Understanding Medicare

Come your 65th birthday, and you’ll enter into a whole world of benefits, discounts and special deals. Whether you’re out to see a movie, looking for a meal or searching for insurance, you can be sure to find a specific deal just for you! Medicare is available to anyone 65 and older and who have worked full time while paying taxes for at least 40 quarters or the equivalent of 10 years. And while Medicare may be an unfamiliar topic to those approaching their golden years, here we have broken down and explained each part and every option available to you. Upon your eligibility for Medicare, do not hesitate to reach out for consultation in choosing the plan that is best for you.

What are the four parts of Medicare and what do they cover?

Medicare has four parts and two ways in which you can put your plan together. The first part, A, includes hospital coverage. Upon reaching retirement age, you will be automatically enrolled into part A, and it does not include a premium. Part B covers physician and outpatient medical care. Unlike A, you must select this option as this does include a premium, regardless of how much you’ve worked. This premium is a sliding scale, dependent on your income. You can find more info on this premium cost at Medicare.gov when you search for Plan B premium. In a nutshell, if you earn less than $85,000 a year in retirement or $170,000 as a couple, then your monthly premium for Part B in 2019 will be $135.50.

Understanding Medicare

Parts A and B do not cover everything, however. With these, you will still be responsible for paying for several other services. So, how can you supplement? One option is to opt for Part C which is referred to the Medicare Advantage Plan. This plan bundles together parts A, B and the fourth part of Medicare, Part D all into one package. This product is known as a Medicare HMO. If you decide to enroll in this plan, you’ll select a primary care physician who will direct your care and will refer you to any specialized care you might need.

The final option, besides the HMO, is a Medigap plan or a Medicare Supplement. This is a health insurance policy that you’ll buy from an insurance company with an additional premium. These vary quite drastically, typically ranging from $80-$150, depending on what coverage you require. The Medigap plan does not bundle in Part B which includes drug coverage. Therefore, you’ll have to buy drug coverage which generally costs anywhere from $12 to over $100 a month. This is all dependent on the type of coverage you need.

Understanding Medicare

So what’s best for me?

With so many options, it is often difficult to determine which plan is best for you. We suggest that you take a look at your budget as well as the sort of coverage you received before retirement. Consider what you can afford. For guidance, we suggest that those nearing age 65 on a fixed income and those that do not have a large income, opt for the Medicare Advantage Plan. This will require little out-of-pocket cost and no additional premium payment to the typical $135.50. For those with a higher income, which are used to a PPO health plan, Medigap or Medicare Supplement plan will be the best option. With this, you can expect to pay about $300 a month. This breaks down as: $135.50 + $145-150 for supplementary coverage + $20-30 for drug coverage. With any plan, you ought to refer to your income and health care needs. It is important that you enter into retirement with confidence in your health insurance plan.

As you approach 65, you will be presented with several options for health care coverage. Do not be overwhelmed however by the magnitude of this choice. There are simple ways to break down the decision and choose what is best for you. Please, give us a call with your questions and concerns. We’re here to assist you as you enter into the years of getting the best deals on just about everything!

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