Turning 65 and need to apply for Medicare? 


What is Medicare?

MEDICARE PART A (HOSPITAL INSURANCE)

Medicare Part A covers inpatient hospital stays, skilled nursing facility stays, hospice, and home health care. Most people get Medicare Part A automatically when they turn 65, and anyone who paid into the Medicare system for 10 years, or 40 quarters, will receive Part A for free.

MEDICARE PART B (MEDICAL INSURANCE)

Medicare Part B helps cover medically necessary services not covered by Medicare Part A, which includes most services provided by doctors and specialists, hospital outpatient care, durable medical equipment, and other preventive care services. You must enroll in Medicare Part B when you are first eligible or you will have to pay a late enrollment penalty.


MEDICARE PART C (MEDICARE ADVANTAGE)

Medicare Advantage Plans are offered by Medicare-approved private insurance companies. They tend to be very popular in urban and metropolitan areas, and are not available in many rural areas. Visit Medicare.gov to get a complete list of the plans available in your County.


When considering a Medicare Advantage Plan it is important to contact your doctors, hospital, and other medical service providers to be sure they accept the plan. It is also extremely important to review the summary of benefits and examine what copayments and coinsurance you will be responsible for paying when obtaining medical services.

There are several types of Medicare Advantage Plans:
• Health Maintenance Organization (HMO) Plans
• Preferred Provider Organization (PPO) Plans
• Private Fee-for-Service (PFFS) Plans
• Special Needs Plans (SNP)


MEDICARE PART D (PRESCRIPTION DRUG COVERAGE)

Medicare Part D is your prescription drug coverage, which helps lower the cost of most prescription drugs that are medically necessary. Prescription Drug Plans are offered by Medicare-approved private insurance companies and can be purchased online, via phone, or by contacting Medicare directly. Use the Medicare plan finder at Medicare.gov to compare plans and prices.


Finding the Perfect Plan

STEP 1. DETERMINE WHICH PLAN SUITS YOU BEST                                   

  • Compare the benefits of each plan to find the option that suits your needs.
  • Keep in mind most people need more medical services as they age.
  • Be sure to limit the possibility of catastrophic out-of-pocket expenses.

STEP 2. COMPARE PRICES 

  • Medicare Supplement Plans are standardized, meaning every insurance company offers the same plans with the same benefits. Therefore, it is wise to compare prices from many different insurance companies as some may offer your desired plan for a much more affordable price than others.
  • When considering your budget, make sure to include any out-of-pocket costs you may have to pay for medical services provided.                                   
  • Take a close look at how insurance companies price their plans. Have they had significant price increases in the past? How often will you receive a price increase? The most affordable option when turning 65 isn’t always the most affordable long-term option.

STEP 3. CONVENIENCE                                                                                                                                                                

  • There are other factors that may affect your purchasing decision, such as the ability for the insurance companies to process claims efficiently, the amount of customer service issues they have with current policyholders, and the overall financial health of the company.                             
  • Check with your doctor’s office to see which companies they prefer to work with. This will significantly decrease your chances of getting double-billed or having to file claims manually.
  • Review financial ratings from A.M. Best and Standard & Poor’s to determine the overall financial health of any insurance company you are considering.
  • Check with your friends, family, or an insurance broker to see if the insurance company has a history of customer complaints or service issues.

Tips

  • Medicare Supplement Plan F is the most comprehensive, and the most popular option.                     
  • There can be a big difference in the premiums different insurance companies charge for exactly the same coverage.
  • Compare prices from multiple insurance companies to find the lowest price.                             
  • Contact Gower Insurance Services for a detailed report that includes all insurance companies offering plans in your area, along with prices,  and financial ratings.