Medicare 101

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Medicare can be confusing. Generally, folks are on an employer plan or an individual policy for most of their lives. These policies offer everything needed in one plan, whereas Medicare requires a few different pieces to make sure you’re properly covered. Read on to learn when you should start thinking about Medicare and what parts matter the most.


What Is It?

Health insurance is one of the most expensive costs families take on each year, which is why everyone is waiting for the magic age of 65 - the age you can move to Medicare. However, this doesn’t mean you should wait until your 65th birthday to start planning your transition into Medicare. A year before you turn 65, you need to start thinking about your options as well as start discussing this transition with your employer and insurance agent.


To ensure you have a policy that offers adequate coverage, you’ll need a series of Parts to equal the coverage you had in the under 65 market. To get started, you apply for Part A and B and that process begins 3 months prior to your 65th birthday. 

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Part A

Part A of Medicare  is complimentary from the government if you have worked in the US for at least 10 years or been married to someone who has. It covers hospital visits and is free of charge, but it does not cover general doctor visits. That is where Part B comes into play.  


Part B

Unlike Part A, you have to buy into Part B. The cost per month is a variable rate based on your income level, and starts at $144 per month. Enrolling in Part B is crucial because it covers doctor visits.


Making Your Insurance Comprehensive

After you get A and B, you’ll receive a claim card from the government which allows you to add on additional components, like supplements or advantage plans, to enhance your insurance and give it the look and feel that you were used to.


Part D

Part D is medication coverage, and with a low cost starting around $13 per month, it’s worth it to ensure your current and future prescription needs are covered. Not to mention, if you don’t take Part D as part of your initial enrollment, you will be charged a fine if you decide to enroll later. The cost of Part D is so minimal it’s best to enroll upfront rather than paying the fine.


Supplements vs. Advantage Plans

Similar to the HMO and PPO plans that exist in the under 65 market, you have the option of a supplemental gap plan or advantage plan. Advantage plans closely resemble HMO plans as they do not offer much flexibility in choosing your healthcare providers, but the cost is lower, and often free. Advantage plans are Managed Care Organization (MCO) plans. Supplemental plans, on the other hand, offer much more flexibility (like a PPO plan) when it comes to your healthcare, and they start around $115 per month.


Medicare doesn’t have to be a confusing process. With the right guidance, you can make your healthcare coverage just as comprehensive as before and almost always more affordable than before. If you need help with your Medicare transition, contact us

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