What is Medicare?

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services. Some plans offer non-emergency coverage out of network, but typically at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, 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 copays, coinsurance and deductibles.

US BORN

In order to be eligible for Medicare you must either be of age, on disability, undergoing a course of dialysis or have a transplant.

FOREIGN BORN

If you were not originally born in the US or are not a citizen yet, you may still be eligible for Medicare. You must have at least 5 years of residency in the US, so if you immigrated later than age 60 you would become eligible after the age of 65.

There are a few different situations in which someone would become eligible to enroll into Medicare, the most common are below.

AGE: Medicare coverage based upon your age is at 65. For some who immigrated to the US later in life it could be after 65, depending on residency or alien status.

DISABILITY:  If you are receiving Social Security disability, after 2 years of receiving benefits, you become eligible for Medicare Part A and B. You may be eligible at an earlier date if you are on dialysis, read below.

END-STAGE RENAL DISEASE (ESRD): In the event you have kidney failure and/or a transplant and start a period of dialysis, you could be eligible for Medicare even if you are not on Disability.

Income Related Monthly Adjusted Amount is a surcharge that is based on your income. When you file your taxes with the IRS that information can be shared between federal agencies. Depending on Modified Adjusted Gross Income(MAGI) on your tax return, it could have an impact on what you pay for Medicare Part B and Part D. If you receive notification that you will have a surcharge, you can dispute it if you meet certain criteria. All you need to do is complete a form. Contact us now to find out more!

Assuming you become eligible for Medicare based on one of the situations above, but you already have health insurance via you or your spouse’s current employer? You may not need to enroll into all of Medicare. Everyone has a different situation and different coverage. Contact us today to find out more!