Hakuna Matata
*Swahili phrase, meaning no worries.
Seems like the older we get,
the faster it goes.
When you're young, who even thinks about the aggravation of getting older? Why? Because it's life at that time is so easy. That's why we created our business, to help people navigate something seemingly complex to make it super simple and super effective.
Our services cost you nada! Not one cent.
We've all seen gaggles of commercials talking about Medicare and Medicaid, but we closed our ears off because hey, that's nothing for me to think about right? And as we get older, our health becomes something we think about a lot.
Here's a few quick answers to common questions:
IEP stands for Initial Enrollment Period. This is the time when you are soon to be 65 years old OR first Enroll in Part B of Medicare. Unless you have other creditable coverage from an employer based plan or retirement plan, most of us Enroll in Part B of Medicare at or around the age of 65.
The time period around age 65 works like this:
It starts 3 months prior to your birth month
It includes your birth month
It ends 3 months after your birth month
This 7 month period (IEP) is when you can decide to and enroll in Medicare without any future Penalties for not enrolling when you turn 65.
Generally, we advise people to sign up for Medicare when they’re first eligible to avoid a gap in coverage and/or late enrollment penalties. For most people, Medicare eligibility starts three months before turning 65 and ends three months after turning 65. Some people get Medicare automatically. Visit Medicare.gov for more on eligibility and enrollment.
If you ARE receiving any type of Social Security Payments:
Social Security Retirement, or
Social Security Disability, or
Widow or Widowers Benefits
You will NOT have to Enroll in Medicare. You WILL BE Automatically Enrolled in both Parts A and B of Medicare. You will receive your Medicare Card (your Red, White, and Blue card) usually 2 to 4 months prior to your birth month. On the card, you will see your Medicare Claim number and Parts A and B effective dates.
If you ARE NOT receiving any type of Social Security Payments:
Enroll yourself at SSA.gov . It should only take you 10 to 15 minutes to do this. You will need to create an account on the Social Security website. Also, make sure that toward the end of the application that you choose Yes to enroll in Part B. You can sign up for Medicare Only here without signing up for Social Security Retirement Benefits.
You can request a replacement red, white, and blue Medicare card online using your personal Social Security account. Social Security will mail your replacement card within about 30 days to the address they have on file. You can also print an official copy of your card from your secure Medicare account.
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.
Depending on your job status, it varies. But you can expect it to be much less than any other health plans. Part of the cost also depends on whether you get supplemental insurance called Part B,C or D. Bottom line is every person has different plans, but the government will be paying the majority of it. This is why our consultative services will help you immediately get your expectations set!
Most people don't pay a monthly premium for Medicare Part A (sometimes called "premium-free Part A"). If you don't qualify for premium-free Part A, you can buy Part A. If you buy Part A, you will pay either $259 or $471 each month in 2021. The standard Medicare Part B premium amount is $148.50 (or higher depending on your income) in 2021.You pay $203.00 per year for your Part B deductible in 2021. Medicare Part D requires a monthly premium, but deductibles vary among Medicare drug plans.
Medicare Part B helps cover medical services like doctors' services, outpatient care, and other medical services that Part A doesn't cover.
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
Medicare Part D is Prescription Drug Coverage. Since January 1, 2006, everyone with Medicare, regardless of income, health status, or prescription drug usage has had access to prescription drug coverage. There's also some supplementary plans for prescription coverage that are incredible.
Medicare Supplements Plans (Also known as Medigap plans)
Medicare Supplement Insurance that helps fill the "gaps" in Original Medicare and are sold by private companies. Original Medicare pays for a portion, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:
Copayments
Coinsurance
Deductibles
IMPORTANT FACTS
• You must have Medicare Part A and Part B.
• You pay a monthly premium for your Medigap policy in addition to your Part B premium.
• A Medigap policy covers only one person. Spouses must buy a separate policy.
• A Medigap policy does not include prescription drug coverage. You must purchase a Stand-Alone Medicare drug plan.
• You need to compare Medigap policies as costs vary and may go up as you get older.
GUARANTEED COVERAGE
When you turn 65 or first enroll in Medicare Part B you have six months to choose a Medicare Supplement Plan without answering any health questions. In most cases, after those six months, insurers can ask health questions and can decline your application if they wish.
CHOICE OF DOCTORS AND HOSPITALS
Choose any willing doctor or Hospital that accepts Medicare.
PREMIUMS
A company cannot single you out for a rate increase or drop your coverage if your health changes.
Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans.
Health Maintenance Organization (HMO) Plans
Preferred Provider Organization (PPO) Plans
Private Fee-for-Service (PFFS) Plans
Special Needs Plans (SNPs)
Other less common types of Medicare Advantage Plans that may be available include HMO Point of Service (HMOPOS) Plans and a Medicare Medical Savings Account (MSA) Plan.
Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These "bundled" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).
Covered services in Medicare Advantage Plans
Medicare Advantage Plans cover all Medicare services. Some Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage.
Rules for Medicare Advantage Plans
Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
Each Medicare Advantage Plan can charge different out of pocket costs. They can also have different rules for how you get services, like:
Whether you need a referral to see a specialist
If you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care
These rules can change each year.
There are several federal programs available to provide you and your family with affordable health care coverage. There are also programs specifically available for older Americans, low-income people, children, people with disabilities, people with end-stage renal disease, and pregnant women. These programs include:
