Decoding Medicare’s alphabet soup – brought to you by Easy Medicare Planning, LLC
The alphabet soup of Medicare Parts A, B, C & D, Medicare Gap Coverage, MAPD and PDP…. CONFUSING RIGHT?!
Hello, my name is Jeff Caron and I have been assisting seniors navigate the waters of Medicare for years and I want to thank you for stopping by. My company Easy Medicare Planning, LLC will be providing guidance and direction for you on Medicare.
There is no question that Medicare can be confusing and mistakes can certainly be costly; that is why we are offering you this benefit as part of the CityGate benefits program at no cost to you. My team and I pride ourselves on providing professional, consultative, unbiased advice and we are equipped to handle your needs throughout the country. Your Medicare plan is exactly that, yours. Our goal is to comprehensively review your situation and make recommendations based on you, your family and your needs.
I deeply appreciate the work you do for the Kingdom of God and the opportunity to serve you and your family in this way. I look forward to connecting with you.
(disclaimer-Please know the information on this site is general in nature and may not apply to your geographic location or your specific situation. We highly recommend a one on one conversation to be certain the information you receive is tailored to your situation)
Who – When – Where & How!
Medicare is the federal government program that provides health care coverage (health insurance) if you are 65+, under 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or under 65 and with End-Stage Renal Disease (ESRD). The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs Medicare.
The program is funded in part by Social Security and Medicare taxes you pay on your income, in part through premiums that people with Medicare pay, and in part by the federal budget.
Whether you’re new to Medicare, getting ready to turn 65, or preparing to retire, you’ll need to make several important decisions about your health coverage.
The two foundational parts of Medicare help cover specific services.
- Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Medicare Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
WHO: Who is eligible for Medicare benefits?
You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. There is a premium for Part B. In 2018, seniors with incomes below or at $85,000 will pay a $134 monthly premium and an annual deductible of $183.
Turning 65 is one way you become eligible for Medicare. You can also be under 65 and eligible for Medicare because you are receiving Social Security Disability Insurance, or SSDI. In most cases, you qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months.
Another way that you can become eligible for Medicare is if you are under 65 with End -Stage Renal Disease, also known as ESRD or kidney failure.
WHEN: When may I enroll in Medicare?
Myth: I am automatically enrolled in Medicare when I turn 65.
Fact: You are only automatically enrolled IF you elect to start receiving Social Security benefits or Railroad retirement benefits. If you are not receiving SS or RR retirement benefits and you are not disabled, you will need to initiate your enrollment into Medicare.
- When you are first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. (3 Mo’s before-the month of your 65th-and 3 Mo’s after)
- Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period.
If you’re covered under a GROUP HEALTH PLAN based on current employment, you have an SEP to sign up for Part A and/or Medicare Supplement/Advantage anytime as long as:
- You or your spouse (or family member if you’re disabled) is working.
- You’re covered by a group health plan through the employer or union based on that work.
Usually, you don’t pay a late enrollment penalty if you sign up during a SEP.
WHERE: Where do I enroll in Medicare?
You can enroll in Medicare Part A and/or Medicare Part B in the following ways:
- Online at www.SocialSecurity.gov.
- By calling Social Security at 1-800-772-1213 (TTY users 1-800-0778), Monday through Friday, from 7AM to 7PM.
- In-person at your local Social Security office.
HOW: Now that I am enrolled, HOW do I complete my coverage?
Medicare doesn’t cover everything and was never designed to. If you need certain services Medicare doesn’t cover, you’ll have to pay for them yourself unless:
- You have other insurance that covers them…typically a Medicare Supplement.
- You have a Medicare health plan that covers them…typically a Medicare Advantage plan.
We call this the 2 Paths to Medicare…we can help you determine which is the best fir for you.
Medicare = Parts + Plans!
Part A Hospital Insurance
Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B Medical Insurance
Covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Part C Health Plan
These plans include Parts A and B and usually include Part D. They are administered by Private Health Insurance Companies who are approved by Medicare.
Part D Prescription Drug Coverage
These plans are often referred to as Stand Alone Drug Plans designed to assist seniors with drug costs. They are administered by Private Health Insurance Companies who are approved by Medicare.
Medicare Supplement PLANS (also referred to as Medigap Plans) are designed to “fill in the gaps” on expenses Medicare typically does not cover. This chart in general identifies all plans available on the market. Most carriers do not carry every plan, and all plans are not available in all jurisdictions. If the supplement path is the correct path for you, we will help you understand the differences and make the best decision for you.