#1 – Medicare Starts with the Parts – Learn These First At least 3 months prior to turning 65, begin to read up on Medicare Parts A, B, C and D to familiarize yourself with the basics. You first need to know what Medicare itself covers and doesn’t cover before you can decide whether a Medicare supplement (Medigap) plan makes sense for you, or if a Medicare Advantage plan would fit you better. Your Day 1 Email Lesson will take contain easy reading about the Parts of Medicare and how they coordi- nate to provide you both hospital and outpatient coverage. Look for that lesson in your inbox! # 2 - Determine your Anticipated Costs for Medicare You are eligible for Medicare at age 65 (or earlier if you qualify due to a disability). Medicare Part A will cost nothing for most people. It is considered “paid up” if you have worked at least 10 years in the U.S. and paid taxes during these years toward this future benefit. Medicare Parts B & D have monthly premiums. What you will pay for these parts depends on your modified adjusted gross income as filed on your tax returns. Our Day 2 Email Lesson will provide you charts to look up your anticipated costs. Then use our worksheet on Page 3 of this checklist to write in your expected costs. # 3 – Sign Up for the Medicare Parts that You Need Our Day 3 Email Lesson is all about enrollment. Most people enroll in Medicare at age 65, but if you still have employer-insurance you can opt to delay Part B until you retire. Both parts of Medicare can coordinate with your employer insurance to reduce costs for you. It can be tricky to weigh the cost vs. the benefits in this situation, so speak with an experienced agent to help you analyze what’s best for you. You can enroll in Medicare up to 3 months before your 65 th birthday. Your benefits will usually begin on the 1 st of that month. You can enroll at the Social Security website ( www.ssa.gov) or you can visit your local Social Security office in person to apply. # 4 - Find Out Which Plans Your Doctor Participates In There are 2 primary insurance options to help you with paying for things that Medicare doesn’t. These are Medicare supplement plans (also called Medigap) or Medicare Advantage plans. Finding out which plans your doctor accepts will help you decide which option is a better fit. Medicare supplement plans let you see any doctor that participates in Medicare regardless of which Medi- care supplement insurance company you choose. Medicare Advantage plans, on the other hand, have smaller private networks. If you are considering one, you‘ll want to find out which plans, if any, your doc- tors participates in. See our Day 4 Email Lesson for tips on what questions to ask your doctor so you can be sure. Billy Williams - 800-499-1942
Transcript
#1 – Medicare Starts with the Parts – Learn These First
At least 3 months prior to turning 65, begin to read up on Medicare Parts A, B, C and D to
familiarize yourself with the basics. You first need to know what Medicare itself covers and
doesn’t cover before you can decide whether a Medicare supplement (Medigap) plan makes sense for you, or if a Medicare Advantage plan would fit you better.
Your Day 1 Email Lesson will take contain easy reading about the Parts of Medicare and how they coordi-
nate to provide you both hospital and outpatient coverage. Look for that lesson in your inbox!
# 2 - Determine your Anticipated Costs for Medicare
You are eligible for Medicare at age 65 (or earlier if you qualify due to a disability). Medicare Part A will cost
nothing for most people. It is considered “paid up” if you have worked at least 10 years in the U.S. and paid
taxes during these years toward this future benefit.
Medicare Parts B & D have monthly premiums. What you will pay for these parts depends on your modified
adjusted gross income as filed on your tax returns. Our Day 2 Email Lesson will provide you charts to look
up your anticipated costs. Then use our worksheet on Page 3 of this checklist to write in your expected
costs.
# 3 – Sign Up for the Medicare Parts that You Need
Our Day 3 Email Lesson is all about enrollment. Most people enroll in Medicare at age 65, but if you still
have employer-insurance you can opt to delay Part B until you retire. Both parts of Medicare can
coordinate with your employer insurance to reduce costs for you. It can be tricky to weigh the cost vs. the
benefits in this situation, so speak with an experienced agent to help you analyze what’s best for you.
