As financial advisors who help people save for retirement, we frequently get questions about Medicare enrollment. We are happy to offer free information and assistance to anyone who needs help making decisions about the Medicare options available to them. Schedule a consultation with Jonathan Leonard if you have questions about Medicare and Medicare Advantage plans. He will walk you through the enrollment process and answer all of your questions.
How Much Do You Know About Medicare?
Unless you have helped a parent or friend navigate Medicare, you might not know any more about it than what you occasionally hear on the news. In fact, many seniors who have had excellent health insurance their whole working lives are totally unprepared to make the transition. That's why we're here!
First, the basics. When you turn 65, you become eligible for Medicare, a federal health insurance program primarily available to individuals aged 65 and older. Medicare provides coverage for various health care services and helps reduce out-of-pocket expenses. Here is an overview of Medicare options available to you when you turn 65:
- Medicare Part A (Hospital Insurance). Medicare Part A covers inpatient hospital stays, skilled nursing facility care for a limited amount of time, hospice care, and some home health services. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working.
- Medicare Part B (Medical Insurance). Medicare Part B covers outpatient medical services, such as doctor visits, preventive care, lab tests, and durable medical equipment. Part B requires a monthly premium, and the amount is income-dependent. It is optional, but most individuals choose to enroll in Part B to have comprehensive coverage.
- Medicare Part C (Medicare Advantage). Medicare Advantage plans, also known as Part C, are offered by private insurance companies approved by Medicare. These plans combine the benefits of Part A and Part B and often include prescription drug coverage (Part D). Medicare Advantage plans may offer additional benefits like dental, vision, and hearing coverage. Premiums, deductibles, and co-pays vary depending on the specific plan.
- Medicare Part D (Prescription Drug Coverage). Medicare Part D is prescription drug coverage. It helps cover the cost of prescription medications and is available through private insurance companies approved by Medicare. Part D plans have different formularies and cost-sharing structures. Premiums and out-of-pocket costs depend on the specific plan and the medications covered.
- Medigap (Medicare Supplement Insurance). Medigap policies, also known as Medicare Supplement Insurance, are offered by private insurers to help cover the "gaps" in Original Medicare (Parts A and B). Medigap plans pay for some or all of the out-of-pocket costs, such as deductibles, coinsurance, and co-payments. There are different standardized Medigap plans, each offering different levels of coverage. Medigap policies require an additional monthly premium on top of the Part B premium.
You first become eligible to sign up for Medicare three months before you turn 65. Enrolling late can incur penalties and increase your premiums, so it's important to understand your Medicare obligations.
Talk to Us About Medicare Advantage Plans
Medicare Part C, or Medicare Advantage Plans, can be cost-effective for many people, providing more coverage for less money than traditional Medicare. You have probably seen the ads on TV—they run constantly during the open enrollment period from October through December each year. They might sound too good to be true, but we can walk you through your options and explain the advantages.
These plans offer:
- Comprehensive coverage. Medicare Advantage plans provide comprehensive coverage that combines the benefits of Original Medicare (Parts A and B) in a single plan. This means you have one plan that covers hospital stays, doctor visits, preventive care, and other medical services, often including prescription drug coverage (Part D).
- Additional benefits. Medicare Advantage plans may offer additional benefits not covered by Original Medicare, such as dental care, vision care, hearing aids, fitness programs, transportation services, and wellness programs. These extra benefits can contribute to improved overall health and well-being.
- Cost savings. Medicare Advantage plans often provide cost-saving opportunities compared to Original Medicare. They typically have annual out-of-pocket maximum limits, beyond which you won't have to pay for covered services for the remainder of the year. Some plans also have lower premiums than Original Medicare coupled with additional benefits.
- Care coordination. Medicare Advantage plans often include care coordination services. These services can help manage and coordinate your health care needs, ensuring you receive the appropriate care, minimizing duplicate services, and potentially improving health outcomes.
- Convenient coverage. Medicare Advantage plans can simplify health care administration as they often streamline coverage and claims processes into a single plan. This can be beneficial in terms of managing paperwork, understanding coverage details, and tracking health care expenses.
- Annual enrollment options. Medicare Advantage plans have an annual enrollment period during which you can review and switch plans if necessary. This allows you to reassess your health care needs, compare plan options, and make changes to your coverage as required.
Medicare Advantage plans often have provider networks, meaning you might be limited in the doctors and health care facilities you can go to. That's why it's important to work with a knowledgeable advisor who is not tied to any plan or insurance company.
Trust Us With Your Medicare Questions
At Leonard Financial Solutions, we don't charge a consulting fee to answer your Medicare questions and to help you with the enrollment process, so you have nothing to lose by calling us if you are confused about Medicare. We are happy to help our friends and neighbors understand their options and navigate the process. Contact us to schedule a meeting.