The Next Epic Race: Finding the Best Medicare Options For You Before Open Enrollment Ends!

“Age is just a number!” We’ve all heard or said it in our lifetimes, but we’re here to tell you, when the government puts a number on it, it usually pays to listen! 

So you’ve finally reached the magical age of 65-years-young (which by the way, we’ve heard is the new 45) and Uncle Sam says it’s time to reap your well-deserved benefits earned through years of working and paying into the system. But now what? (Hint: if the answer were that simple we wouldn’t be writing a blog about it!) 

Below you’ll find some important dates and information you should pay attention to, whether you’re just signing up for your Medicare benefits or it’s not your first go-round, now is the time to start planning for any changes you need to make during Medicare’s annual open enrollment period. 

For the Newbies:

what you need to understand 

Medicare is a health insurance program for: 

  • people age 65 or older, 
  • people under age 65 with certain disabilities, and 
  • people of all ages with End-Stage Renal Disease 

Medicare Basics:

Part A Hospital Insurance 

It’s yours for turning 65 – yay! 

Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A, often known as ‘Hospital Insurance’, helps cover inpatient care in hospitals, including critical access hospitals and skilled nursing facilities. It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Part A premium

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A").

  • If you buy Part A, you'll pay up to $458 each month in 2020.
  • If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $458 in 2020.
  • If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252 in 2020.

Part A hospital & inpatient deductible

You pay: $1,408 deductible for each benefit period

  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $352 coinsurance per day of each benefit period
  • Days 91 & beyond: $704 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs

Part B Medical Insurance

In most cases you qualify for it when turning 65 

Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient 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 as well as some home health care. Part B helps pay for these covered services and related supplies when they’re medically necessary. 

Part B Premium 

Most people pay 

$144.60 each month

(or higher depending on your income).

Part B deductible & coinsurance

$198.

After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.

Part C Medicare Advantage Plans 

You can choose to buy it or not. 

If you choose to join one of these plans you generally get all your Medicare-covered health care through the Medicare Advantage Plan. It’s really important to understand that Medicare Advantage plans replace your original Medicare, they’re not an add-on benefit like Part D or supplemental plans. Medicare Advantage Plans include HMOs, PPOs, private fee-for-service plans, Medicare special needs plans and can even include prescription drug coverage. In most advantage plans there are generally extra benefits and lower co-payments than in original Medicare. However, most Medicare Advantage Plans are managed care plans, which means you may have to see specific doctors that belong to the plan or use certain hospitals to get services. 

Part C premium

Part C monthly premium varies by plan

Part D Prescription Drug Coverage 

You can choose to buy it or not; but we recommend you do! 

Did you know that over one-third of prescription drugs used in the U.S. are taken by those 65 and older; and prescription drugs costs aren’t a cheap date! Most people will pay a monthly premium for Part D coverage, provided by private insurance companies, to help lower prescription drug costs and protect against higher costs in the future. Like other insurance, if beneficiaries decide not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later. 

Part D premium

The Part D monthly premium varies by plan

(higher-income consumers may pay more)

Medicare Supplements 

These are also known as Medigap plans; you can choose to buy it or not. 

Medicare Supplements are sold by private insurance companies. These types of policies can help pay some of the health care costs that original Medicare doesn't cover, like co-payments, coinsurance and deductibles. A Medigap policy is different from a Medicare Advantage Plan. Advantage plans are ways to receive your Medicare benefits, while a Medigap policy only supplements your original Medicare benefits. 

For the Seasoned (or any) Medicare Recipients:

enrollment dates & guidelines 

September & October Prep

Take this time to review and compare Medicare Advantage Plans and ensure you understand any notices you may have received from your current plan, about changes for next year.

To learn more about your options, download Medicare and You 2021. 

You can also use Medicare’s tools to find a plan that meets your needs – or better yet – let the RightQuote team do the research and provide you with the best options!

October 15 - December 7 - GAME TIME!

During this one time of the year, every year (did we mention it only happens once a year?!), ANY Medicare recipients can make the following changes, without penalty: 

  • Change from Original Medicare to a Medicare Advantage Plan. 
  • Change from a Medicare Advantage Plan back to Original Medicare. 
  • Switch from one Medicare Advantage Plan to another Medicare Advantage Plan. 
  • Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage. 
  • Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage. 
  • Join a Medicare Prescription Drug Plan. 
  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan. 
  • Drop your Medicare prescription drug coverage completely. 

January 1 - Coverage Begins

On January 1st, if you switched plans your new coverage will begin. Also, if you choose to stay with the same plan, any changes to coverage, benefits, or costs for the new year will begin. 

Between January 1 March 31

Ok, Maybe One Do-Over!

If you’re in a Medicare Advantage Plan (like an HMO or PPO), you can make one change to a different plan or switch back to Original Medicare (and join a stand-alone Medicare Prescription Drug Plan) once during this time. Any changes you make will be effective the first day of the month after the plan receives your request. 

We're here to help!

We told you it was blog-worthy, right? And this is just the tip of the iceberg when it comes to understanding all the ins and outs of each different policy. But don’t feel overwhelmed, because at RightQuote our team of insurance nerds is totally pumped for this time of year! We’re here and we’re ready to be your knowledgeable Medicare advisors, providing advice and guidance in navigating the Medicare system. If you have questions about enrollment or plan comparisons, please give us a call or shoot us an email, we’re here to help and always focused on YOU!

Some of this information was provided www.cms.gov, www.medicare.gov and Medicare and You 20201; visit their sites for additional resources. 

By contacting the phone number on this website, you will be directed to a licensed agent.