November 19, 2018

Transitioning to Medicare

If you’re turning 65 this year, it’s time for Medicare, whether you are retiring or continuing to work until full retirement age of 67 or beyond. While some people automatically receive Medicare Parts A and B, most of us will need to sign up for them. Part A is generally free for most Americans, but Part B is not; failure to enroll for Part B in a timely manner will cost you a penalty every month for the rest of your lifetime.

Transitioning to Medicare from commercial healthcare can be a bit of a challenge, but the basics may seem familiar. You will need to understand commonly used terms, know the difference between Original Medicare and a Medicare Advantage Plan and you’ll want prescription drug coverage as well. ( Drug costs are the most commonly cited reason  for financial worries among  Medicare enrollees.)

Original Medicare includes:

  • Part A – Hospital Insurance (inpatient care). For most enrollees, there is no monthly premium for Part A.
  • Part B- Medical Insurance (doctors, outpatient care). The monthly premium enrollees pay for Part B in 2018 is $134.00. This may be deducted from your Social Security benefit.

There is no prescription drug coverage under  Original Medicare, - if you want drug coverage you must add a  Part D- Medicare Prescription Drug Coverage. (Helps cover the cost of your  medications).Failure to enroll in prescription drug coverage in a timely manner may result in a permanent late enrollment penalty.

Many enrollees prefer a Medicare Advantage Plan (Part C) instead of Original Medicare.  Advantage plans include all of the services covered under Parts A &B, usually include prescription drug coverage, have a yearly limit on your out-of-pocket costs, and may include other services, like eyeglasses. But you may have to use network providers, and there may be a  monthly premium for the Plan.

Regardless of whether you choose Original Medicare or an Advantage Plan, you will need to understand the following terms:

Coinsurance – The amount you may be required to pay for a service after you have met deductibles. (Usually 20%)

Copayment – The amount you may be required to pay as your share of a medical service. ( usually a set amount, like $25 for an office visit or $15 for each prescription.)

Deductible – The amount you must pay before Original Medicare begins to pay anything.

2018 Deductibles are:

  • Part A (hospital)  -  $1340.
  • Part B (Medical)  -  $183.
  • Part D (Prescription) for some plans - $405.

Premium – The periodic (usually monthly) rate you pay to a Plan for health or prescription drug coverage.

Making the best Medicare choices for you requires careful consideration of your individual healthcare needs. Medicare does not cover everything. Dental care- including dentures, eye care, hearing aids, long-term care and more are excluded.

The official U.S. Government Medicare handbook,- “Medicare & You”  sent to every eligible enrollee, every year, informs you of yearly changes and lists all plans available where you live.

To access Medicare information online see https://www.medicare.gov/

To reach Medicare by phone call 1-800-633-4227

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