Home » Part A
Tag:

Part A

Senior woman with laptop and smartphone working in home office
Medicare Plans

How to Enroll in Medicare if You’re Working Past 65

by My Senior Health Plan
written by My Senior Health Plan

For decades, the gold standard for retirement age was 65. But in the last several years, we’ve seen the retirement age inch up with many folks working past 65. Now, 20 percent of Americans age 65 and older are participating in the workforce—the highest rate in nearly six decades.

Some of this is due to the U.S. government formally changing the Social Security retirement age. Since 1983, the retirement age, previously set at 65 has slowly inched toward 67, with the current age set at 66 and eight months.

But there’s more going on here. Not only are we living longer, but also the cost of living is exponentially higher than 10 or 20 years ago. Unfortunately, many of us weren’t able to adequately plan for retirement.

What is fortunate is that no matter your employment status, you can still enroll in your Medicare benefit at age 65. Here’s how.

What if you have employer-provided health benefits?

When you turn 65, even if you’re working, you gain access to what’s called the Initial Enrollment Period (IEP). If you have employer-provided healthcare, you can still apply for Medicare Part A.

You may be wondering why this is necessary. If you require medical care not covered by your employer-provided plan, your Medicare Part A plan will pick up where your primary coverage leaves off. Part A Medicare benefit is premium-free, so you stand nothing to lose financially by enrolling.

If you have a spouse who isn’t working, is over 65 and covered by your private insurance, the same principles apply.

But do stay on top of enrolling, because Medicare won’t remind you to sign up unless you currently get Social Security or Railroad Retirement Board benefits. Also, in order to take advantage of Medicare, you or your spouse must have worked and paid Medicare taxes for at least 10 years of your lives.

What if you’re working past 65 and losing your employer-provided health benefits?

When you decide to retire, you’ll need to make changes to your (and your spouse’s, if applicable) Medicare coverage. You probably already have Part A at this point, but you need to get supplemental coverage to make up for what used to be covered by your employer-provided health insurance.

If you’re beyond your IEP and are losing your employer-provided insurance outside of another enrollment period, like OEP or AEP, you’ll be eligible for a Special Enrollment Period (SEP). SEPs enable beneficiaries with extenuating circumstances to enroll in Medicare programs outside the typical enrollment periods.

The SEP for Parts A and B will last for eight months beginning the month after you lose your private health insurance benefits. The SEP for Parts C and D will last for two months beginning the month after you lose your private health insurance benefits. So, if you retire in March 2020, you’ll have between the months of April and November 2020 to enroll in Medicare Parts A and B and April and May to enroll in Medicare Parts C and D, if needed. Confused? Don’t worry, MySeniorHealthPlan.com is here to help.

What about Medicare Part B and D?

You may be aware of penalties for late enrollment in Medicare Part B and/or D. Since you’re covered by employer-provided health insurance during your IEP, you may be eligible for a Special Enrollment Period (SEP) to delay enrolling in Parts B and D.

You’ll have to consult with your employer to confirm eligibility.

With any health insurance decision, particularly those related to Medicare, we recommend you work with your employer’s plan administrator to understand what coverage you have, what coverage you need and how those options will change upon retirement.

If you need help or have questions about Medicare when working past 65, visit our website or call (877) 255-6273. You’ll talk to a knowledgeable member of our team who will help you navigate the Medicare system and find your best coverage options.

You may also seek assistance from Medicare by calling (800) MEDICARE (1-800-633-4227).

 

0 comment
0 FacebookTwitterPinterestEmail
Medicare Plans

How to Avoid Medicare Late Penalties

by Jagger Esch
written by Jagger Esch

While there are many benefits to having Traditional Medicare, the few disadvantages come in the form of late penalties.

Traditional Medicare consists of two parts, Medicare Part A and Medicare Part B. Part A benefits are your hospital benefits and covers any treatment given during hospitalization.

Part B consists of coverage for doctor’s office visits, diagnostic testing, lab work, outpatient surgeries, and ER visits.

