Turning 65? Over 65? Please Read This!

One of the most confusing issues, not just to my clients, but to millions of Americans, is without a doubt, Medicare! It should be a simple thing. You turn 65, and you get this great (socialized) coverage from Uncle Sam which covers you for everything, for free, forever. Right? Well, no. Now that you’re near the age to get this coverage, or already have it, allow me to alert you. It’s really not that simple. Medicare won’t cover you for everything. Moreover, depending on your future health, you may be at risk for unlimited financial exposure!

  The good news is, private insurers have developed ways, sometimes with an added premium, to keep your financial exposure to a minimum and provide many of the services Medicare does not. It’s crucial to know your choices in this area. Due to a plethora of inquiries we’re getting for the upcoming Open Enrollment Period (Oct 15th -Dec 7th,) my team and I will be helping clients navigate this crucial coverage and arming you with information you can use to tailor the perfect, most affordable options, comparing choice carriers whose plans fit your specific lifestyle. We look forward to this challenge and welcome your calls and emails!

So, What is Medicare? Is it Socialized Healthcare?

Not exactly. Medicare (also called “Original Medicare”) is a fee-for-service health care program for seniors, in which the government pays health care providers directly for services that fall under the Part A and/or Part B of Medicare benefits (see guide below). However, and this is huge, Medicare isn’t designed to cover Prescription Drugs, Dental, Vision and a lot of other things you may need as you age. So if you are looking for more coverage than Original Medicare, you can purchase your choice of Medicare Advantage Plans to receive all of your Part A and Part B benefits, prescription drugs and much more. Medicare is divided into four categories. This allows you to customize your personal coverage when shopping for a comprehensive policy.

  • Part A (hospital/ER insurance): Covers hospital care, emergency services, nursing home care, home health services and hospice.
  • Part B (doctor/clinic insurance): Covers medically necessary services and supplies used for diagnosing and treating medical conditions, and preventative services for illness prevention and/or early detection. Examples include ambulance services, mental health care, outpatient procedures and clinical research.
  • Part C ( Medicare Advantage Plans) Combines Parts A and B and often vision, dental, and prescription drugs (Part D) as well.
  • Part D Offers prescription drug coverage.

When Original Medicare Isn’t Enough

Original Medicare offers coverage for services and supplies that are considered to be medically necessary, such as doctor visits, lab tests and wheelchairs. There are several alternative plans you can choose from for additional coverage, and each plan must offer at least the same coverage as Original Medicare. There are two Medicare plans that we can assist you with:
  1.  A Medicare Advantage Plan, also known as Part C, combines Part A and Part B as a replacement to Medicare for more comprehensive health care coverage. This plan can be customized with additional coverage, such as a prescription drug program (Part D), vision and dental. They are usually linked to an HMO or PPO provider network. Both Original Medicare and Medicare Advantage plans usually have annual deductibles, co-pays, coinsurance as well as monthly premiums.
  2.  A Medicare Supplement Plan, also known as ‘Medigap,’ has a higher premium but is used to cover the co-pays and deductibles that Part A and Part B do not. These plans also don’t limit you to a network.

Why Do You Need Medicare Planning?

As you may already know, seniors are in the most need of health care and the right healthcare insurance. Without it, they will can find themselves financially devastated if a claim where to arise. But once someone retires, those monthly premiums can become hard to maintain. Enrolling in a Medicare program when you’re eligible (the 3 1/2 months surrounding your 65th birthday) allows you to get most of the care you need at minimal cost. However, as many of you who are still reading this are aware, Medicare can be a real bitch to comprehend! And there are a ton of moving parts! Much more than I can mention here. Use us, or find someone you trust, but I won’t suggest trying to navigate this alone. You have options.

To sign up for Medicare, you can call Medicare 24 hours a day by dialing 800-MEDICARE, or go to their website at https://www.medicare.gov For more customized service, feel free to contact us now and learn more about comprehensive top-quality coverage options. We will be happy to work with you and determine which Medicare options work best for your lifestyle, health and budget.