Medicare

What is Medicare?

Turning-65-Years-Old
We know that as you get closer to turning 65 years old, your mailbox starts to get inundated with all of the different insurance companies trying to convince you to call them and choose their plans! At the Premier Agency we are here to try and help make your Medicare decisions simple. We know how confusing Medicare can be, so pride ourselves in helping our clients understand all of your Medicare plan options. Whether we meet in person, over the phone, or virtually, we will go through everything from the prescription drugs you take, your preferred doctors, and even future healthcare needs to help you determine your potential out of pocket expenses and prepare you for the future.

Medicare Basics

Medicare is a federally administered health insurance program typically for people that are 65 or older, people with disabilities, however there may be other circumstances that qualify you for coverage. General eligibility requirements for Medicare include being a US Citizen (or legal resident for at least 5 years), you must be 65 years old, and you must have paid into the Medicare system for at least 10 years or 40 quarters. There are several parts of Medicare, however the first 4 parts are the most important. Part A, Part B, Part C, and Part D.
Medicare Specialist Near Peoria AZ

Getting Medicare when you turn 65

Most people become eligible for Medicare when they turn 65. What you need to do to get Medicare depends on whether you are receiving Social Security retirement benefits or Railroad Retirement benefits.

If you are 65 and receiving Social Security retirement benefits or Railroad Retirement benefits, you will be automatically enrolled in both Medicare Part A and Part B.

  • You do not need to do anything.
  • You will receive a package in the mail three months before your 65th birthday with your new Medicare card and a letter explaining how Medicare works and that you have been automatically signed up for both Medicare Part A and Part B.
  • If you are receiving Social Security retirement benefits, your package and card will come from Social Security.
  • If you get Railroad Retirement benefits, your package and card will come from the Railroad Retirement Board.
The letter will explain that your monthly Part B premium will be automatically deducted from your Social Security check or Railroad Retirement check at the start of the month your coverage begins.

  • You will be given the option to turn down Part B.
Do not turn down Medicare Part B unless you have employer insurance from your or your spouse’s current job. If you do not have employer insurance and you turn down Part B, you may have to pay a late enrollment penalty when you do sign up.

If you are 65, but are not receiving Social Security retirement benefits or Railroad Retirement benefits, you will need to actively enroll in Medicare. To actively enroll:

  • Contact your local Social Security office or your Railroad Retirement Board field office
  • Call Social Security toll free number: 1-800-772-1213 (TTY 1-800-325-0778)
  • Go online at www.SocialSecurity.gov

You may not be collecting Social Security retirement benefits if you are still working or if you were born in 1938 or later (the retirement age is higher for people born after 1938).

Each year, Social Security will tell you if you have to pay more than the standard premium.The amount you pay can change each year depending on your income. If you have to pay a higher amount for your Part B premium and you disagree (for example, if your income goes down), call Social Security at 1-800-722-1213. TTY users should call 1-800-325-0778. If you get benefits from Railroad Retirement benefits, you should still contact Social Security because the Railroad Retirement benefits does not make income determinations.

Getting Medicare when you turn 65
Turning-65-Years-Old

What’s the Part B late enrollment penalty?

If you do not sign up for Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but did not sign up for it. Usually, you do not pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period.

Original Medicare

Hospital (Part A)

Medicare Part A covers hospital charges and most of the services you receive when you are in the hospital, but it does not cover the fees charged by doctors who participate in your care while you are in the hospital.

Medicare Part A shares some costs with you if you need to be hospitalized. The table below shows the different costs that may apply. Costs for 2020 are as follows:

Hospital (Part A)

Medical (Part B)

Medicare Part B covers doctor visits and most routine and emergency medical services. It also covers some preventive care, like flu shots. Medicare Part B shares some costs with you when you see the doctor or use other medical services.

The standard Part B premium in 2020 is $144.60 each month (or higher depending on income). However, most people who get Social Security benefits will pay less than this amount. The payment is deducted from your monthly check if you receive Social Security benefits. Otherwise, you need to send a monthly premium payment to Medicare. Costs for 2020 are as follows:

Medical (Part B)

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