Medicare

A Medicare Primer:

Who is eligible?

65 or older, with at least 10 years of work experience, or earlier with a social security disability. If one has less than 10 years work experience, Medicare may be purchased at a monthly rate.

How do I enroll?

  If you are receiving social security benefits before age 65, you are automatically enrolled and will get your medicare card in the mail. 

For the majority of us it is necessary to contact Social Security and sign up.

You can apply online (socialsecurity.gov), call  Social Security at 1-800-7721213, or go to the local Social Security Office.

What are the parts of Medicare? 

Part A is hospital coverage. There is no monthly premium if you have worked for at least 10 years.

Part B is medical coverage (doctor, tests, surgeries...). There is a monthly premium.

(Parts A and B are also called Original Medicare)

Part C is Private insurance that may be selected instead of Original Medicare. Also called a Medicare Advantage Plan. You must still pay your Part B premium along with the Advantage premium..

Part D is drug coverage from private insurance. There is a monthly cost if you are on Original Medicare. If on an Advantage Plan, many have drug coverage as part of the plan and is already in the Part C premium.

Does Medicare cover all costs?

Short answer: No.

There are gaps in coverage: deductibles (you pay this first) in Parts A and B, and Part B has an 80% coverage limit. If you only have Original Medicare, you are responsible for the deductibles and the 20% not covered.

That 20% could be a financial hardship in a major health event, which is why most people will acquire private health insurance to fill in the gaps of Original Medicare.

What are the types of Private Insurance to fill in the gaps?

Supplemental or Medigap insurance.  

  This type works along with Original Medicare. You will pay Part B premium, and Medicare Supplement premium. Part D is needed, so here is another premium. 

Medicare Advantage Insurance

This type works in  place of Original Medicare. The coverage is at least as good as Original Medicare, if not better. You Pay Part B and Advantage premiums. Drug coverage is often included, so Part D would be covered.

Cost Plan: 

  In specific areas of Minnesota and western Wisconsin, this type works like a supplement in certain parts, and an advantage plan in others. You pay Part B and Cost Plan premiums. 

Drug coverage: 

  If on Original Medicare, or private insurance without drug coverage, a stand alone drug insurance plan is used.

Is Dental Insurance covered in Medicare? Not your normal visits to the dentist. And most private Medicare Insurance do not cover dentistry. 

How can I find out what type of Medicare Insurance is available in my area?

1. Medicare.gov is an excellent and extensive resource which one can find what is available in a particular area.

2. Contact an insurance agent who specializes in Medicare.

There are two types of agents - captive, which works with one insurance company, or independent, which means that they can present multiple insurance companies plans.

Contact Summitt Insurance to help you with learning more about Medicare, plans that are available, which one is right for you, and enrolling.