#1 – Start your research early – about three month before you turn 65
This is your time to read up on Medicare Parts A, B, C and D to familiarize yourself with the basics. You first need to know what Medicare itself covers and doesn’t cover before you can decide whether a Medigap (Medicare Supplement) plan makes sense for you, or if a Medicare Advantage plan would fit you better.
Medicare Part A is your Hospital Insurance. Medicare Part B is your Outpatient Insurance. These 2 parts are called your “Original Medicare” benefits. The Medicare.gov website has great pages that explain these two parts of Medicare and what benefits they provide to you. As well as the Medicare & You guidebook found here.
#2 – Determine your costs for Medicare Parts A & B
You are eligible for Medicare at age 65 (or earlier if you qualify due to a disability). However, what you will pay for Medicare Parts B & D depends on your income.
Medicare Part A will cost nothing for most people. It is considered “paid up” if you have worked at least 10 years in the U.S. and paid taxes during these years toward this future benefit. Medicare Part B has a monthly premium that you will pay to Social Security. Your premium is based on your annual household income. Our worksheet on page 3 will help you lay out your potential costs for Medicare.
#3 – Enroll in Medicare at the Social Security office
Most people enroll in Medicare at age 65, but if you still have employer-insurance you can opt to delay Part B until you retire. Both parts of Medicare can coordinate with your employer insurance to reduce costs for you. It can be tricky to weight the cost vs. benefits in this situation, so seek help from your employer’s human resource department for details.
If Medicare will be your primary insurance (like most people), you can enroll in Medicare up to 3 months before your 65th birthday. Your benefits will usually begin on the 1st day of that month. You can enroll in Medicare at the Social Security website (www.ssa.gov) or by phone at 1-800-772-1213. You may also visit your local Social Security office in person to enroll.
#4 – Find out which insurance plans your doctors participate in
There are 2 primary insurance options to help you with paying for things that Medicare doesn’t. Finding out which plans your doctor accepts will help you decide which option is a better fit.
Medigap plans let you see any doctor/hospital that participates in Medicare (over 800,000 physicians), regardless of which Medigap insurance company you choose.
Medicare Advantage plans, on the other hand, have smaller private networks. If you are considering one, you’ll want to find out which plans, if any, your doctor participates in. It will help you narrow your choices.
#5 – Make a list of your regular medications
Write down your list of regular medications. You will need these to select the right Part D drug coverage. Most states have dozens of Part D plans. It is critical that you choose one that offers your medications at good prices. Choosing the right drug plan can save you hundreds each year.
Medicare’s website has a Plan Finder tool (CLICK HERE) to help you compare plans in your state. Enter your medications and let it search out which drug plans will be most cost effective for you. If you find this tool overwhelming, ask your agent to help you run the analysis. Here is a step-by-step video (CLICK HERE).
#6 – Choosing your Medicare supplemental insurance
Medicare Part B covers only 80% of your outpatient costs. You pay the other 20%, and paying 20% of something like knee surgery would cost you many thousands of dollars. So this is why supplemental insurance exists – to help you pay for hospital and outpatient deductibles AND that other 20%.
Medigap (Medicare Supplement) plans offer the fullest coverage that helps to pay for the 20% and some or all of your deductibles. The plans also let you choose your own doctors – no networks or referrals needed. Read about popular plans like Plan F and G on our website. Then compare quotes from several insurance companies to make sure you get the lowest price from a stable company with good financial ratings. Our worksheet on page 3 will help you with this.
Medicare Advantage plans, on the other hand, usually have HMO or PPO networks of doctors. Complete Step #4 first to determine if any plans include all of your doctors in the network. Then use the Medicare Drug Plan Finder tool from Step #5 to confirm that plan includes the meds you take.
Here is a side-by-side comparison between a Medicare Supplement and Medicare Advantage (CLICK HERE).
An insurance broker who specializes in Medicare insurance can provide quotes from multiple Medigap companies and can usually help you compare Medicare Advantage plans as well.
By David Lasman | President – Medicare Help Network
wwww.MedicareHelpNetwork.com | 866-333-7340
Selecting the right healthcare plan through Medicare can be overwhelming and downright stressful. Medicare Help Network is a nationwide resource that provides guidance and support about Medicare to seniors at no cost to them, and helps them to choose the most suitable insurance plan tailored to their specific needs and budget. Our goal is to educate and empower our clients to make the best decisions regarding their healthcare and clear up the confusion of Medicare. At Medicare Help Network, we aren’t partial to any one insurance company. Our loyalty is to our clients and our mission is to provide them with the best healthcare options at the very lowest cost.