SERVICES
MEDICARE
Medicare ABC's
Are you trying to decide about your Medicare health plan option? Do you need a Medicare Supplement or a Medicare Advantage plan? What is Part D? Do you need Medicare Part B if you’re covered by an employer’s group plan?
​
To get a Medicare plan, either an Advantage or Supplemental plan, you must have Medicare Part A and Part B. If you’re age 65 and receive Social Security retirement benefits, you’re usually automatically enrolled for Part A and Part B. Medicare Supplement plans (or Medigap plans) supplement Original Medicare. There are different types of Medicare Supplement plans; some cover the Medicare Part A deductible in full, while others cover part or none of the Part A deductible. Medicare Supplement plans and Medicare Advantage plans are not complementary, so it’s important for you and our skilled agent to understand which type of policy makes sense for you.
​
Helping people make educated and empowered decisions about their Medicare health plan options is what we do! For almost 40 years, it has been our mission to connect our clients with suitable insurance solutions that fit within their budget. We thank you for the opportunity to help you make sense of the Medicare ABC’s and look forward to helping you decide on a plan that’s right for you!
By providing your name and contact information you are consenting to receive calls, text messages and/or emails from a licensed insurance agent about Medicare Plans at the number provided, and you agree such calls and/or text messages may use an auto dialer or robocall, even if you are on a government do-not-call registry. This agreement is not a condition of enrollment.
Who’s Covered by Medicare?
Medicare is an U.S. Federal Government health insurance program that subsidizes healthcare services. The program covers those over 65, others who meet specific eligibility criteria, and individuals with certain diseases.
What Are the Parts of Medicare?
Part A (Hospital Insurance)
Helps Cover:
​
-
Inpatient care in hospitals.
-
Skilled nursing facility care.
-
Hospice care.
-
Home health care.
Part B (Medical Insurance)
Helps Cover:
​
-
Services from doctors and other health care providers.
-
Outpatient care.
-
Home health care.
-
Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment).
-
Many preventative services (like screenings, shots, vaccines, and yearly “Wellness” visits).
Part D (Drug Coverage)
Helps Cover:
​
-
Helps cover the cost of prescription drugs (including many recommended shots and vaccines).
-
Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.
Understanding What Medicare Costs in 2024
2024 Costs at a Glance
Part A Premium
-
Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A").
​
-
If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $505 in 2024.
​
-
If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $278 in 2024.
Part A Hospital Inpatient Deductible And Coinsurance
You pay:
-
$1,632 in 2024 deductible for each benefit period.
​
-
Days 1-60: $0 coinsurance for each benefit period.
​
-
Days 61-90: $408 in 2024 coinsurance per day of each benefit period.
​
-
Days 91 and beyond: $816 in 2024 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
​
-
Beyond lifetime reserve days: all costs.
-
Skilled Nursing Facility Coinsurance: $204 in 2024
Part B Premium
-
The standard Part B premium amount is $174.70 in 2024 (or higher depending on your income).​
Part B Deductible and Coinsurance
-
$240 in 2024 After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment (DME)
Part C Premium
-
The Part C monthly premium varies by plan.
Part D Premium
-
The Part D monthly premium varies by plan (higher-income consumers may pay more).
This information comes from www.Medicare.gov
Your Medicare Options
When you first enroll in Medicare and during certain times of the year, you can choose how to get your Medicare Coverage. There are two main ways to get Medicare:
Original Medicare
-
Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
​
-
If you want drug coverage, you can join a separate Medicare drug plan (Part D).
​
-
To help pay your out-of-pocket cost in Original Medicare (like your 20% coinsurance), you can also shop for and buy supplemental coverage.
​
-
Can use any doctor or hospital that takes Medicare, anywhere in the U.S.
You can add:
You can also add:
This includes Medicare Supplement Insurance
(Medigap). Or, you can use coverage from a former employer or union, or Medicaid.
