You’re not alone: 77 million baby boomers reaching 65

Those age 65 and older now exceed 35 million, a number that is growing rapidly. January 2011 ushered in the first of approximately 77 million Baby Boomers, born from 1946 through 1964…anticipating their own retirement.

UNLIKE THEIR PARENTS GENERATION, Boomers are different. They exercise twice as much as previous generations. They’ll continue to bike, hike, swim, sail, and ski—play softball and basketball even in their retirement. They’ll live longer and enjoy watching their families grow. We are aware that many will need Medicare coverage.

This is why Cindy Hahn stays current with reform changes and plan updates. She can help you find that Hahn Moment with a Medicare plan you understand.

If you are confused over all the options, we can help.  
  • Should I take Part A?
  • Should I take Part B and when?
  • What about Part D?
  • Do I need Medicare Advantage Plan
  • What is the Medigap Plan?
  • Can I get help with Medicare costs?
  • At what age can I start?

Let us help you figure this out right now

The decisions you are about to make may have a serious effect on your future health coverage and financial situation for many years to come. A wrong decision or indecision could lead to consequences down the road that may be difficult or even impossible to reverse. Avoid these common pitfalls by learning about your Medicare options now!  We know that Medicare coverage can be a confusing, complex system – too many choices and no straightforward answers.

You need someone on your side that will guide you to the best options for your personal situation.

Contact Cindy Today

The Original Medicare Has Two Parts

Part A (Medicare Part A = Hospitalization)

  • Medicare Part A covers 80% of hospital costs after you pay the first $1,156 (your “Part A deductible”)
  • At age 65 most people will automatically be enrolled in Medicare Part A
  • Most people don’t pay a monthly Part A premium because they paid for it through their payroll deductions

Part B (Medicare Part B = Medical services)

  • Medicare Part B covers 80% of the cost of doctor visits and everyday medical services after you pay the first $140 (your “Part B deductible”)
  • You should sign up for Part B as soon as you’re eligible, or you could pay penalties later
  • Your Part B monthly premium will vary depending on where you live
  • You’ll have an annual deductible of $140

You can elect to participate in a Medicare Advantage Plan Part C and Medicare Prescription Drug Coverage Part D

Medicare Advantage Plans

You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in the Original Medicare Plan. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D (Medicare Prescription Drug) coverage.

You make a choice when you are first eligible for Medicare. Each year you should review your health and prescription needs and switch to a different plan in the fall.

Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program, and sometimes called “Part C.” When you join a Medicare Advantage Plan, you are still in Medicare. As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have the Original Medicare Plan, or you belong to a Medicare Advantage Plan (like an HMO or PPO).

What about Prescription Drug Coverage

Medicare Prescription Drug Plans are offered by insurance companies and other private companies approved by Medicare. This is Part D.

Medicare Health Plans

Today’s Medicare is about choice. Your health plan choices include:

The Original Medicare Plan
Medicare + Choice Plans, including:
Medicare Managed Care Plans
Medicare Private Fee-for-Service Plans
Medicare Preferred Provider Organization Plans
Medicare + Choice Plans are available in many areas.

The Medicare health plan that you choose affects many things like cost, benefits (some have extra benefits like prescription drugs), doctor choice, convenience, and quality.

What exactly is Medicare Part A?

Medicare Part A (Hospital Insurance) helps cover your inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. You must meet certain conditions.

Cost

Most people do not pay a monthly Part A premium because they paid Medicare taxes while working.
In 2012, you pay up to $451 each month if you don’t get premium free Part A. If you pay a late enrollment penalty, this amount is higher.
Medicare Part A Helps Cover when needed:

Hospital Stays

Semiprivate room, meals, general nursing, and other hospital services and supplies. This includes inpatient care you get in critical access hospitals and mental health care. This doesn’t include private duty nursing, or a television or telephone in your room. It also doesn’t include a private room, unless medically necessary. Inpatient mental health care in a psychiatric facility is limited to 190 days in a lifetime.

Skilled Nursing Facility Care

Semiprivate room, meals, skilled nursing and rehabilitative services, and other services and supplies (after a related 3-day inpatient hospital stay).

Home Health Care

Part-time or intermittent skilled nursing care and home health aide services, physical therapy, occupational therapy, speech-language therapy, medical social services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), medical supplies, and other services.

Hospice Care

For people with a terminal illness, includes drugs for symptom control and pain relief, medical and support services from a Medicare-approved hospice, and other services not otherwise covered by Medicare. Hospice care is usually given in your home. However, Medicare covers some short-term hospital and inpatient respite care (care given to a hospice patient so that the usual caregiver can rest).

Blood

Pints of blood you get at a hospital or skilled nursing facility during a covered stay.

What exactly is Medicare Part B?

Medicare Part B (Medical Insurance) helps cover your doctors’ services and outpatient hospital care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

Cost

Most people will continue to pay the same premium they paid last year. The 2012 Medicare Premium for Part B is $99.90 per month. In some cases, this amount may be higher if you didn’t sign up for Part B when you first became eligible. The cost of Part B may go up 10% for each 12-month period that you could have had Part B but didn’t sign up for it, except in special cases. You will have to pay this extra amount as long as you have Part B.

Medicare Part B Helps Cover when needed:

Medical and Other Services

Doctors’ services (not routine physical exams), outpatient medical and surgical services and supplies, diagnostic tests, ambulatory surgery center facility fees for approved procedures, and durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers). Also covers second surgical opinions, outpatient mental health care, and outpatient occupational and physical therapy including speech-language therapy. (These services are also covered for long-term nursing home residents).

Clinical Laboratory Services

Blood tests, urinalysis, some screening tests, and more.

Home Health Care

Part-time or intermittent skilled nursing care and home health aide services, physical therapy, occupational therapy, speech-language therapy, medical social services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), medical supplies, and other services.

Outpatient Hospital Services

Hospital services and supplies received as an outpatient as part of a doctor’s care.

Blood

Pints of blood you get as an outpatient or as part of a Part B covered service.

What are Medigap plans?

Medigap is Supplemental Insurance

  • These plans cover costs that Original Medicare doesn’t cover
  • There are 10 standard Medigap plans (A through N), but not all companies offer all of them
  • Plan A covers the least, Plan F covers the most
  • You’ll pay a monthly premium for a Medigap plan
  • Medigap plans don’t cover prescriptions
  • You can’t enroll in a Medigap plan if you have a Medicare Advantage plan
  • During your guaranteed issue period you won’t be denied due to a pre-existing condition

Now what about Medicare Part D for Prescriptions?

  • You’ll pay a monthly premium for a Part D plan unless it’s included in your Medicare Advantage plan
  • Each insurance company decides on a list of what drugs its Part D plan will cover (a “formulary”)
  • The federal government decides on some drugs Medicare will never pay for

Let us help you figure out the best plan for your situation.

Contact Cindy Today