3 Key Steps to Start Medicare Right
1. Learn Medicare basics
Medicare can be feel like a maze
When does Medicare start?
For most people, their Medicare coverage will start the 1st of the month that you turn 65. But if your birthday is on the 1st of the month, then your Medicare coverage will start 1 month before you turn 65.
Here’s 2 examples:
- Your birthday is August 25th. Medicare will start August 1st.
- Your birthday is August 1st. Medicare will start July 1st.
What does Medicare cost?
Traditional Medicare is the combination of Medicare Part A and Medicare Part B.
Most people will pay $144.60 per month for this coverage in 2020.
What does Medicare cover?
Medicare covers you in the hospital as well as outpatient care. But it does NOT cover all of your bills 100%. There are some large gaps that you could have to pay like:
- Medicare Part A (Hospital) deductible $1,408
- Medicare Part B (Outpatient) deductible $198
- Medicare Part B (Outpatient) co-insurance 20% with NO limit (this includes doctor visits, outpatient surgery, chemo, etc.)
- Skilled nursing facility copays $176 each day for up to 80 days
- Plus a few others
2. Do you need to enroll in Medicare?
Are you receiving your Social Security or Railroad Retirement benefits before the age of 65?
If you answered yes, then you will be signed up automatically for Medicare. You will get your Medicare card in the mail about 3 months before you turn 65.
If you answered no, and you want to start Medicare at age 65 then you will need to sign up. You can do that once you are within 3 months of your 65th birthday using 1 of 3 ways:
- Online at https://www.ssa.gov/benefits/medicare/
- Call Social Security (even if you only want to start your Medicare benefits and not Social Security) on the phone at 1-800-772-1213
- In person at your local Social Security Office
If you are considering NOT starting Medicare, then you need to have other coverage in place. Email me at Mike@askMedicareMike.com if you are wondering if you should/can delay Medicare. I’ll be able to give you guidance based on your unique situation.
3.What are your options?
It can feel like there are 100 different options out there for Medicare coverage. But everything really falls into just 2 buckets.
Medicare Advantage or Medicare Supplements. Here’s some key points:
Option 1 Medicare Advantage
These plans replace how you get your Medicare benefits. Because an insurance company provides them for you instead of Medicare. Some of the pros and cons of this option are:
Networks.
These plans have networks so you can only see certain doctors and hospitals or the plan may not pay anything
Low or no premium plan.
Many Advantage plans don’t charge a monthly premium. You still pay your basic Medicare which I mentioned earlier for most people is $144.60 each month
Does NOT help pay what Medicare doesn’t pay.
Medicare Advantage plans do not help what pay what Medicare doesn’t. So you still have bills when you use the plan. This means when you have to see the doctor or use the plan for other reasons, you will have extra costs.
These could be copays for doctor visits, having to pay a deductible before anything is covered, or a percentage of the total cost of the treatment.
Maximum out of pocket.
Unlike Original Medicare, these plans do have a maximum limit. So if you have a really bad year and use your plan a lot, your costs do have a limit to your expenses. This limit varies by plan but can be up to $6,700 each year. If you reach that amount, the insurance company will pay 100% the rest of the calendar year.
All in 1 coverage.
These plans often include prescription drug coverage. They may also include vision and dental coverage
Option 2 Medicare Supplement + Prescription Drug Plan
With this option you stay on Original Medicare and add extra coverage to help fill in the gaps.
The extra coverage varies by how comprehensive you want it to be. But the most comprehensive Medicare supplement option is normally around an extra $100 – $120 per month. This can vary based on several factors including where you live, your gender, age, and tobacco use. But it gives you a ballpark idea of pricing.
Helps pay what Medicare doesn’t
Medicare supplements help pay what Medicare doesn’t pay by filling in some of the gaps. The most comprehensive Medicare supplement most people can buy will cover the hospital deductible, the hospital co-insurance, and the outpatient coinsurance.
So all you have to worry about is the outpatient deductible which is only $198 in 2020.
A la carte coverage
Going this route means that all of your coverage is a la carte. Which gives you the option of choosing the dental insurance you want, the drug plan you want, and the Medicare supplement plan you want.
So you can tailor coverage to exactly what you want instead of settling for something that has been bundled for you.
Flexibility
There are no networks with this option. So you can see any doctor or hospital nationwide.
Predictability
You pay an extra premium in addition to your base Medicare ($144.60/month). This gives you the predictability of knowing that if you need to use that coverage, you won’t see any large medical bills. Because the supplement is going to help pay what Medicare doesn’t pay for.
Limited time for you to get coverage guaranteed
When you first start Medicare, it’s the one time in your life that you are guaranteed to be approved from every Medicare supplement company.
If you choose an Advantage plan, and decide later that you want to pay the extra premium to upgrade to a Medicare supplement, you will need to go through an underwriting review. This means, based on your health history, you could be approved, approved but have to pay more, or declined for coverage.
So it’s important to make a good choice now.
Now what?
Now you know what your options are, it’s time to choose between Medicare Advantage and Medicare supplement. Then go shopping for the plan that offers you the most value based on your needs.
You can do that on your own. Or contact me and I can make it easy for you. I’m an independent Medicare insurance broker that has been licensed since 2009. I work with a bunch of different companies to help you shop for plans that fit your needs.
My services are 100% free. And there is no obligation. If we decide to work together, then the company you choose to enroll with compensates me. But they do not charge you one penny more for using me as a resource.
So call me at 855-712-7316 or fill out the form below. Your info will never be sold. So you won’t get those annoying telemarketer calls. You’ll only talk with me and I can make it easy for you so it will only take about 10 minutes.
Medicare Mike 