You can enroll in Medicare up to 3 months before your 65th birthday. Your benefits will usually begin on the
1st of that month. You can enroll at the Social Security website (www.ssa.gov) or you can visit your local
Social Security office in person to apply.
# 4 - Find Out Which Plans Your Doctor Participates In
There are 2 primary insurance options to help you with paying for things that Medicare doesn’t. These are
Medicare supplement plans (also called Medigap) or Medicare Advantage plans. Finding out which plans
your doctor accepts will help you decide which option is a better fit.
Medicare supplement plans let you see any doctor that participates in Medicare regardless of which Medi-
care supplement insurance company you choose. Medicare Advantage plans, on the other hand, have
smaller private networks. If you are considering one, you‘ll want to find out which plans, if any, your doc-
tors participates in. See our Day 4 Email Lesson for tips on what questions to ask your doctor so you can be
In 2006, Medicare rolled out the Part D program. This is a way for you to get coverage for many of your
retail prescription drugs. Most states have dozens of Part D plans. It is critical that you choose one that
offers your medications at good prices. Choosing the right plan can save you hundreds each year.
See our Day 5 Email Lesson to learn the important pieces of information needed for an accurate drug plan
analysis. Medicare has a great tool for this! If you’d rather have professional help with your analysis, we
handle this free of charge for our Medicare supplement and Medicare Advantage clients here at Medicare
Health Insurance Options.
# 6 – Choose your Supplemental Coverage
Medicare Part B covers only 80% of your outpatient costs. You pay the other 20% with no cap. Paying 20%
of something like knee surgery would cost you many thousands of dollars. So this is why supplemental
insurance exists – to help you pay for hospital and outpatient deductibles AND that other 20%.
Medicare supplement plans offer the fullest coverage. They help to pay that 20% and some (or all) of your
deductibles too. These plans let you choose your own doctors – no networks or referrals needed. See your
Day 6 Email Lesson to learn about popular plans like Plan F and Plan G. Then compare quotes from several
insurance companies to make sure you get the lowest price from a stable company with good financial rat-
ings. Our worksheet on page 3 will help you compare costs.
Medicare Advantage plans, on the other hand, usually have HMO or PPO networks of doctors. Complete
Step #4 first to determine if any plans include all of your doctors in the network. If you find a plan you’re
your doctor is in-network for, you can then use your drug list from Step #5 to confirm that plan includes the
medications that you need before enrolling.
An insurance broker like Medicare Health Insurance Options can provide these quotes and the drug analysis too. More importantly, we help you save time and hassle on the back end. If using another broker, be sure that agent is an independent agent who represents many companies so that you will benefit from price comparison and be able to take advantage of competition in the market place.
Additional Reading and Resources
Our 6-Day New to Medicare Mini course will walk you through each of these steps above in more detail.
We’ll point you to some easy reading material to help you learn more and accomplish each item on the
checklist. In the meantime, here are some resources on our website to further your learning.
Our Web Site - https://MedicareHealthInsuranceOptions.com - Our website has great information for
Medicare Newbies about Medicare costs and eligibility.
Our Facebook Page - https://www.facebook.com/AllThingsMedicare - We have many interesting and
informative stories posted to our page on a regular basis.
Costs for Medicare can vary because your Part B & D premiums are based on your income. You can get spe-cific answers to how much you will pay for your Medicare Part B premium by calling Medicare and soeak
with a specialist who can review your Medicare profile - 800-Medicare (800-633-4227)
Next, get quotes for Medigap plans. These are standardized by the government which makes them easy to
compare. An insurance broker like Boomer Benefits can help you compare not only prices but also financial
ratings and rate increase histories for each company, so that you make a good choice.
Original Medicare
Part A monthly premium – No premium for most people
Part B monthly premium – ________________________ (based on income)
26 Section 2: Signing Up for Medicare Part A & Part B
How much does Part A coverage cost? You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working for a certain amount of time. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy Part A.
In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both.
People who have to buy Part A will pay up to $422 each month in 2018.
