Medicare 101. Presented by Steve W Jenkins

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1 Medicare 101 Presented by Steve W Jenkins

2 Healthcare Options when turning 65 Remain on an Employer Provided Healthcare Plan Remain on an Individual Healthcare Plan Go onto Medicare Go onto Medicare Advantage Medicaid

3 What Medicare is NOT!!! Medicare is not part of the Marketplace The Marketplace does not affect your Medicare Choices Medicare s benefits are not changing because of the Marketplace

4 What is Medicare? Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease

5 Who Runs Medicare? Medicare is run by The Centers for Medicare & Medicaid Services. (Also knows as CMS) Where do I enroll for Medicare? Enrollment is done through the Social Security Administration.

6 Enrollment in Medicare When Do I enroll in Medicare? Approximately 6 months before turning 65 call the Social Security Administration and share your intentions with them. (Caveats) I Plan to keep working or I plan go onto Medicare when I turn 65.

7 Medicare Open Enrollment Medicare Open Enrollment begins three months before your 65 birthday, includes the month you were born and continues for three months after you turn 65. (7 months total) These 7 months are important because any choices you make are guaranteed.no Underwriting! No physical or mental conditions affect your enrollment. Not weight, not acute medical conditions, not medications..nothing.

8 Medicare Open Enrollment? Enrollment in Medicare is Automatic if you are on Social Security. The initial enrollment package is mailed three months prior to your 65 th birthday. If you are disabled and under age 65 the packet will arrive in the 25 th month of your disability. (the packet contains your Medicare card)

9 Medicare Open enrollment Can I put off my enrollment in Medicare.Yes you can but there may be Penalties. There are timeframes to sign up for Medicare and if your go outside those timeframes you can be accessed financial penalties as well as have to wait until the next open enrollment without medical coverage.

10 Medicare Has 4 Parts: Part A- Hospital Coverage Part B- Physician Coverage Part C-Medicare Advantage Part D- Prescription Coverage

11 What does Medicare Cost? Medicare Part A (Hospital Coverage) typically has no cost at all provided you or your spouse have worked for 10 years and paid FICA taxes. Medicare Part B (Physician Coverage) Does have a cost. Premiums are income based with most people paying $ per month. Depending on Income premiums can be as high as $ per month. Medicare Parts A and B are called, Traditional Medicare and Traditional Medicare covers about 80% of your healthcare costs excluding prescriptions, Dental, Vision and Hearing. Vision and Dental coverage are available for purchase.

12 Traditional Medicare Now that we know Medicare covers about 80%... How do we protect ourselves from the other 20% that Medicare does not cover? We purchase a policy called a Medigap or Supplemental Policy. Medigap or Supplemental means the exact same thing. Medigap or Supplemental plans pay for some or all of the 20% gap that Traditional Medicare does not cover. (Deductibles, Co-insurance and Co-payments)

13 Medigap and Supplemental Plans These plans are offered by insurance companies and have names such as Supplemental Plan A, Plan B, Plan C, D to Plan K. Plan A with one insurance company is the same as Plan A with any other insurance company. Plan B is the same as well and so on. For simplicity sake Plan A covers the least and Plan F covers the most.

14 Traditional Medicare and Part D When you choose Medicare and a supplemental plan we also need to purchase Prescription coverage you are required by law to have prescription coverage. Prescription Coverage is called Medicare Part D. Most insurance companies offer three prescription plan options..a Low, Middle and High Option. Premiums are as low as $18 to up to $140 (lower premiums cover fewer prescriptions and higher cost plans cover more

15 Medicare Part D Each plan has its own formulary of covered medications for each health category such as High blood pressure, Cholesterol, Arthritis and so on. Advice..Take Generics

16 Medicare Part C- Medicare Advantage Medicare Advantage Plans are approved by Medicare but administered through private insurers. Medicare pays private insurers a premium each month for each member on the plan. Medicare Advantage is a combination of Medicare Part A, B and D all rolled up into one product. Premiums are typically lower than traditional Medicare, physician networks are more limited and benefits usually require copays, coinsurance and deductibles.

17 Medicare Advantage (Part C) and Part D (Prescriptions) Open Enrollment Medicare Advantage Plans as well as Medicare Part D plans have an open enrollment each year. Open enrollment is Oct 15 th to Dec 7 th of each year. You can switch from one Part D plan to another. You can switch from one Medicare Advantage Plan to another Medicare Advantage Plan. Supplemental plans only have their initial open enrollment.

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