Turning 65? Medicare Advice

Turning 65? How do I get Medicare A and B?

• If you are collecting Social Security, you should be sent a Medicare Card 2-3 months before your 65th birthday.

• They can deduct your part B premium from your Social Security Check.

• If you aren’t collecting Social Security, you can go to the website or call the Bangor office at 877-405-1448

• https://www.ssa.gov/medicare/sign-up

• When you get your Medicare Card call us and we can compare plans and assist you with any questions your have about Medicare Advantage, Medicare supplements and Prescription drug coverage.

Step 1

Part A (hospital insurance)

Helps pay for hospital and inpatient care

Premium- Free as long as you have worked 10 years

$1632 DEDUCTIBLE PER BENEFIT PERIOD

THEN 20% NO MAXIMUM LIMIT

Part B (medical insurance)

Helps pay for doctor and outpatient care

Monthly premium 185.70 for 2024, adjusted for income

$257 DEDUCTIBLE

THEN 20% NO MAXIMUM LIMIT

Original Medicare—comprised of Part A (hospital insurance) and Part B (medical insurance)—provides broad coverage for seniors and eligible individuals but notably lacks a cap on out-of-pocket spending. This means that while Medicare covers a significant portion of healthcare costs, beneficiaries can potentially face high, unpredictable expenses if they require extensive or expensive medical services.

Without a maximum out-of-pocket limit, patients under original Medicare might find themselves paying hundreds or even thousands of dollars in deductibles, coinsurance, and copayments over the course of a year. For instance, while Part A helps cover hospital stays, it often requires beneficiaries to shoulder deductibles and coinsurance costs that can accumulate rapidly during extended hospitalizations. Part B, which covers outpatient services and physician visits, typically requires beneficiaries to pay a percentage of each service's cost. Over time, particularly for individuals with chronic conditions or those undergoing frequent medical treatments, these costs can become financially burdensome.

This absence of a spending cap can lead to a degree of financial uncertainty and potential hardship. Beneficiaries must plan for the possibility that, despite Medicare’s extensive coverage, significant healthcare expenses may arise in the absence of a predefined ceiling on out-of-pocket spending.

Step 2: Our Recommendation.

Many Medicare beneficiaries mitigate this risk by purchasing supplemental coverage, such as Medigap policies, which help cover some of the additional costs that original Medicare does not pay. However, these supplemental plans come with their own premiums and limitations.

In contrast, Medicare Advantage plans, offered by private insurance companies approved by Medicare, are required to include an annual maximum out-of-pocket limit for covered services. This limit provides an important safety net by capping the amount beneficiaries must pay out-of-pocket for their healthcare expenses within a given year. Once a beneficiary reaches this cap, the plan pays 100% of covered services for the remainder of the year, providing significant financial protection against catastrophic healthcare costs.

The requirement for a maximum out-of-pocket limit in Medicare Advantage plans represents a crucial benefit for many seniors, as it simplifies budgeting for healthcare expenses and alleviates the financial stress associated with unexpected medical bills. In summary, while original Medicare offers essential healthcare coverage, its lack of a spending cap exposes beneficiaries to potential financial risk—a gap that Medicare Advantage plans aim to fill by providing defined limits on annual out-of-pocket expenses. Sign up for a free Medicare Seminar and receive a Medicare roadmap at www.medicarevince.com

#originalMedicare #MedicarepartA #MedicarePartB #PartC #medicaresupplement

Sign up for a free Medicare Seminar and receive a Medicare roadmap at www.medicarevince.com