best Medicare Advantage Plan or Medicare Supplement for their interest & situation!
best Medicare Advantage Plan or Medicare Supplement for their interest & situation!
I call SS's MediCare regulations "rules". They state you:
-> Become "eligible" for coverage the first day of the month when 65.
-> Decide when to sign up.
-> Can only sign up during the specific enrollment periods — steps to take and when are on this page!
There are two exceptions — A person who :
-> started SS benefits at least four months before 65 is automatically enrolled in Part A & B on their eligible month. Note: 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 usually better since surveys report Individuals received incorrect information when calling SS's main 800 # !
When calling the SS office tell them you want to talk to a Retirement person and ask them about:
-> completing your application for Part A & B.
-> current options to pay your share of Part B's monthly cost. It's $170.10 a month in 2022, Your share is 25% of MediCare Part B's costs across the US divided by the number of individuals participating.
Note: Your monthly Part B cost will be higher if your IRS 1040 AGI, from two years ago, is above 91k for Single & 182k for Joint. There are five income levels above the 91k, base and each has a higher monthly cost!
-> SS has good info on selecting a good age to start SS benefits. This summary may be useful.
A back and forth conversation with a SS Retirement person has many advantages. You can also go online and sign up on this SS page Note:
-> Online sign up is somewhat complicated so I recommend being careful.
-> The online option 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 ] to 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.
Last fall many Medicare Advantage ads were on TV with spokesmen saying — Call Today — get better coverage! — However, these ads:
● Cause people to be confused
● Mention " various new benefits" — BUT most are only available for low income individuals who are also eligible for MedicAid.
● Do not follow several Medicare marketing rules: The key one — most people can't sign up for a Medicare Advantage plan when they want!
Note: Scroll down on this page to the section on federal enrollment periods
Currently — MA ads during Jan, Feb, and Mar cannot just say anyone can call today. They must be focused. For example — call if you will soon be eligible for MediCare would be OK!
Note: The first three months of each year is MediCare's Medicare Advantage Open Enrollment Period. It is only for individuals not satisfied with their current Medicare Advantage plan, to make a change!
Another ongoing ad says - Buy their Medigap plan! [a Medicare Supplement] But:
● This companies plan is not approved in CT!
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.
Another survey found ― 55% of people report being confused!
Tip: Call John C Parker at (860) 451-9793. [Google Voice #] — We will talk about your situation / interest plus:
● 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 commitment to talk to John - not to enroll!
First — To sign up for Part B after 65 and not have a Part B late enrollment penalty:
● You have to be covered by your employers medical plan - or were in past 63 days. If so you will be eligible for a Special Enrollment Period (SEP)
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 [$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 to avoid B's late enrollment penalty
-> means you can select Part B coverage the month after leaving your employer or a month or two after.
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 and $233 in 2022.
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 take you to information on how each works with the MediCare system when you have many medical treatment / services:
● Medicare Advantage Plan in New London CT or a
● Medicare Supplement in CT
There are options for different level of coverage in each to meet your situation / interest / budget.
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 — John@MedicarePlansSECT.com
