Medicare Explained

Part A: 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. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252.

Part B: The standard Part B premium amount in 2020 is $144.60. Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

How to Enroll

You can apply online for Medicare even if you are not ready to retire. 

Enroll in Medicare Part A and Part B by either:

  • In-person at your local Social Security Office 
  • Calling Social Security at 1 (800) 772-1213
  • Enrolling online at WWW.SSA.GOV

Things to Keep in Mind:

Most people should enroll in Medicare Part A (Hospital Insurance) but certain people may choose to delay Medicare Part B (Medical Insurance) especially if they still have coverage through their employer. In most cases, it may make sense to drop your employer coverage for Medicare Insurance. 

Remember this enrolls you into Original Medicare not an Insurance Plan through a private carrier. 

Make sure to talk to a licensed professional such as a Coverage2Care broker to see if it makes sense. 

When to Enroll

Most People will enroll during this time period:

Initial Enrollment Period

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.

If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

 General Enrollment Period

You can sign up for Part A and/or Part B during the General Enrollment Period between January 1–March 31 each year if both of these apply:

  • You didn’t sign up when you were first eligible.
  • You aren’t eligible for a Special Enrollment Period (see below).

You must pay premiums for Part A and/or Part B. Your coverage will start July 1. You may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.

Special Enrollment Period

Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period (SEP). If you’re covered under a group health plan based on current employment, you have a SEP to sign up for Part A and/or Part B anytime as long as:

  • You or your spouse (or family member if you’re disabled) is working.
  • You’re covered by a group health plan through the employer or union based on that work.

You also have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):

  • The month after the employment ends
  • The month after group health plan insurance based on current employment ends

Usually, you don’t pay a late enrollment penalty if you sign up during a SEP.

How to Save

Lower prescription costs

·   If you meet certain income and resource limits, you may qualify for a program called Extra Help from Medicare to pay the prescription costs, premiums, deductibles, and coinsurance of Medicare prescription drug coverage. 

·  In 2020, you may qualify if you have up to $19,140 in yearly income ($25,860 for a married couple) and up to $14,610 in resources ($29,160 for a married couple).

Medicaid

Medicaid is a joint federal and state program that:

  • Helps with medical costs for some people with limited income and resources
  • Offers benefits not normally covered by Medicare, like nursing home care and personal care services

Medicare Savings Programs

You can get help from your state paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if you meet certain conditions.

Make sure to talk to a licensed professional such as a Coverage2Care broker to see if it makes sense.

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