Medicare Basics in 15 Minutes

 

Presented by Andrea Hicks
Recorded on August 26th, 2024

A very basic explanation of Medicare and a simple explanation about the differences between a Medicare Advantage Plan and a Medicare Supplemental Plan. Some details may have changed, please speak to a licensed insurance agent or visit medicare.gov for the most up to date information

Turning 65? Here's What You Need to Know:

1. Still Working?
If you’re turning 65 and still working, the first thing you should do is visit medicare.gov to sign up for Part A (hospital insurance). As long as you’ve worked for 40 quarters (about 10 years) and paid into Social Security, you’re entitled to Part A at no cost.

If you have group health coverage through work, sign up for Part A and stop there for now

2. Not Working?
If you’re not continuing to work and need Medicare, you’ll need to sign up for both Part A and Part B (medical insurance). In 2024, the premium for Part B is $174.70 per month. Once you have both, you’ll receive your Medicare card.

Medicare Options:
Once you’re enrolled, you have three main choices:

1. Original Medicare
This includes Part A and Part B.
You’ll have a deductible for hospital stays ($1,632 in 2024 for up to 60 days). If you’re readmitted after 60 days, you’ll pay another deductible. For medical services, you’ll pay an annual deductible ($240 in 2024) and 20% of the cost of services afterward.

2. Medicare Advantage (Part C)
Combines Parts A, B, and D (prescription drugs) into one plan offered by private insurance companies. Often includes extra benefits like vision, dental, hearing, gym memberships, and over-the-counter items. You’ll still pay the Part B premium, but this plan simplifies coverage into one card.

3. Medicare Supplement (Medigap)
Medigap helps cover costs like deductibles and co-pays that Original Medicare doesn’t. Plans like G and N are popular choices. They offer the same coverage across insurers; only the premiums vary.

Medigap premiums increase with age and do not include prescription drug coverage, so you’ll need to enroll in a separate Part D plan.

Special Situations:
Dual Eligibility (Medicare + Medicaid):
If you qualify for Medicaid due to low income (less than $1,400/month in 2024), you can combine it with Medicare for full coverage, often at no cost.

Veterans:
Veterans should still consider enrolling in Part D for prescription drug coverage, even if they use VA benefits. Missing out can result in penalties.

Enrollment Periods:
1. Annual Election Period (AEP):
Runs from October 15 – December 7. During this time, you can review and change your Advantage or Part D plans.

2. Open Enrollment Period (OEP):
From January 1 – March 31, you can switch Advantage plans if needed (e.g., your doctor doesn’t accept your current plan).

Advantage vs. Medigap:
The decision often comes down to cost and preference: Advantage Plans: Lower monthly costs but include co-pays for services like hospital stays and MRIs. Medigap Plans: Higher monthly premiums but no co-pays for services.

Why Work with Me?
Navigating Medicare can be overwhelming. I offer free guidance to help you make the right choice for your situation. Whether or not you become my client, I’m here to answer your questions and make this process easier for you.