital stay, as well as end of life hospice care. This is provided to almost everyone at no charge. If you don't have a Medicare Supplement or a Medicare Part C plan, you will be responsible for your deductible of $1,632 for each new benefit period (new hospitalization period).
If you are already collecting social security benefits then your Medicare red, white and blue medical insurance card will be mailed to you approx 100 days before your Medicare effective date, which is the 1st of the month that you turn 65 in. For example, if your DOB is 9/14/1956, your Medicare Part A effective date will be 9/1/2021. If you are not collecting social security you can go online to www.ssa.gov and sign up for Medicare Part A (and also part B if you wish), or you can call the SS office at 1-800-772-1213 M-F from 7am - 7pm. Click below for more details.
Medicare Part B
Medicare Part B
For those turning 65 - Medicare Part B is offered from Social Security when you turn 65 and helps pay for doctor visits and other medically necessary services including some preventive services and mental health services. There is a cost to have Medicare Part B and the cost depends on your household modified adjusted gross income, click on the cost button below. Medicare Part B has an annual deductible of $240 that is your responsibility before it will start to pay for services, and for most services it pays 80%, you pay 20% coinsurance with no cap on the 20%. For that reason, I recommend you pair it with either a Medicare supplement that will pay the 20% coinsurance or replace your traditional Medicare Part A & B with a Medicare Part C Medicare Advantage plan.
Just like with Part A, if you are already collecting social security you will be automatically sent your Medicare Red, White and Blue medical insurance card approx 100 days before your Medicare effective date, and if you still have insurance from your employer you can opt out of Part B if you wish. If you are not collecting social security you can go online to ssa.gov and sign up for Medicare Part A & B, or you can call the social security office at 1-800-772-1213 M-F from 7am - 7pm.
Important Note - If you opt out of Medicare Part B, and do not have other health insurance, you can be penalized for not taking it if you try to enroll later in life. Also note that if you are receiving a tax credit on healthcare.gov for your health insurance this tax credit will end if you are eligible for Medicare. Click below for more details.
Medicare Part C
Medicare Part C
Once you have Medicare Part A & B, you can opt to have a Medicare Part C plan instead of original Medicare Part A & B. This is known as a Medicare Advantage Plan and is offered by a private insurance company of your choice (for example, Aetna, United Healthcare, Humana, etc.). Medicare requires that these plans must offer benefits to you that are at least as good as Medicare benefits, but due to the competitive arena, these plans often have benefits that exceed those offered by Medicare. For example, Medicare Advantage plans typically include a Medicare Part D prescription drug plan. They often include some dental, vision and hearing aid coverage as well as many other ancillary benefits that aren’t available with original Medicare. An important feature of a Medicare Advantage Plan is that it offers a max out of pocket, which means you have the security of knowing up front what is the maximum you might have to spend in a given year for approved medical expenses before the plan will pay 100% for the remainder of the year.
In addition, most Medicare Advantage Plans do not have a deductible, rather you pay affordable copays for almost all services. They often do not cost anything, or a very affordable premium, however you will continue to pay social security for your Medicare Part B and Medicare will pay the Medicare Advantage Plan. It is also possible for you to add a hospital indemnity plan to help pay for out of pocket copays and coinsurance.
We recommend that you have an agent review both Medicare Advantage Plans and Medicare Supplements with you so you fully understand the differences and can make an informed decision on which type of Medicare insurance product is best for you and your personal situation. Click below for more details.
What are the Parts of Medicare?
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SUPP
Medicare Part D
Medicare Part D
Medicare Part D is a Medicare Prescription drug plan that Medicare partially subsidizes, and you partially subsidize. The cost of your Medicare Part D plan is based on your household income and the plan that you choose, which is available from several companies (Aetna, Humana, Wellcare, United Healthcare and many others). Also note that if you choose a Medicare Part C, Advantage Plan, these typically have a Medicare Part D drug plan embedded in the plan so you would not purchase it separately if this was the case.
If you choose to stay on Original Medicare Part A & B, we recommend that you should review a supplement, and a separate Medicare Part D drug plan.
Your health insurance agent should help you choose a drug plan based on your specific medications and your preference for drug stores. Note that you can change your drug plan every year during Medicare open enrollment (Oct 15 - Dec 7).
Important Note - If you opt out of Medicare Part D drug plan, and do not have another drug plan with benefits at least as good as Medicare's, you can be penalized for not taking it if you try to enroll later in life. Click below for more details.
Medicare Supplements
Medicare Supplements
A Medicare supplement is designed to pay what Medicare does not when you have Original Medicare Part A & B. Medicare designs the supplement plans, and all companies have to pay the same. So if you have a Medicare supplement Plan A, it will pay the same regardless of who you buy it from. If you have a Medicare Supplement Plan G it will pay the same regardless of who you buy it from. Medicare is primary, Medicare decides what is a medically necessary expense, and they approve that expense, pay the Medicare portion, and the Medicare supplement pays the remainder at the rate of the supplement plan that you purchased. The supplement company coordinates benefits with Medicare so you don't have to.
The most full featured Medicare supplement plan that is available for people who turned 65 after Jan 1, 2020, is a Medicare supplement Plan G, and this is the most popular plan as well. If you purchase a Medicare supplement Plan G, you are responsible for the Medicare Part B deductible of $240 per year, but after that it pays 100% of Medicare approved medical bills for the remainder of the year. So it provides tremendous piece of mind. However, you pay a premium every month for a Medicare supplement, in addition to your Medicare Part B premium. You will also need a separate drug plan since supplements do not include a drug plan. So the cost is quite a bit more costly than most Medicare Advantage Plans.
We recommend you ask an agent to quote both a Medicare Advantage Plan and a Medicare Supplement so you can make an informed decision on what is the best plan for your personal situation.
Click the More button below to see a list of all Medicare Plan types and what they pay.
Advantage or Supplement?
Advantage or Supplement?
The question we get asked the most is should you get an Advantage plan or a Medicare supplement.
Think of it this way - with a Medicare Supplement you pay into it each month, regardless if you use the services. You do so to have the peace of mind that you won't have a year with some large surprise bills.
With a Medicare Advantage Plan, you typically don't have a monthly premium (but you must continue to pay for your Medicare Part B), however, you will also have copays or coinsurance for most services. You pay the copays and coinsurance until you reach your max out of pocket each year. Some people are very comfortable with this, others are more comfortable with the security of the supplement.
It is a personal decision, but we are here to not only make sure you are making the best personal decision for your health and finances, but also we will review this each year with you to make sure you are comfortable long term as well.
Please note that agents are paid a commission if we assist you with signing up for Medicare health insurance plans, but there is never a cost to you for that. Medicare requires the insurance company pay the commission, not you! Find a knowledgeable agent (preferrably from Jo Elworth Insurance), that is committed to helping you year after year, not just once and done!