Retirement Partners LLC Blog
Medicare Supplements or Medigap plans are guaranteed issue during your open enrollment period. This begins the first month you have Medicare Part B and are 65 or older and it lasts six months. What this means is during this six-month period, you cannot be turned down or be given a waiting period for any pre-existing conditions. Pre-existing condition is a health condition that existed before the start of a policy (i.e., diabetes, heart disease, cancer, etc.).
If you are trying to get out of a Medicare Advantage Plan and enroll back into Original Medicare you can only do that during the annual AEP which is October 15th through December 7th.
Health care is one of the biggest expenses most seniors have during retirement, so it’s important to understand the costs associated with health care. Budgeting for health care should be one of your top priorities and every senior should have a solid understanding of Medicare costs and benefits. Seniors should factor in Medicare costs when planning for retirement, and choose the Medicare plan that makes the most financial sense for you.
Medicare Parts A and B, (original Medicare) cover a majority of your medical expenses after you turn 65 but I want to go over what it doesn’t cover.
Medicare Part A (hospital insurance) helps pay for inpatient hospital stays, stays in skilled nursing facilities, surgery, hospice care, and even some home health care. Medicare Part B (medical insurance) will help you pay for doctors visits, outpatient care, some preventive services, and some medical equipment and supplies. Most people can start signing up for Medicare three months prior to the month they turn 65.
Medicare Part A and B have some significant gaps in coverage that all seniors should be aware of. So I wanted to go over what isn’t covered by Medicare and go over supplemental insurance to fill in the gaps of Medicare Part A and Medicare Part B.
What Medicare does and does not cover can be confusing so I thought I would go into Vision Care since many of my clients ask me about this. Regular vision exams are important as you get older, so let's go over what you can expect.
Medicare Vision Benefits - Part A
Medicare Part A is hospital insurance and only covers vision care when the condition is considered a medical problem - as in a medical emergency or a traumatic injury when you are admitted into the hospital. It does not over routine eye exams.
Medicare Vision Benefits - Part B
Medicare Part B is medical Insurance and covers some vision care, but not routine vision exams. You are also not covered for vision correction such as eyeglasses or contact lenses. An exception to this is if you needed them after cataract surgery. Medicare Part B also does not cover eye refractions.
Medicare Part B covers yearly gluacoma screenings for people who are at high risk. These patients include those with family history and people with diabetes.
Medicare Part B vision benefits cover cataract surgery. Medicare covers the cost of the artificial lens you would need to replace the lens that's affected by cataracts, as well as the cost for vision correction products, such as glasses. Medicare Part B vision benefits also cover eye prostheses for patients with absence or shrinkage of the eye due to birth defect, trauma, or surgical removal. Medicare Part B will cover ocular photodynamic therapy with verteporfin, which is a treatment for patients with macular degeneration.
Medicare Vision Benefits - Part D
Medicare Part D is prescription drug coverage, which works along side Medicare Parts A & B (Original Medicare) coverage. The prescription drug coverage with help cover certain medications related to vision care, like eye drops or other vision medications prescribed by a doctor.
For any Medicare Questions please give us a call!!
Medicare has released its prices for 2021
Medicare Part A
Part B Deductible $203
Medicare Supplement High F, G, & J Deductible - $2370
Plan K Out-of-Pocket Limit - $6,220
Plan L Out-of-Pocket Limit - $3,110
Plan N Co-Payments
Medicare Part B Premium
The standard Part B premium for 2021 will be $148.50. Most people will pay the standard amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard amount and an income related Monthly Adjustment Amount (IRMAA). This is an extra charge added to your premium.
Filing Individual tax returns
Above $88,00 up to $111,000 = 207.50
Above $111,000 up to $138,000 = $297.00
Above $138,000 up to $165,000 = $386.10
Above $165,000 but less $500,000 = $475.20
$500,000 or more = $504.90
Filing Joint Tax Returns
Above $176,000 up to $222,000 = $207.90
Above $222,000 up to $276,000 = $297.00
Above $276,000 up to $330,000 = $386.10
Above $330,000 buy less $750,000 = $475.20
$750,000 and above = $504.90
Let us know if you have any questions.
Low Income Subsidy or (LIS) is for beneficiaries who need extra help paying for Part D
Are you having trouble paying for your Medicare Part D costs? Their may but help and many beneficiaries don't know about it. For individuals who are receiving LIS, the benefits are help with monthly premium, deductibles, co-insurance and co-payments. Another benefit is you are no longer subject to gap in your drug coverage. Also known as the Donut Hole.
The amount of the subsidy depends on your income compared to the Federal Poverty Level and resource limitations that are set by Social Security.
