Two Popular Medigap Plans Are Ending. Should You Enroll While You Can?

If you will soon turn 65 and be applying for Medicare, you should carefully consider which Medigap policy to enroll in because two of the most popular plans will be ending soon. In 2020, Medicare beneficiaries will no longer be able to enroll in Plans F and C.

Between copayments, deductibles, and coverage exclusions, Medicare does not cover all medical expenses. Offered by private insurers, Medigap (or “supplemental”) plans are designed to supplement and fill in the “gaps” in Medicare coverage. There are 10 Medigap plans currently being sold, identified by letters. Each plan package offers a different combination of benefits, allowing purchasers to choose the combination that is right for them.

Plans F and C are popular Medigap plans in part because they both offer coverage of the Medicare Part B deductible. Enrollees in Plans F and C do not have to pay the deductible. Plan F, the most comprehensive Medigap plan currently available, also pays for all doctor, test, and hospital fees. Plan C is similar, but it does not cover the excess fees that doctors charge over Medicare’s limits. According to the Kaiser Family Foundation, 53 percent of Medigap enrollees have either plan F or plan C.

As a result of legislation passed by Congress in 2015, starting in 2020 Medigap insurers will no longer be allowed to offer plans that cover the Medicare Part B deductible – in other words, Plans F and C. (“Critics argue that Plan F makes it too easy for people to go to the doctor without thinking twice about the cost,” observed the Chicago Tribune.) However, people currently enrolled in Plans F and C, as well as those who buy policies before 2020, may keep their F and C coverage for the rest of their lives.

Although his appears to offer an incentive to “lock in” these two comprehensive plans while you still can, before enrolling in Plans F or C new Medicare beneficiaries should consider the risk. While the plans are comprehensive, without new enrollees after 2020 experts warn that premiums may go up. As the enrollees in Plans F and C age and get sicker, the companies offering Plans F and C may experience more costs that won’t be offset by new younger, healthier enrollees. An alternative is Plan G, another comprehensive plan that does not cover the Part B deductible. But some experts believe that premiums will rise for this plan, too, as more beneficiaries in poor health enroll in it.

The choice of Medigap plan is important because once you choose one, it is difficult to switch. Medigap plans cannot consider pre-existing conditions when you enroll during the open enrollment period, which is a six-month period that begins on the first day of the month in which you are 65 or older and enrolled in Medicare Part B. But if you don’t enroll during the open enrollment period, there is no guarantee that the insurance company won’t charge you more for a pre-existing condition.

Before choosing a Medigap plan, you should weigh your need for comprehensive coverage with the risk of higher premiums. With the imminent phase-out of Plans F and C, it’s a tough choice and there are no easy answers. For more information from the Chicago Tribune about what the elimination of plans F and C means for consumers, click here.

Original Article:

Original Date: Dec 22 2017

Medicare Supplement rule amended for beneficiaries under age 65

BOISE, Idaho — The Idaho Department of Insurance would like to remind Medicare beneficiaries who are under the age of 65 that they are eligible for a six-month open enrollment period and may now purchase a Medicare Supplement (aka Medigap) policy as early as Jan. 1, 2018.

Medigap coverage can help pay some, or all, of the health care costs that original Medicare does not cover, such as copayments, coinsurance and deductibles. During an open enrollment period the beneficiary cannot be turned down for coverage. Beneficiaries under age 65 who already have a Medigap policy are also eligible for the open enrollment period and may change policies without underwriting or denial.

Although the Medicare Annual Election Period ended Dec. 7, the Medicare Advantage (MA) Disenrollment Period, which is Jan. 1 to Feb. 14, may be an option for those wishing to leave their Medicare Advantage plan and purchase a Medigap policy. During the MA Disenrollment period, eligible beneficiaries switching from an MA plan to original Medicare will also have an opportunity to purchase a Part D plan by Feb. 14.

