If you are age 65 or older, or have a disability, you are entitled to receive Medicare private health insurance benefits to ensure you have affordable access to quality health benefit coverage. With a variety of plan options available, it is important to carefully choose a plan that provides you with comprehensive coverage and access to quality providers. At the same time, you’ll want to ensure you’re not paying more than you need to for quality coverage.
Original Medicare private health insurance is comprised of Part A (hospital insurance), and Part B (medical insurance). Most individuals will be eligible for Part A upon turning age 65. At that time, they may also elect to enroll in Part B. You may also be eligible for Original Medicare if you have a disability, or have been diagnosed with End Stage Renal Disease (ERSD).
While most qualified enrollees will be eligible for premium-free Part A, you will likely need to pay a monthly premium for Part B. Your premium for Part B will be dependent upon your income, and when you enroll in Part B. For most individuals, the average Part B premium in 2017 is $134 per month. Click here for more information on qualifying for premium-free Part A, and click here for more information on estimated premium costs for Part B.
As an alternative to enrolling in Original Medicare private health insurance, you may elect to enroll in a Medicare Advantage Plan. Also referred to as Medicare Part C, Medicare Advantage plans offer the same benefits as Original Medicare, but through private health insurance companies. There are a variety of coverage levels, network structures, and tier options available. Depending on the option you choose, your plan may include dental, vision, hearing, or drug benefits.
To determine whether your costs will be less with Original Medicare or a Medicare Advantage plan, speak with one of our advisors to compare available plans in your area.
If you elect to enroll in Original Medicare, you will be eligible to obtain prescription drug benefits though a Medicare Part D, or drug plan. To obtain Medicare drug coverage, you must select and enroll in a plan managed by a Medicare-approved private health insurance, or other private, company. As there are a variety of plans available, costs will vary. One of our advisors can assist you in choosing the plan that will best cover your drug needs at the most affordable cost.
As an alternative to a Medicare Advantage plan, you may choose to enroll in a Medicare Supplement, or a Medigap plan. Medicare Supplement plans are also offered by private insurance companies. They cover services that are not covered by Original Medicare and can help you to pay for out-of-pocket costs such as deductibles, copayment, and your Medicare Plan Part B premiums.
Unlike Medicare Advantage, Medicare Supplement plans do not offer prescription drug coverage and do not cover dental or vision care.
For Medicare Supplement Plans, there are 10 standardized plans available in 47 states. Even though benefits are standardized across most Medicare Supplement plans, your out-of-pocket costs, including premiums, may vary. Speak with one of our advisors to determine if a Medicare Supplement plan is right for you, and if so, what plan option will best suite your needs and be most affordable.
If you are under age 65 but are eligible for Medicare because you have a disability, you will also be eligible to enroll in a Medicare Advantage plan unless you have already been diagnosed with ESRD. If you have ESRD, require regular dialysis, or a kidney transplant, your benefits will be covered under Original Medicare.
You may be eligible for both Medicare and Medicaid. Individuals considered to be “dual eligible,” are usually older and/or disabled, and are eligible for financial assistance to pay Medicare costs because they meet low income requirements.
For these individuals, Medicaid can help to pay for out-of-pocket Medicare costs, including premiums, deductibles, copayments, and coinsurance. Medicaid also provides coverage for some services that Medicare does not cover.
To enroll in Medicare for 2018, plan to sign up during the Medicare Open Enrollment period, which will take place in 2017 from October 15 through December 7.
If you are already enrolled in Medicare Part D or a Medicare Advantage plan in 2017 and want to remain in your same plan in 2018, you do not need to take any steps as long as your plan will remain available in 2018. Be aware, however, that your premiums or benefits may change from year to year, so confirm any changes before you decide to automatically reenroll.
If you choose to change Medicare Advantage coverage, or switch to Original Medicare, you can do so between January 1 and February 14 of each year. Once you have switched plans, you may also enroll in a Medicare Part D plan, if eligible, by February 14.
For more information on affordable Medicare solutions, or to determine your eligibility for Medicare, call us today. Our Licensed Medicare Advisors are certified in twenty states. We will work with you one-on-one to help you assess your needs and determine which plan will help ensure you maintain affordable, comprehensive health coverage.
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