Medicare Extra Help Qualifications
You may qualify for LIS under Medicare Part D if:
Assets that count toward you eligibility:
Medicare does not count resources such as your primary residence, car and insurance against you. Many Medicare Beneficiaries qualify for extra help and don't even know it. If you are unsure if you qualify the best way to find out is to apply.
How to Apply for Medicare Low Income Subsidy (LIS)
To apply you need to fill out an application form with Social Security. This form is on our website under extra help.
If you have more questions or need help give us a call!
Independant Insurance Agent
Owner at Retirement Partners
The Fall Medicare Open Enrollment lets you change your current Medicare Coverage. You are able to return to Original Medicare, switch to a Medicare Advantage, switch to a different Medicare Advantage and lastly switch to a different Medicare Part D plan ( drug plan). This happens annually from October 15th to December 7th. The new plans take effect January 1st.
If you are satisfied with your current Medicare Plan, you DON'T need to do anything. Your current plan will rollover to the next year. However, plans can change annually so you may want to at least compare options to make sure your plan is still the best fit for your needs. This can be very important for your drug plans (Medicare Part D) because medications change often and drug prices vary year to year.
Changes that can be made during Open Enrollment
If you would like a review of your current Medicare Plan, contact me and we can go over your options!
When you first enroll in Medicare you get a one-time only Welcome To Medicare physical exam. This is covered by Medicare the first 12 months after you have enrolled in Medicare Part B. The exam will include a thorough review of your health, education about preventive services you need and referrals for other care. I highly recommend everyone take advantage of this.
This is an easy way to get up to date on crucial screenings, shots and a chance to talk with your doctor about family history. At the Welcome to Medicare appointment your doctor will record your medical history, check your vision, blood pressure, and make sure you are up to date with all your preventative screenings like cancer and immunizations. If needed they will also order further tests. When you leave you will get a written plan letting you know which screenings and other preventative services you should have done.
How Much does the Welcome To Medicare Visit Cost?
It is free the first 12 months after you have enrolled in Medicare Part B. After the 12 months has come and gone you can get a yearly wellness visit which is also covered under Medicare. If you have any additional tests or services during these visits you may have to pay coinsurance and the Medicare Part B deductible.
What do I need to bring with me?
If you have any questions or comments please reach out to me
When starting Medicare it's important to know the difference between all the parts of Medicare. Part A, B, C, and D. You want to make sure you get the most out of Medicare and you find a plan that fits your needs as well.
The Basics of Medicare
Medicare is a federal health program, administered by CMS (Centers for Medicare and Medicaid) which is a division of the U.S. Health and Human Services (HHS). Most Medicare beneficiaries are senior citizens 65 and older. However, adults with permanent disabilities and some approved medical conditions such as ALS may also be eligible for Medicare Benefits.
U.S. citizens are eligible to enroll by working and paying taxes for 40 quarters. If you don't have the required amount of quarters you may still be eligible, but you will have to pay more.
4 Parts of Medicare A,B,C and D
Medicare Part A covers inpatient hospital Care, limited time in a skilled nursing facility, limited home health services, and hospice care. Think of this as your Hospital insurance. Most beneficiaries don't have to pay a premium for this part. If you worked your 40 quarters (10 years) and paid taxes Part A is free. If you didn't you can still receive benefits for Medicare Part A but you will have a premium.
Be aware that Part A doesn't cover the full amount of your hospital bill, and you will be responsible for the difference. There is also a deductible you have to pay before your benefits begin.
Medicare Part B covers the non-hospital medical expenses. Doctor visits, blood tests, X-rays, diabetic screening and supplies, and outpatient hospital care. For Medicare Part B you have a monthly premium. This premium for Original Medicare varies by income. The fee is much higher for people in high income brackets. For people in low income brackets who need help with coverage Medicaid is also available.
Medicare Part B also has a deductible before your benefits kick in. After that you are responsible for 20% of the bill.
Medicare Part C commonly know as Advantage Plans. These plans are offered by private insurance companies and are contracted through CMS. The benefit package are an alternative to Original Medicare but to qualify for Medicare Part C you must still be enrolled in Original Medicare. You still have to pay your Part B premium .
Medicare Advantage plans have to provide all the benefits of Original Medicare (except hospice) they can include additional benefits such as eye exams, hearing aids, and dental care. Many Medicare Advantage plans also include prescription drug coverage. These are called Medicare Advantage Prescription Drug plans.
Medicare Part D is prescription drug coverage. This is a stand alone plan through private insurance companies and the monthly fees vary between companies. Open enrollment for Part D is October 15th through December 7th and these plans may change every year.
Have questions or just need help Give Me a Call.
Welcome to our new insurance agency blog!
This is our very first post. We're not quite sure what we're going to write about here, but the plan is to create helpful content for customers and prospective clients about information that is relevant to you.
We hope you'll come to view this as a top resource for keeping your family and your finances safe.
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