8 Things to Know About Medicare BeforeTurning 65!
Susan Diamond | September 24, 2024
Turning 65 is no small feat — it’s a significant milestone.
As we approach our golden years, healthcare assumes a pivotal role in our lives. This is where Medicare comes into play, providing health insurance for those aged 65 or older and those with certain medical conditions.
There is a lot to know about Medicare, and navigating the complexities may appear overwhelming. To guide you through this process, we’ve pinpointed nine key facts about Medicare to get you started:
Eligibility Criteria
To be eligible for Medicare requires being 65 years old, disabled for 24 months, or having End Stage Renal Disease.
Coverage Options
Medicare is divided into four Parts: A, B, C, and D.
Part A covers inpatient care in hospitals and other medical facilities, while Part B covers medical services and supplies, such as doctor visits and preventative care. Part C, also known as Medicare Advantage, combines Part A, and B, and often includes additional benefits such as dental, vision, and hearing. Part D covers prescription drug costs. Private insurance companies provide Medicare Advantage plans and Part D drug coverage. Each part incurs varying costs, including monthly premiums, deductibles, coinsurance, and copays.
Enrollment Periods
Medicare enrollment is limited to specific times of the year, and it is crucial to enroll during the seven months that surround your 65th birthday. This ensures you can access the benefits when you need them. Failure to do so can result in late enrollment penalties.
Additionally, there are special enrollment periods for individuals who continue to work past the age of 65.
Late Enrollment Penalties
If you miss your initial or special enrollment period, you may face penalties in the form of higher premiums for Part B and potentially Part D coverage as well. It is essential to stay informed about enrollment deadlines to avoid these penalties.
Working Past 65?
For those who continue to work past the age of 65, it is essential to take proactive steps to ensure coverage upon retirement. Consider options like staying on your employer’s or spouse’s healthcare plan, or signing up for Medicare. Plan ahead to guarantee the right coverage when needed.
Medicare Supplement Plans
Medicare Supplement plans, which are offered by private insurance companies, help fill the payment gaps left by Medicare. These plans provide coverage for deductibles, coinsurance, and copay costs, albeit with a higher monthly premium. Supplement plans offer peace of mind by reducing out-of-pocket expenses.
In- and Out-of-Network Providers:
As mentioned earlier, Medicare Advantage (MA) plans, also known as Part C, are provided by private insurance companies. These companies have networks of hospitals, doctors, and healthcare providers that have agreements with the plan. If you’re enrolled in an MA plan, you may be restricted to using providers within this network. Using providers outside the network, except in emergencies, may result in higher out-of-pocket expenses or denial of services.
Receiving Medicare through Social Security
If you receive Social Security benefits before reaching 65, you will automatically be enrolled in Medicare Parts A and B once you turn 65. A portion of your benefits will go towards covering the Medicare premiums monthly. Premiums and costs for Parts A and B vary based on income level, but most individuals pay the standard premium.
If you are not currently receiving Social Security benefits, you must enroll for Medicare through the Social Security Administration website.
Medicare Mastery
At Health Options NY, we believe education is at the heart of everything. Before diving into the many Medicare insurance plans, let’s start with the basics. With this strong foundation, you’ll be ready to make informed decisions with confidence.
Kick off with our Medicare Simplified Video—it’s a great way to get to know the fundamentals and clear up any common misconceptions about Medicare. This will help you see the bigger picture and understand what steps to take next.
Personalized Assistance with Health Options NY
Looking for one-on-one help? We’re here to guide you every step of the way! As an independent insurance agency partnered with multiple carriers in New York, we’re ready to help you find the perfect plan and prescription drug coverage as you transition to Medicare.
Our services are completely free for you!
Click the calendar link HERE and let’s get started.
Stay informed with our LinkedIn Medicare Mastery Newsletter! Tailored for seniors, HR professionals, and small business owners. Subscribe here.
Our goal is to safeguard not just your well-being and health, but also your peace of mind.
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At HealthOptionsNY, our main priority is to provide insight into Medicare for individuals, nonprofits, and small businesses in New York, all at no extra charge. We firmly believe that knowledge serves as the foundation for making informed decisions.
OUR SERVICES INCLUDE:
EDUCATIONAL GUIDANCE & CONSULTATION
We simplify the complexities of Medicare’s various segments (Parts A, B, C, D, and Medigap) and help differentiate between Original Medicare and Medicare Advantage plans clearly. Ask us about our free workshop Medicare Mondays.
TAILOR-MADE ADVICE
Depending on your unique situation, we’ll guide you on whether it’s best to postpone Medicare enrollment or start with it as soon as you’re eligible.
SEAMLESS MEDICARE TRANSITION
When it’s time to make the switch to Medicare, we ensure a smooth transition, providing detailed insights into the insurance landscape. We can also assist with signing up for Medicare Parts A & B.
CONTINUOUS ASSISTANCE
Our commitment to your Medicare needs is ongoing, ready to adapt our support as your situation or the available plans evolve.
FREE EXPERTISE
Our professional advice comes at no cost to you. Should you choose a supplemental plan through us, the insurance provider compensates our agency directly.
EMPLOYER OPPORTUNITY
- Assist employees in making decisions tailored to their individual needs.
- Achieve cost savings by transitioning employees to Medicare.
- Minimize the administrative workload for the Human Resources team.
EMPLOYEE OPPORTUNITY
- Employees aged 65 and over are empowered with the choice of their own healthcare plans.
- Medicare presents a range of comprehensive and cost-effective plan options tailored to individual needs.
- Expert licensed agents offer personalized guidance in selecting the most suitable Medicare plan.
Connect with US today and unlock the benefits of our trusted partnership. For questions and support, please contact: Susan Diamond | Independent Broker: 845-594-4818 | [email protected] | www.healthoptionsny.com
Collaborating with HealthOptionsNY offers a holistic approach to supporting your clients and/or employees’ Medicare needs, ensuring comprehensive and personalized care and peace of mind.
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