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 supplemental plan.

Note: If you like to plan ahead to make things easy, applying for Medicare Part B is a good first step.

Medicare coverage 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.  If you don’t get supplemental coverage, be prepared to pay 20% of your bills; this is especially important for large medical expenses such as heart disease, cancer, etc.

There is no cost for Medicare part A.

It depends on your income. The basic premium is $144.60 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. For example, if you had chemotherapy ($100,000), your 20% would be $20,000!  There is no out-of-pocket maximum or limit for Medicare Part B.

Average Monthly Premiums in 2020

Medicare Supplement Plan G         $ 118 to $128

Medicare Supplement Plan N         $108 to $128

Medicare Supplement Plans are MUCH LESS expensive than traditional under-65 health plans

  • A Platinum-level Health Plan in the under-65 market has an out-of-pocket exposure for $4,000; the premium would be around $2000/month.
  • A Medicare Supplement Plan G ($125)  PLUS a Medicare Part D Prescription Drug Plan ($15) is far less expensive than the under-65 health plans.
  • Out-of-pocket exposure for medical expenses is $198/year.

The lowest cost prescription drug plan is around $13/month. These low cost plans are excellent for someone who is only taking generic drugs as well as people who don’t currently take any medications.

For people who take a number of more expensive brand name drugs, the plans will also be more expensive ($25-$40/month)

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.

You can spend 20-30 hours on your own researching Medicare and supplement plans for Medicare only to end up thoroughly confused.

OR, 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 supplemental coverage
  • Help you find the best supplemental plan that offers the most value for your needs
  • Assist in completing the paper work
  • Help you search and enroll you in a Prescription Drug Benefit plan (Medicare Part D) that best fits your particular needs

      All in all, a professional insurance agent is your best resource.

There is no cost to you at all.

Insurance companies usually compensate agents around 10% of the premium cost to help the client find the right plans, and more importantly to provide ongoing services and guidance.

You can see any doctor who has 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.

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.

  • Yearly Wellness Visit”