Retirees – Should You Enroll in Medicare?
- Are you turning 65?
- Are you over 65 and still working?
- Are you over 65 and in the process of retiring?
- Are you recently retired?
There is a market shift in benefits for those working beyond age 65. With the state of the economy, skyrocketing healthcare costs, losses in 401k’s and other retirement plans; the employee benefits market is changing as many employees continue to work beyond age 65.
FACE THE FACTS:
- Large employers who’ve historically offered retiree health benefits are now reducing or eliminating coverage.
- Mid-sized employers often included those working after age 65 in their group plans, may no longer afford to do so.
- Smaller employers have typically never offered health benefits to retirees and the cost passed onto those 65 and over is often cost prohibitive.
It is important to coordinate with your Human Resource department the Health options that may be available to you through your employer.
Let Feinman, Rettig & Associates Streamline Your Transition To Medicare…. Consider Us As Your Resource To The Senior Health Insurance Exchange.
Feinman, Rettig & Associates can assist you in choosing an affordable and comprehensive Health Insurance Plan. Some plans in your area may have a $0 monthly premium cost. People aging into Medicare want help understanding the options available in their local area. There are many plans to choose from and this may be the first time you won’t have someone choosing and explaining a healthcare plan for you.
UNDERSTANDING YOUR OPTIONS:
Your most important decision may be whether you want to choose Medicare (Parts A and B), Medicare Advantage plan (Part C), Medicare Prescription Drug Coverage (Part D) or other Medicare Supplemental insurance plans. Once you make that decision, there are other things to consider.
Medicare (Parts A & B)
Is provided by the federal government and you must qualify to be entitled to these parts as well as perhaps paying a monthly premium. Medicare pays fees for your care directly to the doctors and hospitals you visit. Some people call this “fee for service”.
Medicare Advantage (Part C)
Medicare Advantage plans are provided by private companies approved by Medicare. If a person is enrolled in a Medicare Advantage plan, all Original Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage plans also offer prescription drug coverage that must follow the same rules as Medicare prescription drug plans(Part D). Medicare pays a fixed fee each month to the carriers for your care. Then the plan pays the doctors and hospitals. There are many different carriers and plans available depending on your geographic location that you reside in. These plans have certain requirements before you enroll.
A Medicare Supplement policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare plan coverage. If you have this type of policy, then Medicare and your Medicare Supplement policy will pay their shares of covered health costs. These types of plans also have certain requirements before you can enroll.
Prescription Drug Plans (Part D)
Part D Prescription Drug Plans are provided by private health carriers that have a contract with Medicare. These types of plans have premiums, deductibles and co-pays depending on the prescription covered on the carriers formulary. It is important to review the prescriptions that you take to ensure that they are covered under a particular Part D plan. You can choose a Part D plan to compliment a Medicare Supplement or may obtain Part D coverage through a Medicare Advantage Part C (MAPD) plan.
Feinman, Rettig & Associates offers a “Transitional Individual Medicare Services Program” that will assist a retiring employee transition from their group health insurance to their Medicare Health Insurance Options.
MEDICARE PREMIUMS FOR 2020:
Part A: (Hospital Insurance) Premium
- Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
- The Part A premium could be as high as $437.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have worked less than 40 quarters of Medicare-covered employment.
Part B: (Medical Insurance) Premium
- The premium is $144.60 per month in 2020.
- If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher.
MEDICARE DEDUCTIBLE & COINSURANCE AMOUNTS FOR 2020:
Part A: (Pays for inpatient hospital, skilled nursing facility, and some home health care.)
- For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2020 = $1,408) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
For each benefit period you pay:
- A total of $1,408 for a hospital stay of 1-60 days.
- $352 per day for days 61-90 of a hospital stay.
- $704 per day for days 91 and beyond for a hospital stay (Lifetime Reserve Days).
Skilled Nursing Facility Coinsurance
- $178 per day for days 21 through 100 each benefit period.
Part B: (Covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment.)
- $198.00 annual deductible. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $183.00 deductible.)
Part C: Medicare Advantage plans are another health insurance choice that you may choose to have. These plans are offered by private insurance companies approved by Medicare.
By joining a Medicare Advantage plan, the plan will provide all of your Part A (Hospital insurance) and your Part B (Medical insurance) coverage.
Medicare Advantage plans must cover all of the services that Original Medicare covers.
Medicare Advantage plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs.
Most include Medicare prescription drug coverage. There may be a monthly premium for these plans in addition to your Part B premium.
Some examples of Medicare Advantage plans include:
- HMO (Health Maintenance Organization)
- PPO (Preferred Provider Organization)
- PFFS (Private Fee for Service)
- MSA (Medical Savings Account)
- SNP (Special Needs Plans)
In order to enroll in a Medicare Part C plan you must have Medicare Parts A and B, must reside in the plans service area, and must not have End Stage Disease (ESRD).
Since there can be numerous Medicare Advantage plans available in your area, it is advisable to review each plans’ features and benefits to confirm that the plan you choose is suitable for your needs.
Part D: These Medicare Prescription Drug plans are available through private insurance companies approved by Medicare.
These are stand-alone prescription drug plans that do have monthly premiums, co-pays and deductibles depending upon the plan that you choose.
There may be a Part D penalty if you do not enroll in a Part D plan when you first become eligible for Medicare.
As of 2012 there is also a Part D adjustment which increases your Part D premiums according to your income.