The Department’s Senior Health Insurance Benefits Advisors (SHIBA) counselors are available to answer questions and provide information to all Idahoans who are eligible for Medicare coverage. Consumers are also encouraged to consult with a licensed insurance agent before purchasing coverage.

Original Source:

Original Author: Idaho Department of Insurance press release

Original Date: Jan 1 2018

Does Medicare Cover Nursing Homes?

Bad news: For the most part, no.

It’s estimated that 70% of seniors 65 and over will need some type of long-term care in their lifetime, and that includes nursing home stays. Now if you’re eligible for Medicare, you might assume that if you wind up in a nursing home, your costs will mostly be covered. But actually, that’s not true. Unfortunately, there are a lot of services traditional Medicare doesn’t cover, and nursing home care is one of them. If you really want to protect yourself from this potentially colossal expense, then you’ll need to consider investing in long-term care insurance.

What Medicare will cover

There’s a difference between needing a nursing service to assist you with a medical issue or recovery versus needing constant custodial care. Under Medicare Part A, you’re typically covered for care in a certified skilled nursing facility if that care is medically necessary. But that also assumes that your condition is expected to improve over time.

Man in scrubs tending to senior male with food in front of him


On the other hand, if your needs fall under the blanket of what’s known as custodial care, you typically won’t be eligible for coverage under Medicare. Custodial care refers to the things you need to do to function daily, like bathing and getting dressed. If that’s really the only type of care you need, then Medicare generally won’t pay for it. Rather, it’ll be on you to cover the cost of a nursing home, where you’ll get the assistance you need with all things related to daily living.

How much of an expense might you be looking at? Get ready, because it’s a hefty one. According to Genworth Financial, the average nursing home stay will run you $225 per day, or $82,125 per year, and that assumes you’re willing to bunk with a roommate. If you’re not, then prepare to pay even more — a private room costs $253 per day, or $92,345 per year, on average.

Fortunately, there is a way to defray the cost of an extended nursing home stay, and it’s to buy long-term care insurance. And the sooner you apply, the more affordable that insurance will be.

When to apply for long-term care insurance

If long-term care insurance were free or inexpensive, more people would no doubt have it. Unfortunately, it isn’t cheap. The average 60-year-old couple, for instance, pays a premium of roughly $3,400 per year. On the other hand, if you apply for a policy when you’re relatively young, and when your health is relatively strong, you’re more likely to not just get approved but snag a lifelong discount.

The American Association for Long-Term Care Insurance reports that more than half of applicants in their 50s qualify for health-based discounts on their premiums, but that number drops to 42% for applicants in their 60s and 24% for those in their 70s. The lesson here? If you’re thinking of getting long-term care insurance, don’t wait too long. Otherwise, be prepared to pay more.

Of course, even with insurance, you’ll still see your fair share of costs if you end up needing to live in a nursing home for several years. However, the financial blow will be far less significant.

What about Medigap?

Medigap, also known as Medicare Supplement Insurance, is designed to cover some of the costs Medicare itself won’t pay for. But if you’re thinking of getting Medigap to help defray the cost of a nursing home, think again — most plans don’t cover nursing homes.

So what can you do to protect yourself from the whopping cost of a nursing home in the absence of long-term care insurance? Save as much as you can during your working years so that you have more income available in retirement. If you start saving early on in your career and end up retiring with a few million dollars, the idea of spending $82,000 to $92,000 on a nursing home for three or four years may not be quite as daunting.

No matter what plans you make to account for the cost of long-term care, don’t make the mistake of assuming Medicare will pay for it. In fact, you should familiarize yourself with all of the services Medicare does and doesn’t cover. This way, you’ll know how to save appropriately and avoid surprises when you’re older.

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Original Source:

Original Author: Maurie Backman

Original Date: Dec 13 2017


Medicare and the Medicare advantage enrollment periods are over

Your time is up as of Dec. 7 to get a new Medicare Advantage program or convert to a lower cost one. However, you can still lower your Medicare Supplemental Insurance costs by speaking with a licensed Health Insurance professional. Twenty insurance companies in New Jersey are offering MedSupp’s from Plan F to Plan N, including High Deductible “F” that will lower your Medicare Advantage program and you can see any doctor that takes the RED, White, and Blue Medicare card. NO Exclusions!

