WE STRONGLY RECOMMEND YOU APPLY AS EARLY AS POSSIBLE
- You can apply for Medicare Part B three (3) months prior to your “birth month.”
- For example, if your birth month is July, count back three months–June, May, April.
- You can apply for Medicare starting on April 1.
- The quickest way is applying online. See “New-to Medicare Checklist” on left menu.
- Starting 1-1-2020 insurance agents are required to include your new Medicare number in order to apply for a health plan. Normally it takes 3-6 weeks after you apply before you receive your new card.
- Once you receive your Medicare card, you should make an appointment to enroll in a Medicare Insurance Plan.
Note: If you like to plan ahead to make things easy, applying for Medicare Part B is a good first step.
Medicare coverage typically begins on the first day of your birthday month. If you were born on July 20th, then Medicare begins on July 1.
When you come off your group plan, that opens up a special enrollment and you can apply for Medicare, and any supplemental plans for Medicare, without any penalties. You will need to get a letter from your employer or insurance company verifying that you have had continuous coverage since turning 65.
Medicare Part A pays for hospital services. Part A also covers facility costs at a skilled nursing facility.
Medicare Part B pays for expenses other than facility charges such as doctor visits, labs, x-rays, surgeon, assistant surgeon and anesthesiologist.
Remember the 80/20 formula for Part B expenses. Medicare pays 80% of your medical costs. The remaining 20% is your out-of-pocket cost. If you get supplemental coverage, that supplement will pay that 20% for you.
For most there is no cost for Medicare part A.
It depends on your income. The basic premium is $164.90 per month, billed quarterly (every 3 months). If you have a higher individual or family yearly income, you may pay more for your Part B premium. Click on link below to see Part B Premium costs for higher annual income.
https://www.medicare.gov/your-medicare-costs/part-b-costs
If you receive Social Security, this Part B cost can be automatically deducted from your Social Security check saving you the stress/worry of missing a payment. If you are not receiving Social Security, you can have your Part B premium paid automatically using the Medicare “Easy Pay” System. Click on link below:
https://www.medicare.gov/your-medicare-costs/ways-to-pay-part-a-part-b-premiums/medicare-easy-pay
Medicare coverage has separate deductibles for hospital and medical services that you are required to pay. In addition, after meeting the deductible for medical services such as doctor visits, labs, x-rays, as well as MRI’s, surgeon and anesthesiologist, you will pay 20% of the costs. A Medicare Supplement plan pays those 20% costs for you.
The cost of the prescription drug plan varies based on the medications an individual uses.
For every month that you are eligible and don’t have a prescription drug you will be penalized 1% per month. For example, if you go five years without a plan, that totals 60 months (5 years x 12 months =60 months). When you get a plan, the penalty will be an additional 60% of the average plan at that time. And this penalty will be for a lifetime.
In about an hour, you can meet with a professional insurance agent at Hopper Insurance Services.
The agent will:
- Educate you on Medicare
- Educate you on options for Medicare Insurance Plans
- Help you find the best plan that offers the best value for your needs and budget
- Assist in completing the enrollment
All in all, a professional insurance agent is your best resource.
Agents are compensated by the insurance company; there is no cost to the client.
For Medicare Supplements, you can see any doctor who is contracted with Medicare. If you go to doctors who are not contracted with Medicare, you will need to pay their costs in full. Medicare pays $0 for non-contracted doctors.
For Medicare Advantage PPO, you can see any doctor who is in the insurance company network; you will pay a higher copay for a doctor out of the network.
For Medicare Advantage HMO, you can see only doctors in the insurance company network; there is no out of network coverage except in an emergency.
Since people over 65 often have greater medical requirements than younger people, doctors realize that contracting with Medicare will allow them to provide services to the rapidly growing group over age 65.
To find out if your doctor is contracted with medicare, click on the following link: http://www.medicare.gov/physiciancompare/search.html
Medicare has their own very cost-effective system for annual exams.
- “Welcome to Medicare Preventive Visit”
- During the first 12 months after you join Medicare, you can schedule an exam that provides your doctor with your baseline information.
- Click here for more details: https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit
- “Yearly Wellness Visit”
- After your first year on Medicare, you will get a yearly wellness visit, where your physician will review your Medical history and order the specific tests that you will need for that year.
- Click here for more details: https://www.medicare.gov/coverage/yearly-wellness-visits
We recommend that EVERYONE sign up for automatic monthly premium payments from your checking account.
Why? You never have to worry about being cancelled or dropped for nonpayment. Your trusted agent will complete all the paperwork for you, right there at the time of application.
You will have three (3) separate bills for your medical coverage
- The Medicare Part B premium: $144.60/month in 2020. Medicare will bill you on a QUARTERLY basis ($433.80).
- The Medicare Supplemental insurance premium ($89 to $130/month)
- The Prescription Drug Plan premium ($13 to $40/month)
All of these premiums can be set up on to be paid automatically from your checking account (aka “Easy Pay” or “Auto Pay”)