What’s the Part A late enrollment penalty? If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, your monthly premium may go up 10%. You’ll have to pay the higher premium for twice the number of years you could’ve had Part A, but didn’t sign up.
Example: If you were eligible for Part A for 2 years but didn’t sign up, you’ll have to pay a 10% higher premium for 4 years.
How much does Part B coverage cost? The standard Part B premium amount for 2018 is $134 or higher depending on income. However, some people who get Social Security benefits will pay less than this amount ($130 on average). Social Security will tell you the exact amount you’ll pay for Part B in 2018. You’ll pay the standard premium amount (or higher) if:
■ You enroll in Part B for the first time in 2018. ■ You don’t get Social Security benefits. ■ You’re directly billed for your Part B premiums. ■ You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134 in 2018.) ■ Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. If so, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount, also known as IRMAA. IRMAA is an extra charge added to your premium.
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27Section 2: Signing Up for Medicare Part A & Part B
If your yearly income in 2016 wasYou pay (in 2018)
File individual tax return
File joint tax return
File married & separate tax return
$85,000 or less $170,000 or less $85,000 or less $134.00 above $85,000 up to $107,000
What’s the Part B late enrollment penalty? If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could’ve had Part B, but didn’t sign up for it. If you’re allowed to sign up for Part B during a Special Enrollment Period, you usually don’t pay a late enrollment penalty. See pages 21–22.
Example: Mr. Smith’s Initial Enrollment Period ended September 30, 2015. He waited to sign up for Part B until March 2018 during the General Enrollment Period. His Part B premium penalty is 20%, and he’ll have to pay this penalty for as long as he has Part B. (Even though Mr. Smith waited a total of 30 months to sign up, this included only 2 full 12-month periods.)
How can I pay my Part B premium? If you get Social Security or Railroad Retirement Board (RRB) benefits, your Medicare Part B (Medical Insurance) premium will get deducted from your benefit payment.
If you’re a federal retiree with an annuity from OPM and not entitled to RRB or SSA benefits, you may request to have your Medicare Part B premiums deducted from your annuity. You may contact 1-800-MEDICARE (1-800-633-4227) to make your request. TTY userscan call 1-877-486-2048.
Definitions of blue words are on pages 129–132.
If you need help paying your Part B premium, see pages 99–100.
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28 Section 2: Signing Up for Medicare Part A & Part B
If you don’t get these benefit payments, you’ll get a bill. If you choose to buy Part A, you’ll always get a bill for your premium. There are 4 ways to pay these bills:
1. Mail your premium payments to: Medicare Premium Collection Center P.O. Box 790355 St. Louis, Missouri 63179-0355
If you get a bill from the RRB, mail your premium payments to: RRB Medicare Premium Payments P.O. Box 979024 St. Louis, Missouri 63197-9000
2. Pay by credit/debit card. To do this, complete the bottom portion of the payment coupon on your Medicare bill and mail it to the address above.
3. Sign up for Medicare Easy Pay. Th s is a free service that automatically deducts your premium payments from your savings or checking account each month. Visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to learn more and to fi d out how to sign up. TTY users can call 1-877-486-2048.
4. Make an online bill payment. Th s is a more secure and faster way to make your payment without sending your personal information in the mail. Ask your bank if it allows customers to pay bills online. Not all banks offer this service and some may charge a fee. You’ll need to give the bank this information: ■ Account number: Your Medicare number without dashes (you’ll find this number on your red, white, and blue Medicare card). ■ Biller name: CMS Medicare Insurance ■ Remittance address:
Medicare Premium Collection Center P.O. Box 790355 St. Louis, Missouri 63179-0355
If you have questions about your premiums or need to change your address on your bill, call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. If your bills are from the RRB, call 1-877-772-5772. TTY users can call 1-312-751-4701.
If you’d like more information about paying your Medicare premiums, visit Medicare.gov to view the brochure “Understanding the Medicare Premium Bill Form (CMS-500).”