If you are paying more than $100 per month for your premium and visit your Medicare professionals less than once per month, you should be able to save a lot of your out-of-pocket dollars each year.

If your premium has a deductible for over $2,200 per year, you too can save money. If you are healthy and really do not see a medical professional frequently, then see a licensed health insurance professional who can show you different plans from other than the companies that advertise on TV, Radio, in the mail and in print, and drive their rates, your premiums to a point where you do not get the values from the insurance company that you deserve.

Don’t overpay! I have seen people who purchase a MedSup plan for $225 per month ($2,700 per year) and see their doctors eight times per year with $20 out of pocket co pays. That totals $2,860. Does that make sense when there are many other MedSupp companies that are offering premiums as low as around $700 per year and 20 percent co-pays? Do the math. ($2,700 – $860)

Once you receive Part A, because you turned 65, and purchase Part B, now that you are not being covered by an employer, it’s time to look at what a MedSupp/Donut hole program could do for you. After you pay the initial $186 annual deductible this year to Medicare, you will be responsible for the potentially thousands of dollars for medical coverage that Medicare does not cover. Can you afford that?

Look into a Medicare Supplemental program, NOT sponsored by those companies that advertise on radio, TV, in magazines or the US Mail. Why? Because they spend MONEY for advertising and not on lowering their MedSupp Premium. Remember, hospitals, doctors and even the insurance company itself can drop a Medicare Advantage program whenever it wants to and the policy holder is left out in the cold. If that be the case, they would need to apply and fill out a new medical questionnaire, etc., and if you got sick before the renewal, they might not approve the new policy. Remember, purchase a guaranteed renewal policy from a A+ rated insurance company with customer service right here in the USA. Good luck.

Original Source:

Original Date: Dec 5 2017

Original Author: Paul Onish


Looking to Buy Medicare Supplemental Insurance In Arizona

To purchase Medicare Supplemental Insurance plans in Arizona, you need to qualify for Part A and B of Medicare. Most of you will plan to enroll in both parts of Original Medicare around your 65th birthday. This is an ideal time to consider enhancing your hard earned benefits with a Arizona Medicare supplement insurance plan. Some companies will even allow you to apply a few months early. This is to be certain you have health coverage in place when you turn 65.

Original Medicare Parts A and B

Some people are not sure on when they get parts A and B and that’s okay, we are here to help. You can always check out for that information. But, usually there are two ways to obtain these plans. The 1st one is you automatically get it. The other option is you have to sign up for it. It all depends if you are getting social security benefits. If you are not sure chances are you will have to sign up for it.

When to start looking at Arizona Medicare

You should start looking at AZ Medicare usually a few months before you turn 65. You want to know your options so when you turn 65, you can get the coverage you need and want. However, you have a 7 months to decide on a plan. 3 months before your 65th birthday, the month of your birthday and 3 months after that. So you are in no rush, but just a warning they do charge a late enrollment penalty.

Missed Medicare enrollment on your birthday?

If you didn’t get a chance to sign up on your birthday no worries! You can always sign up between January 1 through March 31. Keep in mind you will more than likely be charged a few or a higher premium.

I have Medicare Part A and B, now what?

You should know or have already heard that these two parts don’t always cover everything. That’s why private insurance companies sell a “Medicare Supplemental Insurance” commonly known as Medigap. Yes, this type of insurance has many names; we even call it Medsup (short for Medicare Supplemental). You can view our Medicare Medigap guide for more information. Don’t be scared away when we say private insurance companies. These plans are still regulated by the federal government.

Private Insurance Companies?

