We provide all of the Education you need for Original Medicare and Medicare Advantage Plans so you can make an informed decision. Please take a moment to connect directly with one of our agents or use our Contact us page for an agent in your area. We look forward to serving you!

 

Today's Medicare is working with private companies that provide different ways to get your health care and prescription drug coverage in the Medicare Program. The Medicare plan that you choose affects many things like cost, benefits, doctor choice, convenience, and quality.

 

Help Paying for Health Care Costs

Your Medicare plan choices include:

 

Original Medicare – This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue Medicare card. There is an annual Hospital deductible of $1,484 and Medical is $203 for 2021

 

The Original Medicare Plan pays for many health care services and supplies, but it doesn't pay all of your health care costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called "GAPS" in Medicare coverage. You might want to consider buying a Medigap policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.

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There are wide ranges of health care coverage choices that may help pay for some of your health care costs. These health care choices work with the benefits you have from Medicare. What you choose will affect how much you pay, what benefits you have, which doctors you can see, and other things that may be important to you. For more information about programs that may help pay for some of your health care costs. Contact me for more information on Medicare

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• To manually enroll in Medicare Part A:

  • Visit Medicare.gov

  • Call 1-800-MEDICARE (1-800-633-4227) or TTY 1-877-486-2048

  • Medicare representatives are available 24/7

• You qualify for manual enrollment if:

  • You're 65 or older and meet citizenship/residency requirements

  • You're under 65, disabled, and lost premium-free Medicare Part A due to work

  • You haven't paid Medicare taxes or worked enough for premium-free Part A

• Costs (2023)if you have NOT worked the 40 quarter /10 year requirement:

  • Individuals/couples with 30–39 quarters: $278.00/month

  • Individuals/couples with fewer than 30 quarters: $506.00/month

• Situations requiring manual sign-up:

  • Not getting Social Security benefits

  • Have end-stage renal disease (ESRD)

  • Not eligible for premium-free Part A

• Annual adjusted premium rates:

  • Individuals/couples with 30–39 quarters: $278.00/month

  • Individuals/couples with fewer than 30 quarters: $506.00/month

• For more info and enrollment, contact Medicare via website or phone.

• Online: Social Security website at secure.ssa.gov/iClaim/rib to apply for Medicare Part A or Part B.

• By phone: Call Social Security at 1-800-772-1213 (TTY users, call 1-800-325-0778). Representatives are available Monday through Friday, from 7 AM to 7 PM.

• In-person: Visit your local Social Security office to apply. If you worked for a railroad, contact the RRB to apply at 1-877-772-5772. (TTY users, call 1-312-751-4701). You can call Monday through Friday, 9 AM to 3:30 PM, to speak to an RRB representative.

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Late Enrollment Penalty:

• If you delay enrolling in Medicare Part A and/or Part B, you might face a penalty.

• You can enroll during your Initial Enrollment Period, 3 months before you turn 65, including your birthday month, and 3 months after.

• Missed this? General Enrollment Period is Jan 1 - Mar 31, coverage begins July 1.

Late Enrollment Consequences:

• Waiting may lead to higher Part B premium (up 10%).

• Pay higher premium for twice the years you could've enrolled but didn't.

• Special Enrollment Period (SEP) can waive penalty, like if you have employer coverage.

• Employer Coverage Consideration:

  • If working and covered by employer health plan, Medicare signup might not be immediate.

  • Wait until leaving employer coverage to enroll in Medicare.

  • Some individuals or couples only sign up for Part A initially, Part B later after retiring.

Exceptions:

• Not a universal rule, restrictions apply.

• Check with employer's human resources for guidance on Medicare signup.

Remember, timely enrollment helps avoid penalties.

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How does Medicare supplement insurance work?​

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While Medicare Parts A and B (also called “Original Medicare”) cover some health care costs, they don’t pay for everything. Medicare supplement insurance plans from private insurers complement your Medicare coverage. These plans help cover some of your out-of-pocket expenses not paid by Medicare.

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Standardized Medicare supplement insurance plan benefits are set by the federal government. That means the basic benefit structure for each plan is the same, no matter which insurance company is selling it to you.

Some plan features are:

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• You're able to keep your own doctor without network restrictions, as long as they accept Medicare patients.

• Coverage goes with you when you travel in the U.S.

• You are guaranteed coverage for life. †As long as premiums are paid on time and there has been no material misrepresentation on the application. 

• Rates are subject to change. Any change will apply to all members of the same class insured under your plan who reside in your state.

• You may visit any specialist who accepts Medicare patients without a referral.

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Medicare Advantage - 

Medicare Advantage (Medicare “Part C”) is an “all in one” alternative to Original Medicare. These “bundled” plans include but are not limited to:

• Part A, Part B, and usually Part D. Most plans offer extra benefits Original Medicare doesn’t cover Your Medicare health plan decisions affect how much you pay for coverage, what services you get, what doctors you can use, and your quality of care.

• You my pay $0 in premium and as low as $0 to see a PCP (primary care physician) 

• May include benefits like: dental, vision, hearing, hearing aids, transportation, vitamins, in home care, "Give Back Benefit" Teledoctor, tele mental health, 24/7 nurse line and more. 

 

Learning about your Medicare coverage choices, getting help from people you trust, and comparing different plans can help you understand all the options available to you.

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Prescription Plans

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Prescription Drug Plans – Medicare does not pay for medicine from the pharmacy. There are stand-alone plans add prescription drug coverage to the Original Medicare Plan is know as Medicare Part D. Contact me for more information on Medicare Prescription Drug Plans. Most plans have high deductibles and most prescriptions have copays. If you use more than $4,430 worth of medication in a year you will likely enter what is know as the coverage gap also known as a donut hole. In the coverage gap you may be required to pay higher copays until you exit the coverage gap at $7,050. At that time you copays will decrease dramatically.

Ask one of our professionals now to learn more. 

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To learn more about this and other Health related topics, talk with a professional in your community. Make an appointment to speak with one of our professionals and see for yourself the Elkin Insurance difference. At Elkin Insurance "We Care About You".

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Call: 336-366-0960

Text: 336-366-0960

Email: Info@Elkininsurance.com

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The diagram below helps explain the Coverage Gap / Donut Hole.

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