Medicare can be cumbersome for a lot of people and this article is meant to highlight the first steps. If you or someone you know is needing assistance with where to start, go to ssa.gov and create a login. Sometimes people are confused in going to the social security website to sign up for health coverage benefits but rest assured, you are in the right place to enroll in Medicare. If you have already created a social security login to view your social security statements, it should be under the same login. To create an account, you will need know some basic information such as social security number, date of birth, address, etc. Once you are logged into the social security website follow the instructions to sign up for Medicare Part A. Even if you are still working at age 65 or older it is wise to activate Medicare Part A because it costs nothing to enroll in Part A and it creates your Medicare ID number. Additionally, if the unexpected happens and you need care from a hospital, Medicare Part A could potentially supplement your work coverage. Long story short, there is no advantage to not signing up for Medicare Part A after you become eligible, but at this point in time there is also no penalty for not signing up for Part A.
Medicare Part B is often misunderstood. There can be lifelong penalties to people if they are eligible for Medicare B and do not enroll or have credible coverage through another source such as an employer because they are still working. There is a cost associated with signing up for Medicare Part B, the participant’s income will determine how much someone with pay for Medicare Part B and it is typically deducted from people’s social security income payments. If a participant is currently not receiving social security income payments, they will pay Medicare directly for the part B premium. Medicare Part B covers 80% of a participant’s medical costs (not covered under Part A), the participant is responsible for the remaining 20% of the bill. If people are eligible for Part B and do not have credible coverage and procrastinates signing up for Medicare Part B, they will pay a penalty when/if they eventually enroll in Part B. Some people think that delaying signing up for Medicare Part B will save them money because they do not have the deduction taken out of their social security income payments, but ultimately, they could end up paying more over the long run by delaying. Our recommendation for people is to sign up for Medicare Part B when they are eligible unless they have credible coverage in place. If someone has credible coverage in place, sign up for Medicare Part B when there is no longer credible coverage in place.
Medicare Part C is commonly known as Medicare Advantage and is administered through private insurance companies. The main reason why participants sign up for Medicare Advantage or Medicare Supplemental Insurance is to transfer the risk of the remaining 20% obligation they could face. With Medicare Part C there is a maximum out of pocket for participant, this is commonly referred to as “MOOP”, and is in the ballpark of $5,000 to $7,500. Medicare Part C advertisements can be misleading with “no costs” premium plans but you may still pay deductibles and copays for covered services, and you still must pay the Medicare Part B premium. There are pros and cons to Medicare Part C plans. Our recommendation is to speak with a knowledgeable independent insurance agent who is appointed with multiple insurance companies in order to gain the knowledge of the best Medicare plans in the participants zip code.
Medicare Part D pertains to prescription drug benefits. There can also be lifelong penalties to people if they are eligible for Medicare but do not have credible prescription drug coverage. Meaning if
someone retires at age 65 or older and they sign up for Medicare Part A & B but do not sign up for a prescription drug plan they will most likely incur a penalty per month on the premium if/when they do enroll in a prescription drug plan. If a participant signs up for a Medicare Part C plan, generally it will include a prescription drug option built into the plan. Our recommendation is to sign up for a Medicare Part D plan when someone is eligible unless they have credible prescription coverage through another source.
If you are interested in learning more about Medicare options, please reach out directly to our Bellevue, Washington office at 425-246-4222 or visit www.pacificinsurancegroup.com. One of our knowledgeable insurance licensed agents will be happy to listen and guide you to helpful information.