Blue Cross Blue Shield, Aetna, Priority Health, United Healthcare (AARP), Humana all sell this type of insurance. There are even more companies these are just a few popular ones. We have access to these companies and even more to get you the best Medicare Supplemental Insurance rates! Remember when we said these plan are regulated by the government? Keep in mind that the pricing or premiums are different. Each company will sell the same plans, but the prices will be different! That is why we look over different companies, and is how we get you a great Medigap rate.

More information about Arizona Medicare Supplemental Insurance Plans

The internet is full of information; sometimes this information is not correct. In order to best serve you in researching these supplemental plans, we recommend you call us! We are licensed to sell Arizona Medigap plans. That’s right, one think to keep in mind is these companies need to be licensed to sell in certain states like Michigan, Tennessee, Arizona, and Arizona. You can also visit these reliable sites.

As always you’re more than welcome to call us. We can recommend a plan that fits your health care and budget. We can answer any questions you might have on Medicare or Supplemental Insurance policies in Arizona. Call toll free at 877-202-9248!

You can also learn more about Arizona Medicare Supplemental Insurance rates at


Help Squad: What to know when considering Medigap and Medicare Advantage plans

I just read your column, “Health insurance and open enrollment – what you need to know” in today’s Chicago Tribune. I was wondering if you could help me out. I’m looking for supplemental insurance to go along with my Medicare. The costs are high and the deductible on some is $2,000! I’m 67, retired and on a fixed income. Any suggestions?

Kathy Lipscomb, health care advocacy consultant at KL Services, LLC, in Skokie, was one of the experts providing health insurance guidance in the above-mentioned Help Squad column, so it was to her that I turned for advice on Paul’s behalf.

Lipscomb began by explaining that Medicare supplemental insurance, also known as Medigap coverage, is insurance that can be purchased to cover costs that original Medicare – Part A (hospitalization) and Part B (medical) – doesn’t cover. These costs can include copayments, coinsurance and deductibles. A Medigap policy will not cover Medicare Advantage Plan (Part C) copayments, deductibles or premiums. Medigap is designed to supplement original Medicare benefits, whereas Part C is a policy purchased from a private insurer to cover Part A, Part B and extra benefits such as vision, hearing, dental and prescriptions. Part C plans are used in place of, not in combination with, Medigap. (Medicare pays a fixed amount each month to the companies providing Medicare Advantage Plans to Medicare policyholders.)

Another important point to note: The timing of Medicare enrollment is different than health insurance marketplace open enrollment. Per the website: “The best time to buy a Medigap policy is during your six-month Medigap open enrollment period. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you’re 65 and enrolled in Medicare Part B. After this enrollment period, you may not be able to buy a Medigap policy. If you’re able to buy one, it may cost more … If you apply for Medigap coverage after your open enrollment period, there’s no guarantee an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements.”

Lipscomb recommended the following for selecting a Medigap policy: First, go to, then click “Supplements and Other Insurance” at the top of the page. From the drop-down, select “How to Compare Medigap Policies.” This provides a chart comparing the various plan options and what is covered in each.

Said Lipscomb: “It is important to remember that all policies, by law, offer the same standardized basic benefits. So, Plan G from insurance provider ABC is going to have the same benefits and coverage as from insurance provider XYZ. Only the cost of the policy might be different.” She added that some plans offer coverage when traveling out of the country and some might include your Medicare Part B premium. She emphasized the importance of comparing copays and deductibles before deciding on a plan. can assist consumers in finding Medicare supplemental plans in their area if they click on “Find health & drug plans” under the “Sign Up/Change Plans” tab at the top of the home page. Lipscomb additionally recommended checking individual insurance companies’ websites, contacting AARP, and/or speaking with an insurance broker who sells medical insurance.

And for those interested in exploring Medicare Advantage Plans (Part C), provides assistance via “Your Medicare coverage choices,” which can be found in the drop-down under the “Sign Up/Change Plans” tab.

It is important to evaluate your overall Medicare costs and benefits when deciding whether or not to enroll in an Advantage Plan. As explained on the Medicare website: “Your cost sharing is lower (or included) if you’re in a Medicare Advantage Plan.” However, it is possible that your premium will be higher than it would be if you had original Medicare combined with a Medigap supplement.

