Easy Medicare Overview - Sixty Five Insurance Group

“I’ve been researching online for the last 2 weeks and I am more confused now than when I started.”

-Randal W. Houston, TX (actual customer quote)

We have clients who bring out entire bags of mail that they never even opened because the volume was so overwhelming and they didn’t understand what they were reading.

If you are new to Medicare, you might feel the same way. With all the parts and plans to Medicare and the endless commercials and mailings, it can be hard to get things straight in your mind. How does this work?

When Do You Get Medicare?

While most people start Medicare when they turn 65 years old, you can also gain access to Medicare before age 65 by virtue of a qualifying disability or by developing certain conditions such as ALS (Lou Gehrig’s Disease) or ESRD (End Stage Renal Disease). You could also be considered “new” if you delayed Medicare, continued working past age 65, and remained on your employer group health plan. Regardless of how you are approaching Medicare, as you are getting ready to take the “plunge” you may be wondering “now what”? You may have even heard that you could be fined or penalized by not signing up when you are eligible!

When it is time for Medicare, it can seem overwhelming and that is too bad because it shouldn’t be. Medicare is, by most accounts, a very popular government program. For many, it is the first time in a long time that they have affordable health coverage. The process of choosing your Medicare health plan should be exciting, not scary or confusing.

We make it Clear…We make it Easy

Who Can Get Medicare?

You must be a citizen or legal residents. A legal resident must have lived in the United States for at least 5 years in a row including the 5 years immediately preceding applying for Medicare.

You must also be:

What Are The Parts of Medicare?

Medicare Supplement Plan G has been gaining in popular in recent years. It functions exactly like Plan F, except for the Part B deductible. You agree to pay the Part B deductible each year, and after that, it pays everything else. The Part B deductible is $198 per year as of 2020. Quite often we can find Medicare Supplement Plan G premiums that save you more than $198/year. This means that you come out ahead in the long run. Click here to learn more about Medigap Plan G.

Part A

– Helps pay for hospital stays, inpatient care, hospice, and skilled nursing.

Part B

– Helps pay for doctor visits, testing and outpatient care

Parts A& B are commonly known as “Original Medicare”

Part C

– Combines Part A and B of Medicare into one plan and is offered by private companies. These plans usually include prescription drug coverage.

Part D

– Helps pay for prescription drugs. Can be accessed as a “stand alone” plan with Original Medicare (A&B) or as part of a Medicare Advantage Plan (Part C).

How Do I Enroll?

If you are receiving Social Security or Railroad Retirement Board benefits, enrollment in Medicare is automatic when you become eligible. You will get your card in the mail.

If, however, you are not receiving benefits, you will have to enroll yourself when you become eligible. You can enroll online, call or visit the local Social Security office.

What Does Medicare Cost?

Part A

For most people Medicare Part A is premium free by virtue of a life full of working and paying taxes. In fact roughly 99% of beneficiaries do not have to pay premium for Part A. The work requirement is working 40 quarters (10 years) and pay payroll taxes. For those that did not work 40 quarters, there will be a premium. For those who worked less than 30 quarters, the premium is $458/mo. Working more than 30 quarters results in a prorated premium of $252.

Part B

Part B cost is based on your income. Most people pay the standard rate which is $144.60/mo. This premium is deducted from your social security payment of you are receiving benefits. If you haven’t started taking your social security, you will be billed quarterly. For people who earn more, Medicare calculates your Modified Adjusted Gross Income (MAGI) to determine your premium. Your MAGI is determined from your IRS tax return from two years prior. Currently about 5% of beneficiaries must pay more than the standard rate.

Part D

Part D plans can run as low as $13/mo for a basic plan and as high as $80/mo or more for plans with enhanced coverage. Which plan you enroll in should be determined by a thorough analysis of your prescription drug needs. Like Part B, people who earn more will have a higher premium requirement for Part D.