Coverage
Original Medicare covers most medically necessary services and supplies in hospitals, doctors’ offices, and other health care settings. Original Medicare doesn’t cover some benefits like eye exams, most dental care, and routine exams.
​
You can join a separate Medicare drug plan (Part D) to get drug coverage.
​
In most cases, you don’t have to get a service or supply approved ahead of time for Original Medicare to cover it.
Travel
Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy a Medicare Supplement Insurance (Medigap) policy that covers care outside the U.S.
Medicare Advantage
(also known as Part C)
-
Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
​
-
Plans may have lower out-of-pocket cost than Original Medicare.
​
-
In many cases, you’ll need to use doctors who are in the plan’s network.
​
-
Most plans offer extra benefits that Original Medicare doesn’t cover – like vision, hearing, dental and more.
Most plans include:
Some plans also include:
Coverage
Plans must cover all of the medically necessary services that Original Medicare covers. Most plans offer extra benefits that original Medicare doesn’t cover – like some vision, hearing, dental, routine exams, and more. Plans can now cover more of these benefits.
​
Drug coverage (Part D) is included in most plans. In most types of Medicare Advantage Plans, you don’t need to join a separate Medicare drug plan.
​
In some cases, you have to get a service or supply approved ahead of time for the plan to cover it.
Travel
Plans generally don’t cover care outside the U.S.
When Should You Apply for Medicare?
If you are aging into Medicare, there is a 7 month window in which you must enroll without incurring a penalty. This is called your Medicare Initial Enrollment Period. This time frame is 3 months before your 65th birthday, the month you were born, and 3 months after your 65th birthday.
We recommend you apply immediately when you first become eligible. You will find that getting started early is a plus so that you’ll have your new Medicare card in hand before your effective date.
What if I Still Have Employer Coverage Available?
If you have insurance through your or your spouse’s current job, in most cases you should at least enroll in Part A, as it’s free for most people.
To decide whether to take Part B, for which everyone pays a monthly premium, you should ask your benefits manager or human resources department how your employer insurance works with Medicare and confirm this information with the Social Security Administration (SSA) and Medicare. Be aware that when you qualify for Medicare, your employer insurance may start to work differently for you when you enroll in Original Medicare. You will need to figure out whether paying for both types of coverage will be useful in offsetting your health care cost.
Understanding Your Medicare Enrollment Options
-
Apply Online: To apply for JUST Medicare: https://secure.ssa.gov/iClaim/rib and complete the application process. To apply for BOTH Social Security benefit and Medicare at the same time go to https://www.ssa.gov/retire. Be sure to carefully read every question before answering.
​
-
Contact Social Security by Phone: 1-800-772-1213 (TTY users dial it 1-800-325-0778). Your Social Security representative may send you some forms to complete. Generally these forms are simple. One caveat about phone applications for Medicare is that they take longer. The forms have to be mailed to you, and then you complete them and mail back. This can cause delays. Use the phone enrollment option only if you have a month or two before your intended Medicare effective date.
​
-
Apply In Person: By visiting your local Social Security office. To avoid waiting delays we recommend you call first to set an appointment. Be sure to ask for a printout which shows that you have applied for Medicare Part A & B. This form will give you all the information you need to move forward with your Medicare Supplement application and/or Part D drug plan.
​
-
Apply for Medicare with our FREE Assistance: If Medicare will be your primary insurance, and you’d like a personal guide to take you from applying for Medicare all the way through to setting up your Medicare Advantage, Medicare Supplement and/or Part D plans, contact us.
Original Medicare with a Medicare Supplement vs. Medicare Advantage Plan
When considering whether to stay with Original Medicare and purchase a Medicare supplement plan, or a Medicare Advantage plan, we recommend you consider these important factors:
What is your budget?