Lipscomb advised: “Most major insurance providers have a Part C plan. You can contact insurance providers through their websites. Also, retirees should check with their former employers. If they worked for a large company, they may be able to get Part C coverage through that company.

Original Source:

Original Author: Cathy Cunningham

Original Date: Nov 8 2017

Getting the wrap on Medigaps

Medicare provides coverage for a wide array of medical and drug benefits, but with its deductibles, cost-sharing requirements, and lack of an annual out-of-pocket spending limit, approximately 23 percent of all Medicare beneficiaries purchase supplemental insurance to help cover their out-of-pocket costs.

Here are a few things to consider when purchasing a Medicare Supplement (Medigap) policy

•Your best time to buy a Medicare Supplement policy is when you’re first eligible. The best time to buy a policy is during your Medicare Supplement Open Enrollment Period. This is different from the Annual Open Enrollment Period that occurs every fall. Under Federal law the Medicare Supplement Open Enrollment period lasts for six months. It starts on the first day of the month in which you are enrolled in Medicare Part B whether you are over age 65 or under 65 and disabled. If you have Medicare due to a disability you will have a second open enrollment when you turn 65. When you buy a Medicare Supplement policy you get a 30-day free look period. If you change your mind within 30 days of your policy effective date you can cancel it and get a refund.

•Medicare Supplement plans are standardized. Medicare Supplement plans are standardized meaning that each plan of the same letter (designated A through N) must offer the same basic benefits, regardless of which insurance company sells it. To see a chart of the different plans and benefits for particular Medicare Supplement plans you may refer to page 11 in the 2017 Choosing a Medigap policy: A Guide to Health Insurance for People with Medicare which can be found at

•Insurance companies price their Medicare Supplement plans differently. The cost of Medicare Supplement plans can vary widely. Different insurance companies charge different premiums for the same coverage. The cost of these plans may depend on whether the company offers discounts. The system the company uses for rating their premiums can also affect the cost. There are three types of premium ratings:

Community rated: The same monthly premium is charged to everyone who has the Medicare supplement policy and lives in the designated geographic area, regardless of age. Premiums are the same no matter how old you are.

Issue age rated: The premium is based on the age you are when you buy the plan. Premiums are lower for younger buyers and won’t changes as you age other than adjustments for inflation or annual cost increases.

Attained age rated: The premium is based on your current age so the premium goes up as you age. Premiums are low for younger buyers, but go up as they get older and can eventually become the most expensive plan options.

•Medicare Supplement plans don’t cover everything. Most Medicare Supplement policies do not cover benefits that are not otherwise covered by Medicare. For instance, they generally don’t cover long-term care, vision or dental services, hearing aids, eyeglasses, or private-duty nursing services.

•You can’t combine a Medicare Supplement with certain types of health insurance. Medicare Supplement plans are meant to work with Original Medicare (Part A and Part B). It may be illegal for an insurance company to sell you a Medicare Supplement plan if you have another type of insurance, such as Medicare Advantage or Medicaid. If you have a Medicare Advantage plan, you can only apply for a Medicare Supplement policy if you are planning to return to Original Medicare. None of the Medicare Supplement plans sold today includes prescription drug coverage, but you can add a Medicare Part D prescription drug plan to your Original Medicare and Medicare Supplement coverage.

•In most cases, you cannot be dropped by your Medicare Supplement plan. If you bought your policy after 1990, the policy is guaranteed renewable. This means your insurance company can only drop you under very limited circumstances, such as if you stop paying your premium, you weren’t truthful on your policy application, or the company becomes bankrupt or insolvent. During the period of your guaranteed issue rights, an insurance company can’t charge you more for a Medicare Supplement policy because of past or present health problems.