Prescription drug coverage is not available on Medicare Part A or Medicare Part B. There is Medicare Part D, which is stand-alone insurance that provides prescription medication coverage.

And while Medicare covers most everything, there’s still out of pocket costs like deductibles, copayments, coinsurance, and other medical expenses.

How to Avoid Medicare Part A Late Penalty Fees

Most seniors are automatically enrolled for Traditional Medicare Part A by the time they turn 65 years of age. If you or your spouse worked for ten or more years, you’ve paid into Medicare and are then enrolled without charge.

If you haven’t previously worked or haven’t fulfilled the required amount of time to become eligible, you may still enroll; however, there may be a premium to pay.

For those not automatically enrolled in Medicare Part A, there’s a timeframe called the Initial Enrollment Period (IEP). The IEP starts the three months leading up to your 65th birthday and then lasts through the three months following your birthday month.

Failing to enroll during this period will result in the Medicare Part A penalty. The Medicare Part A penalty adds an extra 10% to the Part A premiums.

Each year gone without Part A benefits is multiplied by two and then added onto the premium costs. Depending on how long gone without enrollment, will determine the penalty fees as well as how long they will be charged.

How to Avoid Medicare Part B Late Penalty Fees

With Medicare Part B, enrollment is standard, and the Initial Enrollment Period is the same as enrollment for Medicare Part A.

As of 2018, The Centers for Medicare and Medicaid Services (CMS) set the Part B premium as $134.00. This can increase, however, based on income and decrease if ones on Social Security or disabled.

While the IEP’s are the same with both Medicare Part A and Medicare Part B, the penalty is different. The Medicare Part B penalty increases your monthly premium by 10% for every year gone without Part B benefits.

Unlike Medicare Part A’s penalty, with the Medicare Part B penalty, the extra premium charge is paid for the duration of time the Part B benefits are carried.

How to Avoid Medicare Part D Late Penalty Fees

With Medicare Part D, the various private health insurance carriers in your area offer the Prescription Drug Plans (PDP).

As of 2018, the Medicare Part D premium averages around $34.00; however, plan pricing can differ because of location and plan.

Just like with Traditional Medicare, the IEP is effective for the seven months surrounding your 65th birthday. Medicare Part D for prescription drug coverage is optional; however, there is a Part D penalty for not enrolling in the Initial Enrollment Period.

After 63 consecutive days or more having gone without Medicare Part D results in the penalty.

You will be penalized unless you have any of the following:

  • A Medicare PDP
  • A Medicare Advantage Plan or Medicare Part C Plan offering prescription benefits
  • Creditable coverage through employmentor the union with benefits offers at least, if not more, of Medicare’s standard prescription drug coverage.
  • Any other Prescription Drug Plan offered by a different Medicare Plan

 

The Part D penalty is calculated by adding 1% for each month without prescription drug coverage. Once this is determined, the penalty is then rounded to the nearest $.10 and then added onto the monthly premium.

The Part D penalty is permanent and must be paid while prescription drug coverage is active.

Another downside, the penalty may increase every time there’s an increase in the national base beneficiary premium.

Medicare Late Enrollment Exceptions

For Medicare Part A and Medicare Part B, penalty exceptions are possible if you or a spouse carry qualifying health insurance from another source.

Although there are Special Enrollment Periods (SEP) available when an individual loses health insurance from a union or group health plan, they have 8 months to enroll for Traditional Medicare benefits.

If the Medicare beneficiary enrolls during the SEP, no penalties will be enforced.

There is also a late enrollment exception with Medicare Part D. Medicare Part D offers the Extra Help program which subsidizes prescription drug costs for individuals with low income.

This Extra Help Program helps on expenses associated with deductibles, premiums, copays, and coinsurance.

With the Extra Help program, there are no late penalty fees. Another benefit with the Extra Help program is there is no Part D coverage gap which is also known as the. “donut hole”.

Additional Medicare Help

With all the penalties tied to late enrollment, it’s easy to see how quickly the out of pocket expenses can add up.

Most seniors are on a fixed income, you’ll want to enroll in Medicare as soon as possible to avoid any late penalty fees associated with the three parts offered by Medicare.

