Medicare
Are you turning 65 soon? Watch this brief video on what to expect. Medicare 101
Basics
Being an established nationwide agency, we’re often called upon to educate area residents about Medicare.
Signed into law by President Johnson in 1965, Medicare was a federal program intended to provide all people aged 65 and over with health insurance. Over the years, Medicare has undergone several changes. Originally it only included Part A and Part B. But we will discuss here what changes have been made.
Seeing that changes are common enough with this program, most people wonder: What precisely does Medicare provide? Does it give me any coverage options?
At My Medicare Hotline, we stand ready to help. Our agents are licensed brokers who can clarify the program’s ambiguities and help you select a plan that offers the coverage you need.
Most of all, what’s important to understand is that Medicare is divided into four parts, A, B, C, and D.
– Part A offers hospital benefits and is administered by the federal government. Most people do not pay a Part A monthly premium if they or their spouse has paid into Medicare for at least 40 quarters. In 2023, if you are hospitalized, you are responsible for paying the first $1,600 as your Part A deductible. This covers you for the first 60 days as an inpatient. If, after a hospital stay, you require Skilled nursing care (inpatient rehab), you will have the first 20 days covered for free. For days 21 – 100, you will be responsible for paying $200 per day. You are responsible for 100% of the cost of Skilled nursing care after 100 days.
– Part B, also administered by the federal government, provides physician benefits. These include doctor bills, medical services, and supplies that hospital insurance doesn’t cover. Part B monthly premiums can be different for each person. Are you new to Medicare in 2023? Your Part B premium will most likely be $164.90/month. These premiums will be automatically deducted from your SS check if you collect Social Security. Not collecting Social Security? Your Part B premium bill will come in the mail and be paid quarterly for those not collecting Social Security. Note: You could pay more for individuals making over $97,000/year and couples making more than $194,000/year.
Part B has an annual deductible you must pay before Medicare pays anything; in 2023, that is $226. After you pay that, you will be responsible for paying 20% of the approved procedures. There is no maximum annual out-of-pocket amount. Therefore, you could spend tens of thousands of dollars if your procedure is expensive.
– Part C, Medicare Advantage, deals with network plans like HMOs and PPOs. Most people under 65 are used to this kind of insurance through individual or group health plans through their employer because they have networks of doctors, and you will most likely incur copays. These are administered by private insurance companies contracted with the federal government. Though not administered federally, these plans still come under federal oversight.
– Part D is a prescription drug benefit through PDPs (prescription drug plans). These plans are also administered through private insurance companies. Therefore, if you choose a Medicare supplement plan, you most likely would want to purchase a Part D plan to make sure you aren’t penalized for not having one. Since supplement plans are not allowed to include a drug benefit, you could be penalized for the rest of your life!
Other options
You also have access to Medicare Supplements, also known as Medigap Plans, that cover the cost of co-pays and deductibles left over from traditional Part A and Part B. These plans are known to have premium increases yearly. Part C plans usually have copay changes every year on January 1. Due to this, some plans get better, while others may worsen.
Gov’t Programs
Here at My Medicare Hotline, we can examine your Medicare plan along with your benefits and advise what best suits your needs if needed. We can also address if you are eligible for government programs like “extra help,” which can help with your Part D prescription drug cost and premiums, and check to see if you qualify for the Medicare Savings program, which can pay for your Part B monthly premiums.
To learn more about Medicare and how it might benefit you, delve further into our website. Then contact Us Today!