•Make sure the insurance company is reliable. Check with the Pennsylvania Department of Insurance at to confirm that the insurance company is licensed to do business in the Commonwealth. You can also find out which insurance companies sell Medicare Supplement policies in your area by visiting the Medicare Supplement policy search tool at: or by calling 1-800-MEDICARE. You can also get free and unbiased assistance from your local APPRISE program.

•Watch out for illegal insurance practices. It is illegal for anyone to pressure you into buying a Medicare Supplement policy, lie or mislead you to switch to another company or sell you a second policy when they know that you already have one.

Original source:

Original Date: Oct 24 2017

Is Arizona Medicare Supplemental Insurance Necessary?

If you read our previous article on Medicare supplemental insurance in Michigan, we stated that how you are being affected by the Medigap Plan among other things is factored according to one’s location. Beneficiaries who wish to add coverage to their Part A and Part B plans would want to choose to do a Medicare Supplement Plan in Arizona.

Medicare supplemental insurance coverage in Arizona would be similar to what we saw in Michigan such as it would include deductibles, copayments, and coinsurance. Other hospital coverage may as well be added, like hospice care.

Medicare vs Medicare Advantage Program

A Medicare supplement health plan in Arizona differs when compared to that of the Medicare Advantage program. First, It is seen in how it is purchased. Unlike that of the Advantage program, the Medicare supplemental insurance plan in Arizona is designed to be purchased as a standalone, however, can be purchased in combination with original Medicare.

For beneficiaries in Arizona who would want to get the independent purchasing coverage, might need to consider changing from Original Medicare to a Medicare Advantage plan.

Medicare United Through The States

A medical supplemental insurance plan in Arizona is the same when compared to that of Michigan. Here, the insurance plan is lettered up to the tone of 10 standardized letters. These ten standardized letters are available across the country, and each letter offers the same benefit with little regard to the insurance company providing it. Among other letters, the most common letter that is available nationwide is Medigap Plan F. This is the most common available medical insurance plan in Arizona.

However the fact that each of these ten letters offers benefits that make each beneficiary indifferent, the cost may vary depending on the particular company providing each of these benefits. While coverage may not include additional care such as prescription, hearing, vision, and or dental care, it, however, covers insurance while on a trip abroad.

Also similar to what is tenable in Michigan, Medicare supplemental insurance beneficiaries have the choice to enroll in Medicare supplement plan in Arizona during their six-month Medical supplemental insurance open enrollment period, which often begins on the first day of the month that one clocks their 65th year birthday.

During the Medigap enrollment period in Arizona, companies are prohibited from denying beneficiaries the coverage that is due to them, neither are they allowed to charge outrageous premiums to beneficiaries through their pre-existing medical conditions. And after the six-month enrollment period, beneficiaries would have to enroll in a Medigap Plan. However, coverage for pre-existing medical conditions would cease to be a working condition.

How to Choose Medicare Supplemental Insurance Plan in Arizona

Just as fore stated, Arizona Medigap plan coverage may be similar to the different lettered plans in Michigan, the cost of the program can vary depending on the insurance company that is involved. However, beneficiaries should select a plan that meets their needs regarding of coverage options. After that, beneficiaries can shop for different plans that are still within their single plan type, all based on the cost of the program.

eMedicare Supplemental Insurance is based in United States and has many knowledgeable, licensed agents ready to help you choose a supplemental health plan. We can also help you with any questions you have regarding Medicare and supplemental health care. Feel free to call us at 1-877-202-9248 or visit our website at

12 Frequently Asked Medicare Questions

Medicare provides health coverage for millions of older Americans, but many future and current beneficiaries don’t understand many of the program’s basic features. With that in mind, here are 12 frequently asked Medicare questions and what you need to know about each one.

1. Am I eligible for Medicare?

The majority of Americans become eligible for Medicare benefits at age 65. To qualify, you or your spouse will need to have earned enough Social Security “credits.”

A senior man being examined by a physician with a stethoscope.

Image source: Getty Images.

2. What is the difference between Medicare and Medicaid?

Medicare is federal health insurance, primarily designed for elderly Americans. Medicaid is a state-run health insurance program that is primarily designed for low-income residents.

