the best Medicare Advantage Plan or Medicare Supplement for their situation & budget!
the best Medicare Advantage Plan or Medicare Supplement for their situation & budget!
I call these SS regulations for MediCare "rules". They state you:
-> Decide when to sign up.
-> Become "eligible" to have coverage the first day of the month when 65.
-> Can only sign up during specific enrollment periods — they are listed in the middle of the page.
There are two exceptions to the — individuals are eligible at 65 rules! A person who :
-> started SS benefits four months or more before 65 is automatically enrolled in MediCare's Part A & B on their eligible month. [They can opt out of Part B if on an employer medical plan.]
-> qualified for SS disability when under 65 becomes eligible for Part A & B after 24 months!
* The Local office is better since surveys report Individuals received incorrect information when calling SS's main 800 # !
When talking to the SS office ask about:
-> completing your application for Part A & B.
-> the options to pay your share of Part B's monthly cost. It = 25% of MediCare Part B's costs across the US divided by the number participating. It's $148.50 a month during 2021 and will be $170.10 in 2022.
Note: Your monthly cost will be higher if the AGI on your IRS 1040, from two years ago, is above 91k for Single & $182 for Joint. There are five income levels above the 91k base level each with a higher monthly cost!
-> SS's info to help you, select a good age to start SS benefits. Ask if they can mail the charts to you or can you get it online?.
A back and forth conversation with a SS Retirement person has many advantages. However, you can also go online and sign up on this SS page Scroll down to – How to apply just for MediCare then — select the Blue Button.
Note: On line sign up is not recommended when leaving an employer plan after 65! — Call if any questions on this .
Note: When the application is complete - MediCare calls you "entitled" [not enrolled ] for coverage under:
-> Part A — inpatient care in a hospital.
-> Part B — medically necessary outpatient services.
Note: Entitled is on your MediCare ID card above the date your Part A & B medical coverage started! See this ID card pic. The page also has info explaining the new style ID card.
A survey of individuals over 65 found:
- > 29% do not understand Medicare Advantage Plans
- > 23% do not understand Medicare Supplements
- > only 48% said enrollment was easy.
Tip: Call John C Parker at (860) 451-9793. [Google Voice #] — We will talk about your situation / interest then:
● how MediCare works
● if sign up is available, which type of Medicare Health Plan will be the best option for your situation!
Note: Calling is just a comment to talk to John - not to enroll!
First — To sign up after 65 with no Part B late enrollment penalty:
● You have to be covered by your employers medical plan - or were in past 63 days to be eligible for a Special Enrollment Period (SEP) to apply for Part B.
Second — Call the Local SS office — ask to talk to — a Retirement person. Tell them the date you plan to leave employer coverage and want to:
● Start Part B at that time.
-> FYI. They will also activate Part A but it will be backdated six months from your Part B date.
● Discuss options to pay your monthly cost for Part B [$148.80 in 2021 & $170.10 in 2022 ] :
-> it's deducted from SS when receiving benefits.
Third — To implement this SEP your employer has to complete a CMS-L564 form to confirm the dates you had employer medical coverage. Ask if they can:
-> eMail it to you.
You can also find CMS-L564 on this link – scroll down to the CMS-L564 link. You can also get the application form for Part B, CMS-40B, below it.
When the CMS-L564 is signed and returned to SS it:
-> approves your SEP so you can select the Part B date you want.
-> means you avoid B's late enrollment penalty.
BTW — If you did not have employer medical coverage you can't just sign up for Part B when you want! <—> Federal regulations limit sign up times when past 65 to these periods.
Let's look at — what would you pay for treatment/services if just using Part A & Part B! (called original Medicare)
MediCare — does not pay MDs or other outpatient providers 100% of the approved amount for the services they provide!
Let's look at — how the MediCare's system works — It:
● Reviews all medical treatments and services and "assigns" ** an approved amount for each.
● Asks MDs and other outpatient providers, who agreed to participate, to accept just 80% of the approved amount. Thus, providers have to accept "assignment".
** Discounted, often deeply, from retail!
Thus, when you use "original Medicare" and go for — any:
● Outpatient treatments or services you pay 20% of the amount MediCare's approved! You also pay, at the beginning of each year, Part B' deductible — It's $203 in 2021.
Bottom line — so many medical treatment and services are outpatient today so paying 20% could quickly be a Big Risk to your income & savings!
● In hospital treatment: When admitted Part A's coverage is very extensive and MediCare pays all medically necessary treatments / services — You would be responsible to pay Part A's deductible each time admitted. It's $1,484 in 2021.
Buy what I like to call a — Medicare Health Plan! Buying this special kind of insurance would be like — putting up an umbrella over your income & savings!
Note: If you don't buy — all the bills for 20% will come like a rain storm!
These two red links have information on how each protects when you have many medical treatment / services:
● Medicare Advantage Plan in New London CT or a
● Medicare Supplement in CT
There are options in each to meet your situation / interest / budget.
When you are thinking about buying a Medicare Health Plan — Beware of TV ads:
They say - Call Today - get better coverage! However:
● You can't call today to sign up for a Medicare Advantage plan. Sign up is limited to certain federal enrollment periods!
● Many of the "new benefits" mentioned are only available for individuals with low income who are also eligible for MedicAid.
Another ad says - Buy their [ Medigap plan ] a Medicare Supplement! But:
● This companies plan is not approved in CT!
It would be nice to not have a change in health — but in every life we know:
● No one can say an accident won't happen!
● The possibility of an illness with complex treatment is high, which means paying 20% for all outpatient treatment = significant costs!
What that means — because of what may happen in your life it's important — to buy either a:
-> Medicare Advantage (MA) Plan approved for New London County
-> Medicare Supplement approved in Connecticut
When you own either option it:
+ + protects your income & savings from big expenses
+ + puts you in control
+ + provides peace of mind which is priceless!
Note: You can change your Medicare Health Plan once a year and a Med. Supp. can be changed at any time!
Whether you'll soon be 65 — or planning to leave an employer plan after working past 65 call/text John C Parker's Google Voice today (860) 451-9793)
In perhaps multiple calls & eMail we can:
● Review your situation / interest / budget and which type will be best!
● Increase understanding of plan details and how it works in out area.
Note: Whatever time you need will be available to help you.
> I am told this is a big Help!
Then too it's OK to say — now is not the right time!
You can also send questions to me about signing up for a Medicare Advantage Plan or a Medicare Supplement:
● Using the form below or
● To — Learn@JohnCParker.agency