There are several options in which additional assistance can be provided for seniors carrying Medicare benefits. Opting for a Medicare Advantage Plan or subsidizing with a Medicare Supplement Plan will save you money and provide benefits.

0 comment
0 FacebookTwitterPinterestEmail
Worried senior couple discussing over medical bills at home
Medicare Plans

Are You Ready for Medicare Open Enrollment?

by Carol Marak
written by Carol Marak

It’s Medicare open enrollment period starting October 15 and through December 7, 2019. Your chance to change coverage (Medicare plans) if you want.

Medicare Part C plans, known as Medicare Advantage plans are private health insurance plans, mainly HMOs and PPOs, for people enrolled in Medicare. If you enroll in a Medicare Advantage plan, you still have Medicare, but you get all of your Medicare-covered benefits through a private plan.

Most Medicare Advantage plans also cover prescription drugs and may cover other services, like vision, dental, and hearing. If you have Part A and Part B and are covered under the Original Medicare program, then you do not need to sign up for a Medicare Advantage plan during Open Enrollment unless you want to get your Medicare benefits through a private plan.

Medicare Advantage plans restrict the health care providers that enrollees see (provider networks) whereas beneficiaries in the Original Medicare may see any doctor that accepts Medicare, without needing prior authorization or a referral from their primary care doctor.

Start Your Research

Now is the time to research and make preliminary calls to get an idea of what changes (if any) need to be made to your Medicare coverage. Gathering information now will prevent you from making knee-jerk decisions at the end of enrollment. Here are six steps to take:

  • Become familiar with each part of Medicare, Part A, Part B, Part C, and Part D. This glossary explains terms in the Medicare program, https://www.medicare.gov/glossary/.
  • If you have a Medicare Advantage Plan (Part C), are you happy with it? Be sure to read all mail from the carrier which arrives in September and October. Look for any changes to monthly premiums, deductibles, copays and provider groups.
  • If you have a Medicare Supplemental Insurance policy (Medigap), check for any changes or monthly premium increases. Some beneficiaries switch from Medigap to a Part C (Medicare Advantage Plan) at this time of year.
  • If you’ve spent a lot of money out-of-pocket on hospital visits and doctor’s appointments because you don’t have a Supplemental insurance plan or Medicare Advantage Plan, add up expenses to know if a more coverage would help save money. Or check with Medicaid, a state Medicare Savings Program, the “Extra Help” program, or the local State Health Insurance Assistance Program (SHIP).
  • Get up-to-date information on your health status. Is your annual visit with the primary care physician coming up? Will you need to see a specialist? Make a list of all your prescription medications. If any are brand name, ask the pharmacist if there are generic equivalent. If not, ask your insurance plan Part C or Part D for an exception if the expensive brand-name medication isn’t part of the drug formulary.
0 comment
0 FacebookTwitterPinterestEmail
Medicare Plans

Medicare Open Enrollment 2019: What You Should Know

by Guest Blogger
written by Guest Blogger

What: Medicare Annual Enrollment Period (AEP)
Also known as the Annual Election Period or Medicare Open Enrollment

When: October 15 through December 7, 2019

Medicare beneficiaries have one guaranteed chance to make changes to their Medicare enrollment each year — the Medicare Annual Enrollment Period from October 15th through December 7th. During this period, you can:

  • Enroll in a Medicare Advantage Plan
  • Enroll in a Part D Prescription Drug Plan
  • Drop a Part C or D Plan

Understanding the Medicare Parts

Original Medicare — Parts A & B

Original Medicare, the coverage offered by the federal government, includes coverage for some hospital services, as well as preventative and medically necessary care. It does not include coverage for prescription drugs, vision, dental, and a number of other categories. You only have to enroll in this coverage once, when you are initially eligible by turning 65or through having a disability, end-stage renal disease, or ALS.

Medicare Advantage — Part C

Medicare Advantage Plansare offered by private insurance companies that are contracted with the federal government. These plans include the same coverage as Original Medicare, and many plans also offer additional benefits like vision, dental, hearing, fitness, and wellness. Some also offer prescription drug coverage, which is critical for many people.

