What is Medicare?
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with permanent kidney failure (also known as End-Stage Renal Disease or ESRD). Medicare covers many health care services and supplies, but there are many costs (gaps) it does not cover.
Different parts of Medicare:
• Part A (Hospital Insurance) - helps covers inpatient care in hospital and helps cover skilled nursing facilities, home health, and hospice care. The monthly premium is zero for most members if they have paid into Social Security.
• Part B (Medical Insurance) - helps covers doctor’s services and outpatient care, other medical services that Part A does not cover (like physical and occupational therapists), and some home health care. The monthly premium for this benefit is $134 for 2017 and increases approximately 5% every year.
•Part C (Medicare Advantage Plans) – health coverage options (like PPOs and HMOs) run by private companies approved by and under contract with Medicare. Includes Part A and Part B, and usually includes other coverage like prescription drugs.
• Part D (Medicare Prescription Drug Coverage) – a prescription drug option run by private insurance companies approved by and under contract with Medicare
We know that Medicare, with all its “parts” can get somewhat confusing. On top of that, when it comes time to choose a Medicare Advantage or Supplement plan that is right for you, the possibilities can seem endless. It is important to review your health care needs every year. If you are dissatisfied with your current plan’s cost and coverage or customer services you have options for change.
If you are just starting to investigate senior plans or have questions about your current coverage please call us or Contact Us if you would like to discuss your options.
Deductibles:
2018 Part A $1340 Part B $183
2017 Part A $1316 Part B $183
2016 Part A $1288 Part B $166
2015 Part A $1260 Part B $147
Eligibility:
Enrolled in Medicare A & B
Guaranteed issue rights
Enrollment Periods:
Annual Election Period: October 15 to December 7
Medicare Dis-enrollment Period: January 1 to February 14
Initial Coverage Enrollment Period (ICEP): Within 3 months of your 65th birthday, and 3 months after your birthday month
General Enrollment Period: January 1 - March 31 If you did not sign up for Part A and/or Part B (for which you must pay premiums) when you were first eligible, you can sign up. Your coverage will begin July 1. You may have to pay a higher Part A and/or Part B premium for late enrollment.
Special Election Period: when circumstances apply such as moving into a new area, change in Medicaid eligibility, full and partial dual eligibility. Within 60 days of losing your group health coverage.
Open Enrollment Period for Institutionalized Individuals (OEPI): a continuous period for individuals who move into, reside in, or move out of an institution. OEPI ends two months after the month the individual moves out of an institution.