3. What are the “parts” of Medicare?

Medicare Part A is known as Hospital Insurance, or HI, and covers things like hospital and skilled nursing stays. Medicare Part B is Medical Insurance, and covers things like doctors’ appointments and outpatient procedures. Collectively, Medicare Parts A and B are known as Original Medicare.

Medicare Part C is Medicare Advantage, which are plans provided by third-party insurance companies and authorized by Medicare to provide benefits. Finally, Medicare Part D is prescription drug coverage, which is optional for retirees.

4. Will I be automatically enrolled in Medicare at 65?

It depends. If you’re already receiving Social Security benefits when you turn 65, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65 and your Part B premiums will be taken out of your Social Security checks. On the other hand, if you aren’t already receiving Social Security retirement benefits, you’ll need to sign up.

5. How can I enroll in Medicare?

The process of enrolling in Medicare only is rather painless, and can be completed in 15 minutes or so at the Social Security Administration’s website.

When you first turn 65, your initial enrollment period runs for seven months beginning three months before the month of your 65th birthday. If you aren’t exempt from enrolling due to having group coverage through an employer (more on that shortly), your Part B premiums can be permanently increased for failing to enroll during your initial enrollment period. If you do have group coverage and choose not to enroll in Parts A and B during your initial enrollment period, you’ll get an eight-month special enrollment period after you (or your spouse) leave your employment.

6. Do I need Medicare if I have other health insurance?

As I’ll discuss in a minute, most Americans should enroll in Medicare Part A at age 65 whether they need it or not.

If your health insurance is through your or your spouse’s employer, and the employer has more than 20 employees, you aren’t required to enroll in Medicare Part B at 65. Once you leave employment, you’ll have a special eight-month enrollment period.

If your employer’s coverage doesn’t meet the 20-employee requirement, or if you have Marketplace coverage, COBRA, or TRICARE (nonactive duty), you’ll still need to sign up during your initial enrollment period.

7. Can I only enroll in Medicare Part A?

Yes. In fact, this is a common strategy for senior citizens who are 65 or older, but are still covered through an employer’s plan. As long as you’re eligible for Medicare benefits, Part A is free, while Part B comes with a monthly premium. Therefore, it can make sense to delay Part B enrollment if you don’t need it, but since it’s free, there’s no financial reason not to enroll in Part A as soon as you’re able to.

8. How much does Medicare cost?

For most seniors, Medicare Part A is free. You won’t have to pay a premium for your coverage (although there are deductible and coinsurance expenses when you use it). On the other hand, Medicare Part B has a monthly premium, which is $134 per month in 2017. Retirees who already paid their premiums through Social Security pay slightly less due to cost-of-living adjustment rules and higher-income retirees pay more — up to $428.60 per month — depending on their income.

Medicare Part C and D coverage costs vary significantly depending on where the beneficiary is located and how much is covered.

9. What if I don’t enroll in Medicare when I’m first eligible?

Unless you qualify for a special late enrollment period as I’ve discussed elsewhere in this article, you may have to pay a late-enrollment penalty if you don’t sign up for Medicare Part B during your initial enrollment period.

The penalty can be pretty severe. Your monthly Part B premiums can be permanently increased by 10% for every full 12-month period that you could have had Part B, but didn’t sign up.

10. What is Medigap?

Medigap is the common name for Medicare Supplemental Insurance, and is private insurance designed to cover certain expenses not covered by Original Medicare. There are 10 different Medigap plans and availability and cost depend on your location. Don’t confuse Medigap with Medicare Advantage, which is not supplementary coverage but rather is a different way to receive your Medicare.

11. What is covered by Original Medicare?

Medicare Part A, or Hospital Insurance, covers hospital services, skilled nursing facilities (for a limited time), nursing home care if medically necessary, hospice care, and certain home health services. Medicare Part B, Medical Insurance, covers outpatient surgeries, medical supplies, and preventative services like lab tests.