Prescription Drug Plans — Part D

Individuals who are enrolled in just Original Medicare or a Part C plan without prescription drug coverage may also enroll in a Part D plan, which offers only prescription drug coverage.

Changing Plans During AEP

The Medicare Annual Enrollment Periodis a great time to find out what new Medicare plans or benefits might be offered in your area. If you’re covered by Original Medicare only, you may be able to gain benefits like vision, dental, hearing, fitness, and prescription drug coverage by enrolling in a Medicare Advantage Plan. Some of those plans may be available with $0 premiums, copays, and deductibles, making it possible to get more benefits at no additional cost.

If you’re already enrolled in a Medicare Advantage Plan, the Annual Enrollment Period is an opportunity to find out what other Medicare Advantage Plans are available in your area. Plan benefits change each year, so there may be a plan that’s now better suited to you.

New Medicare Advantage Benefits in 2020

Due to updated regulations in 2019 from the Centers for Medicare and Medicaid Services (CMS), insurance providers can now offer a wider range of benefits with Medicare Advantage plans in 2020, including things like:

  • Home helpers/in-home support
  • Transportation
  • Meal delivery
  • Safety/assistive devices
  • Day center visits
  • Fitness membership

 

Several of these additions improve coverage for long-term care and at-home support, which have long been areas where there was little or no Medicare coverage. Review the Medicare Advantage plans in your area to discover if these benefits are available for you.

AEP and Dual Eligibility

Some Medicare beneficiaries are also eligible for Medicaid through their states. These individuals are considered dual eligible and may be qualified for additional assistance with Medicare costs, such as premiums and prescription drugs.

Individuals who are dual eligible can also enroll in Medicare Advantage plans called Special Needs Plans (SNPs). If you are uncertain about your Medicaid eligibility, the Annual Enrollment Period is a good time to look at Medicaid information in your state and make sure you’re not missing out on benefits or assistance you could be receiving.

Medicare Annual Enrollment Period Resources

Medicare AEP Toolkit

You can learn more about this enrollment period with easyMedicare.com’s Annual Enrollment Period Toolkit. This convenient online resource includes information on how to prepare for AEP, a guide to this enrollment period, and answers to frequently asked questions.

Online Enrollment Portal

You can easily enroll in a Medicare Advantage plan during the Annual Enrollment Period using the Medicare Online Enrollment Portal. Use your zip code to search for plans in your area, choose plans to compare side-by-side, and then follow the guided process to enroll in the plan of your choice.

The portal includes plans from a number of top carriers, like Humana, United Healthcare (UHC), and WellCare. It is available 24/7 — no waiting on hold or trying to schedule a callback from an agent. The site is designed with high-contrast adjustable text for your ease of use. It is also equipped with SSL encryption to protect your personal information.

Summary

The Medicare Annual Enrollment Period occurs October 15 through December 7. This enrollment period is critical to your healthcare coverage for 2020 and you may be able to save money, receive additional assistance, or gain new benefits by enrolling in a Medicare Advantage plan during this time. The Medicare AEP Toolkit is a resource for additional information about taking advantage of this enrollment period. You can easily enroll in a Medicare Advantage plan through the Medicare Online Enrollment Portal.

By the easyMedicare.com Team

easyMedicare.com is an independent digital insurance marketplace providing individuals the ability to purchase Medicare insurance from the comfort of their homes. The company has proudly served tens of thousands of people across the United States.

 

 

0 comment
0 FacebookTwitterPinterestEmail
If you get Cancer what does Medicare Cover?
Medicare Plans

If you get cancer, what does medicare cover?

by Jagger Esch
written by Jagger Esch

A cancer diagnosis after the age of 65 can be overwhelming, but with Medicare and the right supplemental coverage, paying for medical care doesn’t have to be. Understanding the facts and benefits of Medicare regarding cancer coverage will make going through the process of treatment, from oral medication to surgery, a little bit easier for patients and their loved ones. If you get Cancer what does Medicare Cover?
Medicare does a very good job of covering cancer treatment for those 65 and over. The American Cancer Society reports that Medicare pays for nearly half of the $74 billion spent on cancer treatment each year.
Medicare covers most of the expenses involved with cancer treatment, and a Medigap plan can cover the rest.

