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  • Writer's picturerobin foster

New to Medicare? Some Basics to Consider.

Updated: Mar 26

Hello everyone,

I hope this email finds you all doing well. I was recently inspired to dig into a topic that is not of much concern for me at the moment, but might be of interest to all of you. Namely, navigating the Medicare regime. I have some information herein for those of you nearing 65 years old and wondering about how to tackle this when the time comes. Or, if you're smart, start focusing on eating right and exercising because figuring this stuff out might make you want to jump off a bridge!

Original Medicare - Original Medicare consists of Medicare Part A (hospital insurance) and Part B (medical insurance). You can sign up during your "Initial Enrollment Period" which lasts for seven months, starting three months before your 65th birthday, including your birthday month, and ending three months later. Did you forget to sign up? No problem, simply sign up during your "General Enrollment Period" from January 1 to March 31. It is primarily intended for those who missed their Initial Enrollment Period and want to sign up for Medicare Part A and/or Part B during this period. Lastly, there's a "Special Enrollment Period"where people may sign up in special circumstances (ie: planning to work beyond the age of 65, losing employer-based health coverage, relocating, or other qualifying situations). 

What is Medicare Part A? Medicare Part A provides hospital insurance, covering inpatient care, skilled nursing facilities, and some home health services. It's smart to enroll in Medicare Part A even if you're still working because it's free and supplements your primary insurance plan through an employer. 

What is Medicare Part B? Medicare Part B covers outpatient medical services including doctor’s visits, preventive care, outpatient surgeries, diagnostic tests, and durable medical equipment. It also covers services that are necessary to diagnose or treat medical conditions. However, you may want to hold off on enrolling in Medicare Part B if you prefer to stay on yours or a spouse's employer-provided plan because Medicare Part B typically requires a monthly premium while Medicare Part A is free for most people. Be aware that you'll need to actively delay your Medicare Part B enrollment upon turning 65 and that penalties will apply if you try enrolling in Medicare Part B later when your employer sponsored plan is lapsed. (Surprise, the government wants you to pay for this "entitlement" so the risk is on you for any mistaken lapse in coverage). 

And Don't Forget Medicare Part C! What? Yes, many people have decided to upgrade their Medicare options using a "Medicare Advantage" or "Medicare Part C" Plan.  Medicare Advantage Plans are another way to get your Medicare Part A and Part B through a private, Medicare approved insurance company. Medicare Advantage plans usually include prescription drug coverage. More importantly, these plans cover things that Original Medicare doesn't cover, like routine vision, dental, and hearing coverage. One client I had in recently also mentioned some pretty cool perks. His plan covers the cost of his gym membership. And some plans even qualify for up to $250 of over the counter medical products quarterly! That's right, why should you pay for bandaids, crutches, adult diapers, vitamins and basic medicine when it's already covered under this upgraded Medicare plan? 

Oh Wait, What's Medicare Part D? A stand-alone Medicare Part D Prescription Drug plan is a prescription drug coverage option that can be used with Original Medicare and, in some cases, Medicare Advantage plans. It is offered by private insurance companies approved by Medicare. Beneficiaries should consider their prescription drug needs when choosing a plan and review each plan’s formulary to ensure their required medications are covered. 

In the end, if you're like me, your eyes will glaze over at the myriad options available. And without the knowledge of how to apply a lot of the variables, it's hard to nail down a perfect choice in my mind. (For instance, will you start having large prescription drug payments or need expensive eye or dental care in the future? Who knows?). But, upon reaching age 65, it's simply something you have to do so you might as well try to get the best bang for your buck. If you want to start looking into your options ahead of time so you can plan accordingly, you might consider this basic website to start your research. I hope it helps.

Have a good rest of your week and don't hesitate to reach out if you have any insights into Medicare that I would be smart to pass along in a future newsletter.

Jason Ebert


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