12. What is not covered by Original Medicare?

While this isn’t an exhaustive list, Medicare doesn’t cover long-term care, dental or vision care, acupuncture, or hearing aids.

It’s also important to mention that you will have certain out-of-pocket expenses for covered services as well. Medicare Part A has a $1,316 deductible per benefit period and coinsurance requirement for longer hospital or skilled nursing stays. Part B has a $183 annual deductible as of 2017, but you’re generally responsible for paying 20% of covered services.

The more you know, the better prepared you’ll be

Medicare is an important part of retired life for virtually all Americans, so it pays to learn some of the basic principles of the program. The more you understand about Medicare, the better equipped you’ll be to choose healthcare services, know what costs you can expect, and make other healthcare decisions, such as whether you need additional health insurance in retirement or not.

Original Source:

Original Author: Mathew Frankel

Original Date: Oct 9 2017


How to navigate through complexities of Medicare

The day you turn 65 is one of the most important milestones in terms of your health. Sure, it’s not as exciting as the day you became eligible for a driver’s license, but 65 does mean a new kind of eligibility – Medicare.

Baby boomers are reaching this milestone at a rate of more than 10,000 per day. And just like studying for your road test, preparing for Medicare eligibility means doing your homework and understanding what’s coming around the bend.

First and foremost, you’ll want to determine your eligibility and calculate your premium at Those who have a special condition, disability, or receive benefits from Social Security or the Railroad Retirement Board may qualify prior to turning 65. Everyone else should apply at a Social Security office or online at starting three months before turning 65 and no later than three months after to avoid late penalties that can be permanent.

If you or your spouse are still working, and you’re covered by the employer’s plan, check with the benefits administrator to see if they require you to sign up for Medicare. If not, you can sign up later during a special enrollment period without a penalty. Also, be sure any prescription drug coverage you receive through an employer after turning 65 is “creditable” – considered by Medicare to be at least as good as its drug coverage – or you’ll be liable for more late penalties.

Once you’ve determined your eligibility, it’s important to understand the fundamental parts of Medicare. Medicare Part A offers hospital insurance for inpatient stays, skilled nursing facilities, and hospice care, while Medicare Part B provides medical insurance for doctor services, outpatient care, medical supplies, and preventive care. Excluded from Parts A and B (original Medicare) are a number of value-added benefits and services like routine vision and dental visits, health management programs, and more.

These costs would be out-of-pocket. Prescription drugs also are not covered by original Medicare and require a separate Medicare prescription drug plan (Medicare Part D). If you’ve worked and paid taxes for 10 years or more, you wouldn’t have a premium for Part A, but there are separate premiums for Parts B and D.

Alternatively, Medicare Advantage plans (Medicare Part C) are offered by health plans – like CDPHP – to replace Medicare Parts A and B while providing additional coverage. Medicare Advantage plans include everything covered by Parts A and B as well as important services such as dental, hearing, vision, annual physicals, case management, medication reviews, nutrition and wellness classes, and even no-cost gym memberships. Many Medicare Advantage plans also provide prescription drug coverage (Part D) and the convenience of having one plan administer all of your Medicare benefits.

It’s important to note that there is an open enrollment period, called AEP or annual election period, for making changes to your Medicare plan that spans from October 15 to December 7. While you can sign up for original Medicare up to three months before turning 65, and have the coverage begin on the first day of your birthday month, changes to your plan can only be made between those dates. You must be enrolled in original Medicare Parts A and B to join a Medicare Advantage plan, so get that squared away first even if you know you’ll be replacing it.

If you’re about to overheat, take a minute to cool down. Medicare can be overwhelming because it requires learning a new system with its own timelines, rules, and terminology. That’s why I suggest starting the process early, asking questions, and reading the information you receive in the mail.

Educating yourself now will allow you to make the right choices for yourself and your health, so you can cruise into this important stage of life without so much as a glimpse in the rearview.

Original Source:

Original Date: Sept 27 2017

Original Author: John D. Bennett