-
While considering the cost of your health insurance should be an important component when choosing the right plan for you, we recommend it not be the deciding factor. Here’s why. You’ve heard the old adage, “if it sounds too good to be true, it usually is.” When shopping for a Medicare health insurance plan nothing could be more true. Television and print media advertising by insurance companies make $0 Dollar per month premiums sound awfully appealing. However it’s important that you get all the facts regarding your potential Maximum Out of Pocket Cost under these plans. The bottom line is when shopping for a Medicare insurance plan, you get what you pay for!
​
What is my financial/health risk?
-
If you have a year of heavy health spending, do you have Enough Savings to spend the possible out-of-pocket maximum that a Medicare Advantage plan might require?
​
Are you OK with your plan limiting what hospitals and doctors are in your network?
-
Medicare Advantage Plans: You Must Use Network Providers (doctors, hospitals, and other providers) that are in your plans provider network. If you choose to use a provider outside your plans provider network you may have to pay more or ALL of the cost. You’re also still responsible for deductibles, copayments and coinsurance.
-
Original Medicare with a Medicare Supplement Plan: You have a choice of doctors, hospitals and other providers that accept Medicare nationwide.
​
What is my potential out-of -pocket costs with each type of plan?
-
Medicare Advantage Plans: Out-of-pocket cost (as much as $7,550 annually) due to deductibles, copays and/or coinsurance.
-
Original Medicare with a Medicare Supplement Plan: Little or no out-of-pocket cost due to deductibles, copays or coinsurance.
I plan to travel in retirement...will my coverage travel with me?
-
Medicare Advantage Plans typically DO NOT cover medical expenses incurred while traveling outside the United States.
-
Medicare Supplement Plans provide a lifetime $50,000 maximum benefit is for emergency care services only for foreign travel during the 1st 60 days of each trip outside the U.S.
​
When choosing a Medicare insurance plan how important is it to choose a solid company that offers Outstanding Customer Service?
-
When comparing companies, the cheapest company might not have an Acceptable Financial Rating. We recommend you consider a company rating by AM Best of A or Better.
-
Regardless of whether you choose to go with a Medicare Advantage Plan or Original Medicare and Medicare Supplement Plan selecting a company with outstanding customer service should be a high priority. We at Legacy Planning Services, LLC only do business with companies that are efficient and offer top notch customer service. As far as we’re concerned Outstanding Customer Service Is a Priceless Commodity!
​
Steer Clear of The Closed Pool
-
Closed Pool – Every once in a while a company decides to stop offering Medicare Supplement plans but will decide to keep servicing their existing contracts (for a profit). This can be Bad News for Closed Pool policy holders because the renewal rate increases are typically much higher than the annual average for contracts held by companies that are still in the market.
​
While there are many other factors to consider when choosing a medical plan in retirement, we feel these are some of the most important issues that need to be considered before selecting either a Medicare Advantage plan or Original Medicare with a Medicare Supplement.
Choosing The Health Insurance Plan That’s Right for You
For over 40 years the professionals at Legacy Planning Services, LLC have been helping individuals make well thought out insurance decisions. Our experts will compare over 30 Medicare quotes from insurance companies in your area to provide competitive Medicare rates, free of charge!
​
​
In addition to getting you Good Rates with the Right Company you’ll receive:
​
Free Medicare Education
We'll first help you to understand how your Original Medicare benefits work.
Competitive Long-Term Rates
We will not only quote companies with the lowest rate now and the BEST customer
service, but also the Lowest Rate Increase Histories so you can Buy Smart.
Rate shopping to Keep Your Rate Low
Each year rates typically go up. We’ll be there year after year to insure you are
taking advantage of ALL savings options available!
Annual Clients-Only Webinars
You’ll be notified of Client-Only Webinars to keep you informed of changes in
Medicare and other important issues that may impact your legacy.
Acclaimed Customer Service
We at Legacy Planning Services, LLC have built our practice on the platform of Client First Customer Service. That’s why generation after generation of clients keep recommending us to their family members. We encourage you to find out what sets Legacy Planning Services, LLC apart.