Contact us

info@qqbenefits.com
855-482-4169

affordable health insurance

SENIORS – 65+


Learning about Medicare

Are you ready to dive into the “Medicare Maze” phase of your health care? As the Baby Boomers age, they are finding there is much to learn and to know about healthplans and how to sign up for the best plan that will suit their own health needs. Although there are other levels of qualification for Medicare, this article will focus on the needs and helps for the 65+ population. By following just a few steps you will find here a guide to simplify the process of entering and navigating the ever-evolving healthcare maze upon reaching the age of sixty-five.

First of all if you have worked at least 10 years for which you have paid Medicare taxes and you are at least 65, you are qualified for Medicare. If you have a disability and are under 65, you could qualify as well. You can always check medicare.gov for additional details. It is important to note that there is a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. It begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you miss this period, you may find you have to pay more for not enrolling when you are first eligible.

Next you will need to choose Original Medicare or a Medicare Advantage Plan. The Original Medicare is made up of Plan A for hospital coverage and Plan B, which is medical insurance for services and supplies deemed necessary to treat a disease or condition. There are also some preventive services that are included and you can get specific answers and details on the Medicare.gov site. Your costs will depend on the types of coverage you choose, but this will be a brief synopsis of Original Medicare Plans offered.

Plan A is the hospital insurance. For most enrollees there is no additional premium required for this coverage. It covers hospital stays including bed, food and tests. However, one must keep in mind that no part of Medicare pays for all of a beneficiary’s medical costs and there are many expenses that are not covered at all.

Plan B medical insurance coverage is for medical services and supplies that can include physician and nursing services, equipment such as walkers, canes, wheelchairs, prosthetic devices and such as meet criteria described for the many different instances of coverage and benefits. The premium for this plan is usually $104.90 a month for most people.

You can enroll in Plan A without Plan B or vice versa; but if you enroll in Plan A without Plan B, you can be penalized with a higher rate for signing up later. It is better to get into the plan at the initial qualified age.

Knowing Your Options - Medicare Supplement Insurance

As you explore more in depth into what all Medicare can offer, you will find there are 10 standardized Medicare Supplement Plans available in 47 states. The Plans are lettered: A, B, C, D, F, G, K, L, M & N and are detailed on the Medicare.gov site. “Standardized” means the Plan with the same letter offers the identical benefits from state to state. In other words Plan F in Texas is the same Plan F you can sign up for in Ohio, although it might not cost the same from state to state or provider to provider. Providers are independent from the government but are approved by Medicare to offer such plans. The three states that offer their own standardized plans are Massachusetts, Minnesota and Wisconsin.

Another important aspect of your health coverage would be the prescription benefit. The prescription coverage is not part of Plan A or Plan B. There is a stand-alone drug plan called Plan D. To enroll in a plan that offers the prescription coverage along with Plan A and Plan B benefitswould be a Medicare Advantage Plan that is Plan C. Private insurance companies are the providers of such services and they have been approved by Medicare to do so. Your options typically include a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) type of plan in which you must use plan doctors, hospitals and other medical providers.You might find these options also help you to avoid higher costs compared to providers outside of an HMO or PPO. There will be a monthly premium in addition to the Part B premium and these premiums will vary according to the extent of coverage you opt for. Copays, co-insurance and deductibles are usually added costs to using these plans.

To choose prescription coverage under the Original Medicare Plan you will need to join a Medicare Prescription Drug Plan and pay that plan’s monthly premium. You should join an HMO or PPO plan that offers drug prescription coverage. If you join a PPO plan that does not cover drug prescription, you should know that you cannot join a Medicare Plan D.

Now there are more options to choose from in order for you to be able to put together a more comprehensive medical coverage for your own personal healthcare needs. There are literally thousands of plans that have been made available, though all plans are not in all states. These are the Medicare Supplement Insurance plans (also referred to as Medigap) that help cover out-of-pocket medical expenses. It is important to note, however, that you cannot use Medicare Supplement Insurance if you are already enrolled in the Medicare Advantage Plan. Medigap plans must follow state as well as federal laws. This not only helps protect you but also provides you with standardized coverage that can be found in all states except for Massachusetts, Minnesota and Wisconsin. These three states have Medigap policies that are standardized in a different way. Also it should be noted that a Medigap policy is only for one person. Your spouse would have to sign up for his or her own plan.

In choosing a Medigap plan it is vital to compare plans, as there is a variance in costs and benefits. You will want to know if premiums increase as you get older under some plans. Even inflation plays a role in the rising costs of any healthcare plan. Find out if there are premium limits on these Medigap plans. Remember that Medigap plans are guaranteed to be renewable, even if you have health problems. Once you are enrolled the company cannot cancel on you if you continue to pay your premiums on time. For up to date information it is best to check with your state’s Department of Insurance. Their sites will usually have comparisons and links to the providers and plans for which they have been able to obtain Medicare approval.They can also inform you of what rights you have under state law.

When comparing plans, be aware of who charges the least for the same plan. Be on the lookout to know which pricing method the provider is using. There are 3 main methods that include: community-rated in which it does not matter what age you are when you sign up – a 65 year old would have the same rate as a 72 year old; issue-rated in which it does matter what age you are upon enrollment; and attained-age-rated based on current age but goes up each year with your birthday.

Here is a short list of pointers to consider for comparing and choosing your Medicare Supplement Plan:

  • Monthly Premium
  • Doctor and facility restrictions
  • Deductibles and co-pay percentages
  • Benefits
  • Anticipated costs based on your normal usage of services
  • Prescription coverage costs as it relates to your current usage

Never drop a current insurance policy until you secure a replacement plan first. This will prevent any gaps occurring in your coverage that might affect your benefits and what gets paid should a health cost be incurred.

You should enroll in Medicare or Medigap as soon as you are eligible because then you can choose from any of the plans that are available, no matter what your health status is. This is the only time such an opening occurs and it is called Initial Open Enrollment. You can do this by going to your local Social Security office or you can go online and enroll at the Medicare.gov site. It is easy to navigate through their enrollment process and informative as well. Or you can call the Social Security office on their toll-free line: 1-800-772-1213.

Finding Assistance through the Maze

Because of the standardization of the Medicare Plans across the nation and because of the pricing controls set by each state there is no advantage to navigate the Medicare insurance plans on your own. In fact there is qualified assistance available by a team of trained, professional and licensed insurance benefit advisors online at QQ Benefits. Check out their site by going towww.qqbenefits.com . They can show you a complete and comprehensive layout of what is available in your state. They will guide you through a simple but secure comparison shopping experience. Their services are free and there are over 140 benefit advisors standing by to help you. You can get a free quote today! Just go online at www.qqbenefits.com or you can call their toll-free number between 9 Am and 9 PM eastern time Monday through Friday at 855-482-4169.


Let Us Help!

Click here for a free QUOTE, or call one of agents at 855-482-4169 with your questions