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Medicare 101

If you’re nearing retirement age, or are over 65 and still working, you may have questions about Medicare. Read on for the information you need to know.

What is Medicare?

Medicare is health insurance for people who are age 65 or older, under 65 with certain disabilities, or any age with End-stage Renal Disease (permanent kidney failure).

Parts of Medicare

There are four parts of Medicare.

Medicare Part A helps cover inpatient care in hospitals, skilled nursing facilities and hospice and home health care. Generally, there is no monthly premium if you qualify and paid Medicare taxes while working.

Medicare Part B helps cover medical services like doctors’ services, outpatient care and other medically necessary services that Part A doesn’t cover. You need to enroll in Medicare Part B and pay a monthly premium determined by your income, along with a deductible.

Many people also purchase a supplemental insurance policy, such as a Medigap plan, to handle any Part A and B coverage gaps.

Medicare Advantage Plans, also known as Medicare Part C, are combination plans managed by private insurance companies approved by Medicare. They typically are a combination of Part A, Part B and sometimes Part D coverage, but must cover medically necessary services. These plans have discretion to assign their own copays, deductibles and coinsurance.

Medicare Part D is prescription drug coverage and is available to everyone with Medicare. It is a separate plan provided by private Medicare-approved companies, and you must pay a monthly premium.

Our value-added services

Medicare can be overwhelming. Our knowledgeable staff will simplify the process and make sure you understand your Medicare options. We stay with you throughout the entire process and are always prepared to answer any of your questions. Whether you need a one-on-one meeting, want to attend an educational seminar, or have a quick phone call, we will always be here to meet your needs.

Let us help you find the product that’s right for you.

Let us take care of the hard stuff. You can breathe easy and forget that pile of Medicare mailers sitting on your counter. There’s no “one policy fits all” solution for Medicare. Our staff will take the time to get to know you and explore what is truly important to you and your family. Together, we’ll discover what type of policy truly fits your needs.

We do not offer every plan available in your area. Currently we represent 19 organizations which offer 151 products in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program to get information on all your options.

Frequently asked questions

I RSVP’d, but now I can’t make it. What do I do?

It’s okay! We understand plans can change, you don’t have to do anything on your end. However, you can still sign up to a different seminar or schedule a 1 on 1. 

Can I bring a friend?

Absolutely! We encourage you to bring a friend, family, or anyone who would also benefit from learning more about these upcoming changes. 

How long will these seminars be?

They are about an hour, but you may leave at anytime if needed.

Do I have to take a drug plan?

If you don’t enroll in a drug plan when you are eligible for Medicare and you do not have creditable coverage there will be a penalty. If you have Senior Care or benefits through the VA, this penalty may not apply.

Do I need to take Medicare Parts A and B if I continue to work?

If continuing to work and you have group health insurance, you may not need to enroll in Medicare Parts A and B; this is dependent upon the number of employees at the place of business. If your place of employment employs less than 20 people you need to sign up for Medicare Parts A and B and Medicare will be the primary payor. If there are more than 20 employees, you may be able to maintain the group plan and not have to enroll in Medicare A and B. If your spouse is working and you are insured through their group employer you may not need Medicare Part A or B, check with your group insurance carrier.

Does COBRA coverage qualify as creditable coverage?

COBRA coverage is not considered creditable coverage, so if you don’t take Medicare Part B, a penalty will apply.

How do I enroll in Medicare Parts A and B?

If you ARE collecting a Social Security check and are turning 65 or are eligible for Medicare due to a disability, your Medicare card will automatically be sent to you about 3 months before your Medicare effective date. If you don’t receive your Medicare card, reach out to Social Security. Medicare begins on the 1st of the month you are turning 65 unless you were born on the 1st of the month, then your Medicare would begin the 1st of the prior month. If you are NOT collecting Social Security and you want your Medicare to begin when you turn 65, you need to reach out to Social Security no sooner than 90 days prior to your birthday month.

How much is the premium for Medicare Part A?

Typically there is no premium for Medicare Part A as long as you or your spouse have worked 40 quarters (10 years) in your lifetime.

What is the difference between a Medicare Advantage plan and a Medicare supplement?

A Medicare supplement pays second to Medicare and only on Medicare-eligible expenses. A Medicare Advantage plan must provide you with coverage equal to or better than original Medicare, but may add additional benefits. You must have Parts A and B of Medicare and continue to pay your Part B premium to be eligible for a Medicare Supplement or a Medicare Advantage plan.

What is the Part B penalty?

If you do not take Part B when you become Medicare eligible and do not have creditable coverage through your employer or your spouse’s employer (you or your spouse must be actively working) You will be penalized 10% every 12-month period you do not have Medicare Part B.

What is the Part D penalty?

If you do not take Part D when eligible and do not have creditable coverage through a group, Senior Care, or the Veterans Administration, you will be penalized when you join a Medicare Part D plan. The penalty is 1% per month for every month you don’t have creditable coverage.  It is based on the national average premium of drug plans, which changes every year. This not a one- time penalty, it is a lifelong penalty that is accessed every month you are on a Part D plan.

What is the premium for Medicare Part B?

The premium for 2024 is $174.70 and this is taken directly out of your Social Security check if you are receiving Social Security. If you are not receiving Social Security, you will be billed quarterly for this premium. High-income earners may have a higher part B premium.