If you’re nearing 65, you might be both excited and nervous about starting a Medicare plan to help pay for your medical expenses. You’ve worked hard your whole life for this benefit, and you’ve reached the age where you can take advantage of a Medicare plan.
There are four parts to Medicare – A, B, C, and D – and within each of those parts, there may be hundreds of plans to choose from. How do you know if you’re optimizing your Medicare coverage and whether you should go off your employer’s healthcare plan if you’re still eligible?
Before you hit The Big 65, talk to an agent about the best Medicare plan for you. Make sure your agent is licensed by your State Department of Insurance. This is available to you free of charge. Though an agent does not work for the federal government or receive an official endorsement from Medicare, they are qualified to demystify insurance plans through Medicare and help you choose the plans that are right for you.
When to Talk to an Agent about Medicare Plans
There are a few significant milestones and times of year that you should call your Medicare agent and talk through insurance and Medicare Advantage Plans:
Before You Turn 65: You and your spouse should talk to your agent about your plans to start Medicare about three months before your birthday. This will give you and your agent time to review your options before you start Medicare.
When You Retire: If you’re over 65 and you or your spouse are planning to retire, you may lose your employer-provided healthcare and opt into a Medicare Advantage Plan. An agent can help you review your options and decide which combination of Medicare and private insurance would work best for you.
Annually During Open Enrollment: You can change your Medicare plan every year from October 15 to December 7. The upcoming year’s plans may differ from the current year’s, and your agent can tell you what has changed and whether a new plan would benefit you more.
When You Need to Reduce Your Existing Costs: If you’re unsure which Medicare plan to choose to reduce your existing costs, you may be paying too much. Talking to an agent about your Medicare coverage can help you discover the options for keeping your premiums and medical bills as low as possible.
You Have a Lower Income and May Qualify for Additional Benefits: If you have a lower income, an agent can help explore additional benefits on your behalf and could unlock thousands of dollars each year in other benefits.
Choosing the Right Combination of Parts in Your Medicare Plan
There are thousands of combinations of Medicare Parts A-D that could save you money when you have an agent review your coverage for your specific needs, medications, doctors, and budget. An agent works with all major insurance carriers to match you to the best Medicare Advantage Plan and supplemental insurance.
Your agent will help you with each part of your Medicare package:
Medicare Part A Hospital Insurance: When you turn 65, you’re eligible to enroll in Medicare Part A, usually with no additional premium since you’ve been paying into this system through your paycheck throughout your career. Medicare Part A covers hospital, nursing, hospice, and home health care.
Medicare Part B Medical Insurance: Part B has a different monthly premium that can be deducted from Social Security. Part B covers many doctor visits, labs and diagnostics, medical equipment, mental health services, and other outpatient services. If you don’t enroll in Part B when you retire, you may pay a 10% penalty for each year you were eligible and chose not to enroll. You can talk to your agent about this stipulation and higher premiums if you are over a certain income.
This article has left out any information about Medicare Supplement Plans/Medigap Plans. Medigap plans are the alternative to Medicare Advantage Plans and a viable option. Leaving them out does provide the reader with the full range of options.
Medicare Part C Medicare Advantage Plans: Medicare Advantage Plans are where an agent can help you. Private health insurance companies offer plans in a package that joins Medicare Parts A, B, and D. You’ll need to decide if you want to package your Medicare or pay separately for the other parts, but Medicare Advantage Plans have a few real benefits:
- They include everything from Medicare Parts A, B, and D plus optional additional coverage like vision and dental.
- They function more like private health insurance coverage, with more streamlined healthcare payments, pre-authorizations, and payouts.
- Medical Advantage Plans have a limit on out-of-pocket expenses for the year. Traditional Medicare does not have this limit. If your healthcare costs are very high, you would never reach a ceiling with Parts A and B.
Medicare Part D Prescription Drug Plans: You can opt into Medicare Part D to help pay for prescription drugs. You will find many drug plans for enrollment through Medicare or through a Medicare Advantage Plan, and premiums can vary based on coverage and whether you fall into the Medicare Part B higher income bracket. Like Part B, you will pay the penalty if you choose to enroll later.
Many consumers will pair a Part D drug plans with a Medicare Supplement Plan.
Talk to An Agent and Find the Right Plan for You
By now, you should understand that enrolling in a Part C Medicare Advantage Plan could save you money over enrolling in Parts A, B, and D individually, especially if you anticipate high out-of-pocket medical costs for the year. Talking to a qualified agent who can review your income and medical expenses to determine the best option will give you the peace of mind that you are not leaving money on the table, either in higher premiums or unnecessary medical costs.
When you call an agent, you are not obligated to pay for any product or service. You just need to call before you set up your Medicare plan and especially before any penalties kick in for not setting up your plan immediately after retirement. They can help you, and your spouse get started on healthcare for this next amazing phase of your life.
