Please reach out to Georgette Reed if you cannot find an answer to your question.
Medicare is a federal health insurance program primarily for people aged 65 and older, as well as some younger individuals with disabilities. It helps cover healthcare costs such as hospital stays, doctor visits, and prescription medications.
Medicare has four parts:
Individuals are generally eligible for Medicare if they are 65 or older, or if they are under 65 and have a qualifying disability, such as end-stage renal disease or amyotrophic lateral sclerosis (ALS). Also, if a person has received Social Security Disability for 2 years, they may qualify for Medicare.
You can apply for Medicare online at the Social Security Administration’s website, (ssa.gov), by phone, or by visiting your local Social Security office. You can also sign up automatically if you are already receiving Social Security benefits.
Medicare brokers, also known as independent Medicare insurance agents, are paid by the insurance companies they represent. There is no extra fee or cost for enrolling through a broker.
Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Part B covers outpatient services like doctor visits, preventive services, lab tests, and medical equipment.
Medicare Advantage plans are offered by private insurance companies and combine the benefits of Part A, Part B, and often Part D (prescription drug coverage) into one plan. These plans may offer additional benefits, such as vision, hearing, and dental coverage. Added benefits may also include fitness benefits, over-the-counter pharmacy monies, and transportation to medical appointments.
There are some plans based on income, chronic conditions, Veteran and Native American health plans, or HMO plans that pay back money to your monthly Medicare Part B. This is something I will review with you to see your options.
No. They are based on COUNTY only. An example is you may live close to Sand Springs, but your physical address is in Osage County. You are not eligible for some plans offered in Tulsa County.
Many times, the companies promoting Medicare help on television are paid by only a few Medicare plans. You may not receive a complete list of options available to you in your county. Also, many Medicare Advantage plans have certain doctors and hospital systems in their networks. Sometimes the national groups selling you a plan don’t take that into consideration when promoting a plan to you.
No. If you are on a full coverage medical plan that includes drug coverage, you can choose to wait to sign up for Medicare. Yet, it would be prudent to review your options off your group plan through work. Many times, the cost for an individual Medicare plan is less than what you are paying through your work group plan. We should review the cost of coverage, deductibles and maximum out of pocket costs you are currently paying through your group plan. It is also important that if you should lose your group coverage for any reason, you can immediately apply for Medicare. You must maintain continuous coverage or there is a possibility of a penalty being assessed by Medicare.
You can sign up for a plan during annual enrollment which is October 15 to December 7th. The plan will not start until January 1st the following year. But you will be charged a penalty for not having a drug plan from your initial enrollment period. Also, it is highly recommended that you have some plan other than straight Medicare A and B. Medicare Advantage Plans that include drug coverage are a great way to add coverage for little to no cost. Yet, you will still be assessed a penalty.
The penalty rate changes year to year, but it is about $5 a year for every year you should have had a plan. It is based on the months missed. This will be added as a monthly charge by Medicare to your plan cost. If your Medicare Advantage plan costs you nothing, and you have waited two years to sign up for a plan, you will have to pay approximately $10 a month for your plan now. The penalty never goes away, so it is important that you think of future issues that could happen for prescription costs.
Unfortunately, there is no way to get out of the penalty if you did not have drug coverage from another source when you were eligible for Medicare. Individuals who have Veteran or Native American healthcare can receive an exception. So, make sure Medicare is aware if you have access to these programs. One way I help individuals with a penalty is to find a plan that offers Medicare Part B pay back. If your plan pays back $75 a month and you have a penalty of $25, then you would still receive an extra $50 off your Medicare Part B. This plan will include drug coverage so the penalty will not continue to rise in cost but freeze at the plan’s start date.
Here is a list of insurance terms by the National Association of Insurance Commissioners.
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