You may wonder if you’re eligible for Medicare, especially when an insurance policy is so expensive. According to the American Association of Retired Persons (AARP), it’s expected that 79 million people will have Medicare by 2030. This rise may be attributed to the high number of individuals who are turning the age to collect these benefit. Family Insurance Associates, serving Ruidoso, NM and the surrounding area, helps individuals understand when they’re eligible as well as other specifics regarding Medicare.
Age Plays a Role
Generally, you can’t receive Medicare unless you’re 65 or older. At this age, you’re eligible for part A, which is hospital insurance. Additionally, you qualify for part B, which is your standard medical insurance. Moreover, if you’re eligible for these two plans, you also can receive a prescription plan, more commonly known as a Part D plan. A spouse who isn’t working may collect at age 62.
How Long You Worked
You have to work at least 10 years to qualify for Medicare benefits. You have to earn at least 40 credits. You earn each credit by working for a quarter. You can still qualify for Medicare if you don’t have enough credits; however, it’ll affect how much you have to pay for your premium.
If you have certain disabilities, you may qualify for Medicare, even if you’re not 65 or don’t have a spouse who’s 65 or over. You must qualify for Social Security Disability to also qualify for Medicare. Before you can apply for Medicare, you have to collect either certain Railroad Retirement Board benefits or Social Security Disability benefits for at least two years.
You may qualify for Medicare based on your medical conditions, such as end-stage renal disease or amyotrophic lateral sclerosis (ALS). You may even utilize your Medicare benefits at the same time as your disability benefits.
Discuss Medicare benefits with an insurance professional from Family Insurance Associates, serving Ruidoso, NM and the surrounding region, by contacting us at 575-257-6146.
Selecting the right Medicare insurance plan or supplemental plan is not always easy. Many people get confused about the differences between policies, what is covered, and what coverage they need. Here at Family Insurance Associates, serving the Ruidoso, NM area, we want to help make the process as easy as possible. Here are a few of the factors you should consider when you are looking to purchase a Medicare insurance plan or supplemental plan.
One of the first things you need to do when considering a Medicare insurance plan is to understand the coverage. Different parts and supplemental plans have different types of coverage. One part may cover prescriptions, while another may cover hospital stays. Think about what coverage you already have or do not have with a private medical plan and then look for a policy that fills in the gaps that you need.
Next, look at any out-of-pocket expenses you may have with a plan, including co-pays and deductibles. You need to ensure you can afford the out-of-pocket costs that go along with the plan you are selecting.
The Star Rating
Lastly, look at the star rating of the plan. The star rating is a rating from both providers and customers related to the plan. The rating is based on customer service, coverage, the plan’s quality, and how well people feel the plan performs for them. This is sort of like a review, allowing you to see how other people rate this specific plan.
At Family Insurance Associates, serving the greater Ruidoso, NM area, we can sit down with you and discuss your medical insurance needs and help you select the right Medicare insurance plan for you. Give us a call now to schedule your appointment.
Medicare Supplement Plans C & F are not going to be available to new enrollees from 2020. December 31st, 2019 will be the last day when anybody eligible will be able to buy Medigap policies C & F. Many Medicare recipients among who chose to buy Medigap Policies chose Plan F in past as it has been the most comprehensive Medigap Plan. The reason for these plans going away is Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). Starting 2020, Section 401 of MACRA will prohibit sale of Medigap Policies that cover Part B deductibles to newly eligible Medicare beneficiaries.
Some people who know Plan F, they think it is a big deal. Medicare Plan F is well-liked because it pays for all the gaps in Original Medicare Part A and Part B, including both your hospital and outpatient deductible as well as the co-insurance. It even pays the 20% that Medicare Part B does not cover. This means zero out-of-pocket for you at the doctor’s office.
People who buy Plan F on or before December 31st, 2019 can renew Plan F every year lifelong, provided there are no further law changes.
Some Insurance carriers also offer Plan F high deductible – that means you must pay the deductible before Plan F pays. Plan F High deductible serves a different financial purpose for some enrollees and because of the deductible it is clearly not the most comprehensive plan.
From 2020 the most comprehensive plan available will be Plan G, which at this time second most comprehensive plan after Plan F, Plan G does not cover part B deductible. Plan C is in the middle tier when you talk about comprehensiveness of the plan. Plan D has almost similar coverage to Plan C except for Part B (Doctors Office and Outpatient services) deductible. Do not get confused between Medigap Plan D vs Medicare Part D – which is Prescription Drug Coverage Plan. None of the Medigap plans give you Prescription drug coverage.
As you can see in above graphic Medicare supplement Plan F has been the most comprehensive Plan as well as simplest to learn about as it has the most checks in all the Medigap plan tabulations you see. As 2020 nears you will see scare tactics from people who might tell you to switch out of Plan F as it is going away, simultaneously you will see scare tactics from other people who will try you to switch to Plan F before it goes away.
Everybody’s financial situation is different, we advise you to choose a plan that makes most financial sense to you.
