Medicare 101: Things to Consider

Your Medicare question answered…

Retiring or New to Medicare? Are you turning 65 or just now retiring? Many folks have continued working past the age of 65 are now considering retirement. You might be feeling a little overwhelmed with all the information out there. Marketing is getting more clever all the time and it makes you feel like you’re not doing something right or you’re missing out on something. Remember it’s marketing. Their job is to reel you in and get you to make that phone call. Here is a quick overview on Medicare.

Original Medicare = Part A & B

These are the only parts that are provided by the Government. If you’ve worked your 40 quarters, which equals 10 years, then Part A should be free. Part B has a standard rate of $164.90, but can be higher based on your income. You can check what your Part B premium will be on Medicare.gov. Once you know this number, you will get a better idea of what your costs are for retirement planning. Many people are surprised about this cost and haven’t planned well enough. Once you’ve enrolled in Medicare Parts A & B, then you can purchase either a Medicare Advantage plan or a Medicare Supplement plan along with a Part D prescription drug plan.

Part C is a Medicare Advantage plan.

Typically these are HMO plans, but some PPO plans have become available over the past few years. The more rural you are, the less available these are. HMO plans are considered Managed Care, where you pick a Primary Care Physician from a network of providers. Once you’ve picked your doctor and start using the plan, you have to get referrals to see specialists. If you choose to go out of network, then you won’t have any coverage with the HMO’s. With PPO plans, you don’t have to pick a primary care physician upon enrolling and you don’t need referrals to see specialists. If you use in network doctors, you pay the in-network pricing. If you use out-of-network doctors, you pay quite a bit more, but at least you have freedom to go out of network.

With Medicare Advantage plans, most have deductibles and copays as you use the plan. Sometimes there are no copays, such as for Preventative Services, where you don’t pay anything. For bigger ticket items, like Inpatient Hospital, Outpatient Surgery, MRI’s, etc., you typically have larger copays. For smaller cost items, like x-rays and lab work, $0 to small copays are normal. Most Advantage plans include a Part D drug plan, so you’ll satisfy that portion that Medicare requires that you have.

Medicare Supplements

Medicare Supplements are not HMO or PPO plans. Supplements are secondary to Medicare. The Supplement can pay your deductibles and coinsurance that Medicare doesn’t pay. There are various plans but the most popular plans are Plan G and N. These plans do not cover medication you pick up at the pharmacy, so you’ll need to add a Part D drug plan also. There is a lot more detail that goes into these plans, but this is a good start to compare the differences.

Medicare Webinars!

To learn more details about Medicare, join one of our free webinars. We host them regularly. Contact us and we’ll send you an invite with a link to view. Or, if you would like to schedule a one on one meeting, feel free to contact us at: michele@mcInsuranceservices or 408-848-2271.

We can help put your mind at ease and our services are always free. If you’d like our help, you can email us at: michele@mcinsuranceservices.com, call our office (408-848-2271) to schedule a free consultation, or use the QR Code to visit our website.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do off er in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.