Medicare is a federal health insurance program that pays for much, but not all, of the medical expenses for people 65 and over.  It also covers individuals under 65 with certain disabilities.

These are the four parts:

  • Part A – helps cover inpatient care in a hospital, skilled nursing facility, hospice and home health care.
  • Part B – helps cover doctor’s services, hospital outpatient care, home health care, durable medical equipment and some preventative services.  For individuals new to Medicare in 2014 the average Part B premium was $104.90 per month. However, individuals whose modified adjusted gross income is above $85,000 or above $170,000 for married couples pay a higher amount.
  • Part C – is also known as Medicare Advantage or a Medicare Health Plan and is managed by Medicare-approved private insurance companies. These plans include all the benefits and services under A, B and usually provide drug coverage (Part D).
  • Part D – is Medicare prescription drug coverage which is managed by Medicare-approved private insurance companies. Individuals with income over a certain amount pay more for this coverage.
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 Medicare Supliment plans8 tips for North Carolina residents turning 65 or losing Employer coverage

1.    If you are retired or retiring from a government agency or company,  check to see if they will pay part or all of your Medicare Supplement Insurance or drug plan.

2.    Since Medicare does not pay for all medical expenses, Medicare beneficiaries who want to limit their medical expenses risk can either purchase a Medicare Supplement and a drug plan or a Medicare Advantage Plan with drug benefits included. With either choice they must be enrolled in Part B and continue to pay their monthly Part B premium. For additional information about Part B contact Social Security at 800-772-1213 or visit their web site at www.ssa.gov.

3.    Medicare Supplements sold today do not cover prescriptions.  If you neglect to purchase a drug plan when you are first eligible you may have to pay a higher premium if you decide to purchase one at a later date. Medicare beneficiaries with a limited income can apply for financial assistance from the Extra Help program that is available at your local Social Security office (www.socialsecurity.gov/extrahelp or call 800-772-1213).

4.    To avoid a break in coverage, being “rated up”(paying a higher premium) or declined due to your health, the best time to purchase a Medicare Supplement, drug plan or Medicare Advantage plan is during the three months before your 65thbirthday.

5.    If you rarely go to the doctor or are trying to keep your premiums low, do consider a Medicare Advantage Plan. In addition to offering low premiums and drug benefits, they frequently offer extras such as gym memberships, dental benefits and vision benefits. However, they typically have co-pays, hospital deductibles and restrictive doctor and hospital networks that you do not encounter with the popular Medicare Supplement Plan F.

6.    Government help for selecting your best plans includes the handbooks Medicare and You and Choosing a Medigap Policy, SHIIP (Seniors’ Health Insurance Information Program, 800-443-9354) and www.medicare.gov (800-633-4227).

7.    What appears to be your least expensive Medicare Supplement might not be in the future.  They can be “rated” in three ways:  Community-rated (Everyone in the same area, such as NC, pays the same, but rates can increase due to inflation and other factors.), Entry age (Rates may go up due to inflation and other factors, but not your age.) and Attained-age (premiums increase with age and inflation). Additionally, some insurance companies offer discounts initially that gradually disappear and leave the beneficiary with higher than anticipated monthly payments.

8.    Despite all the resources, selecting the best plans among these complex choices of benefits and companies is confusing for most people.  A broker (an independent licensed agent who represents multiple insurance companies) can help you navigate this myriad of plans and companies. Since these agents are compensated by the companies they represent, you will not pay an extra fee for using an agent versus doing all the work yourself.

Read more about Medicare Supplements Here, Read more about Medicare Advantage Plans here.

Contact Wanda
for more Medicare information