Feel free to use our Quoting platform below and find out what makes sense. For calculations, 2018 Part B deductible is $183/- per year. As a reminder – Part F & G also covers 100% of Part B excess charges, which is the difference between what a doctor charges and the amount Medicare Part B will approve.
Medicare Part A & B (referred here as Original Medicare) do not cover everything, though these pay for many healthcare services & supplies. Medicare supplement Plans, offered through private insurers, help cover certain costs that Original Medicare does not cover. These might include coinsurance, yearly deductibles & copayments. Certain Medicare supplement plans also help with coverage for a few services that Original Medicare does not pay for, such as emergency overseas travel or Part B excess charges.
Can I get Medicare supplement plan without having Original Medicare?
Medicare Supplement Plans supplement Original Medicare, you can not get Medicare Supplement Plans unless you are enrolled in Original Medicare. Original Medicare will pay first, and your Medigap policy fills in the cost gap. For example, for a Hospital visit if you are charged $10,000/- Original Medicare will pay 80% or $8000/- and Medicare Supplement Plan or Medigap plan might pay remaining 20% or $2000/-, depending on the plan coverage as you have the option of multiple different types of Medicare Supplement Plans. As these plans help cover the gaps in Original Medicare these plans are also commonly called as Medigap Plans.
What are different Medicare Supplement Plans and what do these plans cover?
Medicare Supplement (Medigap) Plans are standardized. The chart below explains the plan coverage. A check mark means the Medigap Plan covers 100% of the described benefit, a percentage denotes the percentage coverage and blank means the plan does not cover that benefit.
What is not covered by Medigap Plans?
Medigap plans generally do not cover Long-term care (care in a nursing home), Routine vision or dental care, Hearing aids, Eyeglasses, Private-duty nursing & Prescription drugs. Also, Medicare Supplement Plans are not Medicare Advantage Plans, you may want talk to our knowledgeable agents if you need information about Medicare Advantage plans.
We can assist you in getting Long Term Care Plans, Vision & Dental Plans, Hearing Plans & Prescription drug plans. Talk to our knowledgeable Agents if you need assistance with any of the above.
What else do I need to know about Medicare Supplement Plans?
To recap you must have Medicare Part A and Part B to get a Medicare Supplement plan.
A Medicare Supplement plan can only cover one person, so if you are married, you and your spouse would need to buy separate policies.
You can usually use your Medicare Supplement plan with any provider that accepts Medicare. However, some types of Medigap plans known as Medicare SELECT plans require you to only use doctors and hospitals in provider network.
Not all types of Medicare Supplement plans may be available in your zip code.
Premium amounts may vary by plan and location, even for the same standardized benefits.
In general, Medicare Supplement plans are guaranteed renewable as long as you continue to pay your premium.
This is not an all inclusive guide, however can help you in deciding what medicare supplement plan to choose. If you are wondering how much these plans cost please feel free to use our Quoting platform below. The link will open in a new window.
You should be 65 years of age and older OR under 65 years and receiving disability beneﬁts from Social Security Administration (SSA) or Railroad Retirement Board (RRB). For people with ALS (Lou Gehrig’s Disease) – Must receive these beneﬁts for 24 months before eligibility for Medicare OR Under 65 years and diagnosed with End Stage Renal Disease.
Enrollment into Medicare
Enrollment into Medicare ie either Automatic or By Application.
AUTOMATIC ENROLLMENT: If already receiving: Social Security Beneﬁts , Social Security Disability or Railroad Retirement Beneﬁts. Beneﬁciary will receive Medicare card 3 months BEFORE beneﬁts are to begin.
ENROLLMENT BY APPLICATION: If not already receiving beneﬁts – beneﬁciary applies through Social Security Administration either 3 months before turning 65 or in the month beneﬁciary turns 65 or 3 months after turning 65. This is called the Initial Enrollment Period.
You may delay enrolling into Medicare if you or your spouse is actively employed AND is covered under group health insurance policy based on active employment. This is called Delayed Enrollment. You may later enroll in medicare when: Employer Group Health Insurance ends. You have 8 Months to enroll. This Eight Month period is called the Special Enrollment Period.
If you do not enroll during the Initial or Delayed Enrollment periods that is if you miss your Initial Enrollment Period or your Special Enrollment Period, you get another chance to enroll between January 1st to March 31st of each year. Your coverage begins July 1st. This is called General Enrollment and in this case you may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.
Medicare Part A helps pay for Hospital or inpatient stay. Medicare Part B helps pay for Doctor Visits & outpatient services.
Medicare Plans are Available through Private Insurers. In New Mexico we can help you find the best plan for your needs through Aetna, BCBS of NM, Cigna, Humana, UnitedHealthcare (AARP) and Presbyterian Insurance.
Please click below for Medicare Supplement Plan Quotes
For Medicare Advantage Plan Quotes & Medicare Prescription Plan Quotes Please call our agents at NM Insure Phone: 575.257.6146