MEDICARE INSURANCE

Medicare is a national health insurance program established and administered by the federal government.  It operates under the same rules and regulations no matter where you live in the US. 

Medicare operates under CMS (The Centers for Medicare and Medicaid Services) under the umbrella of the United States Department of Health and Human Services. 

You generally become eligible for Medicare when you turn 65.  Some people may qualify earlier if they receive Social Security Benefits or have been diagnosed with ALS (Lou Gehrig's Disease) or end-stage renal disease.

Once you turn 65, you have two Credible choices for Health Insurance, Medicare and your Employer Group Health Insurance as long as your employer has over 20 employees.

If your employer has less than 20 employees, you will need to join Medicare as soon as you turn 65 to e in compliance and to avoid Medicare Late Enrollment Penalties.

For many people, Medicare is a much better choice than their employers Health Plan and many employers offer to reimburse employees working past 65 for their Monthly Medicare Part B and their Medicare Supplement. And the most comprehensive plan for those new to Medicare is Medicare Supplement Plan G!

We recommend everyone who is planning on working past age 65 to request a meeting with their Human resources or Benefits Administrator so you can see what options you will have. Compare your weekly/bi-weekly charges for your Group insurance, list what your deductible is and find out if you can how much your employer pays for your plan.  In just about every case your employer will save money by taking you off of their plan roles and just reimburse you for your monthly Medicare premiums.  Then, when you are finally ready for retirement, there is nothing for you to do, you will already be enjoying the benefits and peace of mind from having the most comprehensive healthcare available.

Medicare has  different parts that cover different things: Medicare Part A covers In-Patient Costs, Medicare Part B covers Out-Patient costs.  Medicare Part C refers to Medicare Advantage plans and Medicare Part D covers Prescription Medications.

Original Medicare consists of Medicare Part A and Medicare Part B. Original Medicare is an 80/20 Healthcare plan.  This means that Medicare will pay for 80% of all Medicare covered expenses and all medically necessary procedures.  Then, after Medicare pays, you are responsible for the remaining 20%.

Medicare is not free. There are monthly premiums and cost sharing for things such as deductibles and coinsurance. Today there are over 57 million people on Medicare, there are over 900,000 doctors and hospitals who accept Medicare in the United States. 

Your Initial Enrollment Period (IEP) for Medicare is 7 months long beginning 3 months before your "Birth Month" and continues until 3 months after you turn 65.   Some conditions may qualify some people for Medicare benefits before they reach 65.   

During your IEP you are GUARANTEED issue into Medicare and any Medicare Supplement Plan or Medicare Advantage Plan you choose. During this special period, there are no medical questions to answer and nothing about your past or present health status needs to be disclosed! 

After your IEP, anyone on Medicare is welcome to apply for any Medicare Supplement plan they choose, but; everyone will be subject to Medical Underwriting approval in order to join.  If you care in good overall health, are not dependent on Insulin, have not had Cancer for at least 5 years and have no Cardiac issues (Pacemakers, Stents, Defibrillators) and you do not have ALS or End Stage Renal Disease you should qualify.

There are late penalties if you miss your IEP and do not have any other credible health coverage (such as employer coverage).  You can apply for Medicare from the Social Security Administration in person, online or by telephone.