Being new to Medicare you most likely will receive many calls from agents, brokers, telesales (divisions of the major carriers of Advantage plans and supplement plans). Remember that regardless of how many calls you get and sales pitches like:  "lets lock you in now", or "you need to get this taken care of today" you have a pretty large window of opportunity to make sure you make a decision that is right for you. As you already know there are many plans available from many different carriers.

You need to take a step back and determine what your needs are. Whether it is a specific doctor you want to stay with, how comfortable you are with deductibles vs monthly payments, along with things like do you intend to travel after retirement. These are all simple things that need to be discussed to make sure you pick the right plan.

So remember time is on your side. Find a dedicated, licensed agent that can offer programs from multiple companies, and all plan types, and go over all options available. Your agent should be someone you can talk to, a choice, like your doctor, that will be with you for years to come.

part A

What Is

Part A

After you are applying to Medicare, you are automatically enrolled in Plan A. Plan A is your hospital insurance plan. It covers nursing care and hospital stays, BUT NOT Dr. fees. Part A also covers some home health care, skilled nursing care after a hospital stay, and hospice care.

Typically, you do not have to pay a premium for Part A, as you long as you have paid into Social security via payroll taxes. However, you will have to pay a yearly deductible before Medicare will cover any hospitalization costs. For 2018 the Part A deductible $1340.00

Part A will pay about 80% of your Medicare – Approved inpatient costs for the first 60 days you are hospitalized. If your stay is longer you would have to pay a larger share of the costs.

For a complete in-depth look at Medicare Part A you can go to the Medicare official website and their definitions of Part A at:

part b

What Is

Part B

Part B pays for a portion of your doctor visits, some healthcare, medical equipment, outpatient procedures, rehabilitation therapy, laboratory tests, X-rays, mental health services, ambulance services and blood.

Part B is optional coverage, and you may opt out if you still have health coverage through an employer, credit union, your spouses, etc. The standard premium amount for 2018 was 134.00. and had a deductible of 183, before the part B kicks in, and then you will pay approx. 20%

WARNING!!: If you opt out of Part B when you initially enroll into Medicare, and eventually decide you want to add coverage you MAY have to pay a higher premium.

It is very important to carefully weigh the health care resources you have not only now but also for several years down the road. Having a licensed qualified agent assist in reviewing all your options can help provide the guidance needed to make decisions now that can have an impact years from now.

For a Complete in-depth look at Medicare Part B you can go to the Medicare official website and their definitions of part B at:

part c

What Is

Part C - Is it right for me?

Part C plans are offered through private insurance companies and approved by Medicare. Part C is also known as Medicare advantage, or Medicare Health Plans.

In order to get Part C, you must first have part A and part B.

There are many companies and plans available, and you get to pick the  company and plan based off your personal needs, current doctors (if you want to keep your doctor), Drug list (if choosing a plan with a drug plan attached).  By law part C must pay at the least the same health care services, as original Medicare, but sometimes pay for additional things not covered such as vision, and dental care. Most but not all Part C plans also provide some type of Drug coverage.

Advantage plans are typically organized by HMO’s (Health maintenance Organization) and / or PPO’s (Preferred Provider Organizations). In these types of plans you chose your PCP (Primary Healthcare Provider) and network. And services outside of the networks are either not covered, or covered less then if in your network. Making sure your plan covers your doctor, and hospitals of choice is vital in maintaining your current care structure. Make sure you discuss with your agent your specific requirements or absolutes in picking a plan.

You may additionally look into Private Fee for Service plans in certain areas.


What Is

Medicare Supplements

As with Part C, with supplements you must have parts A & B to be eligible to enroll in any available supplement. Also Medigap (supplements) do not and can not include Drug coverage. There are 11 standard supplement plans labeled A thru G and K thru N. and offer a variety of benefits filling different gaps you may personally need. All plans of the same letter are required to offer the same benefits, Only the premiums and sponsors of the plans vary.

By law you can only have one of these types of plans, and cannot have a Part C plan if you have a supplement. If you are married, you and your spouse will have to have separate plans. Below is a quick table of the standard plans available:

Before buying a supplement, you should review your current coverage if any, Make sure if you are on a retiree plan from your past / current employer, check the coverages offered vs the coverage available. IT may be cheaper to get on a Supplement plan now, but might not be the best decision based of future medical needs. Many retiree plans cease to exist if you choose to leave for different plan.

part d

What Is

Part D

Part D is the newest addition to the Alphabet of Medicare and helps cover prescription drugs.

Part D is optional and available to all who have enrolled in Parts A & B, and can be included in Part C, as a standalone, or in addition to a Medicare Supplement.

Part D plans are offered by private insurance companies that are approved by Medicare, and you sign up directly with the private insurer, or broker, agent.

If you are enrolled in part D, you will pay a monthly premium and sometimes a deductible as well as co-payments for your drugs. Each plan varies in cost of premiums, price of drugs, and its list of covered drugs. Make sure to check your drugs with your agent and the plans they can offer vs the plans available.