What Does Medicare Part A Cover?

Medicare Part A covers hospital stays for cancer treatment. There is a deductible of $1340 (2018) that must be met before coverage begins. That expense can be covered by a Medigap plan, which is a supplemental insurance policy that pays for expenses that Medicare does not. A Medigap plan can greatly reduce the cost of cancer treatment for Medicare recipients.
Medicare Part A also pays for the full cost of skilled nursing facility care for 20 days after cancer surgery. This amount can also be increased with a Medigap plan. Those who don’t have money to pay such expensive medical bill may consider medical loans for bad credit. Low rates and easy repayments!
Skilled nursing care is vital to the successful recovery of patients who have cancer surgery, as it allows for time to heal while being expertly cared for by professionals, as opposed to returning home and having loved ones caring for patients. The idea of more time away from home may not be appealing, but in the long run the extra time in qualified hands will benefit not only the patient but their family members as well.
If hospice care is needed, Medicare Part A will cover it.

What Does Medicare Part B Cover?

Medicare Part B covers 80% of the cost of doctor’s office visits and treatments onsite, including cancer screenings, chemotherapy and radiation administered in the doctor’s office, tests and other outpatient care. A Medigap plan will pay for the other 20% of expenses for doctor’s office visits and treatments.
Part B covers some of the cost of medication for cancer treatment. Part B will pay for 80 percent of the cost of intravenous cancer treatment and intravenous anti-nausea drugs. If your doctor decides to treat your nausea with oral medication instead, it will cover 80% of those medications as long as they are taken within 48 hours of the cancer treatment. A Medigap plan will take care of the 20% of medication costs not covered by Part B.

What Does Medicare Part D Cover?

Medicare Part D, the prescription drug coverage plan, covers cancer prevention medications, anti-nausea drugs in pill form, and any injections that you give yourself during your cancer treatment. The cost of cancer drugs, from chemotherapy to immunotherapy, can be extremely high. Medicare Part D is essential to keeping those costs at a minimum for the patient.

What Does a Medicare Advantage Plan Cover?

Medicare Advantage plans, offered by private, Medicare-approved insurance companies, include all your Medicare Part A and Part B benefits. Medicare Advantage plans often include extra benefits, such as prescription drug coverage that are useful for a patient undergoing cancer treatment.
The downsides of a Medicare Advantage plan for cancer treatment is that patients may need referrals and will be limited as to which doctor they can choose to see based on who is in their plan. This can both slow down the process for getting treatment and prevent patients from seeing doctors who may be experts in treating their form of cancer.

Additional Things to Know About Medicare and Cancer

Medicare is invested in screening and prevention of cancer. Medicare members can and should take advantage of:

  • Mammograms every year for women over 40, including 3D mammograms in some states.
  • Pap smears and pelvic exams to screen for cervical and vaginal cancer, once every 24 months, or annually for women who are at increased risk.
  • Colorectal cancer screenings. A colonoscopy every 10 years is recommended for anyone over 50. Those with a higher risk can be screened more frequently under Medicare plans.
  • Annual lung cancer screenings for smokers or former smokers aged 55-77, if their physicians request the procedure.
  • Prostate cancer screening annually for men over 50. One in seven men is diagnosed with prostate cancer, but only one in 41 will die from it, due to early screening and intervention.
  • Although hair loss is a problematic side effect of some cancer treatments, Medicare does not cover the cost of wigs.
  • Medicare Parts A and B cover cancer treatment no matter how old you are.

Be prepared if you are diagnosed with cancer by understanding the coverage you have under Medicare and Medicare Advantage plans. Consider a Medigap plan to cover the costs that Medicare does not pay for. Get the care and treatment that is available to you through Medicare to stay healthy and get well.

If you get Cancer what does Medicare Cover?

If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover?If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover?

0 comment
0 FacebookTwitterPinterestEmail