Medicare for Over 65

 If you are reading this you are likely turning 65 and going on Medicare.  Congratulations!  We will gladly give you overall education regarding how to get your Medicare set up and explain ALL of your choices.  This is especially important since  some of the decisions you make might have  lifelong consequences that you cannot change. 

Differences Between Traditional Medicare and Medicare Advantage

The most crucial decision you will likely make is whether to go Medicare Advantage or stick with Traditional Medicare when you turn 65.  When comparing, Traditional Medicare only makes sense if you get a Supplement and Drug Coverage so that is the best way to compare.  Here are some major considerations which we can answer and it may help you decide:

  • How much does everything cost in total?
  • Will you owe anything more if you earn more income?
  • Do you have provider choice?
  • Do you understand how to use your plan?
  • Does the doctor or the insurance company decide on your care?
  • Can you change plans in the future?
  • Who will help you change plans in the future?
  • What happens if you travel?
  • What are your potential risks?
  • What are my potential unexpected costs?
Medicare Advantage *

Must stay within a provider network (HMO or PPO)

Must change plan if move

Plans can drastically change each year

Insurance Plan decides whether you get care  (managed care)

Can get in at any open enrollment

Can be as low as  $0 premium

Potential risk for having high out of pocket costs: High

Traditional Medicare (with Supplement or Gap plan) + part D

(FFS)  Choice of Medical Providers

Can keep plan if you move

Contract stays the same each year

Your doctor decides whether you get care

After 65, must pass through underwriting to get in

Supplements can be 150-200/month premium

Potential risk for having high out of pocket costs:  low

We are happy to discuss and educate you when you are ready.  This usually takes about 20 minutes and can be done by appointment.

 

Costs for Traditional Medicare

What does Traditional Medicare Cost? This can differ per person and depends upon your income and which type of plan you choose.  Many people are surprised to find out that wealthier people may much more for Medicare.  Here are the general components:

The equation is  Part A + B + D + IRMAA adjustments for B, D + Premium for Supplement + Premium for Part D= Total Cost .

This usually ends up being around $400/month without IRMAA per person if you want zero out of pocket costs except for drugs.

Medicare Part A and B is paid to the government:  This will cost the average person around $135/month and will be paid whether you choose Traditional Medicare or Medicare Advantage.

Part B IRMAA is paid to the government:  The costs increases dramatically if your income is higher than $85,000/yr due to Income Related Adustment (IRMAA).  This is usually taken out of social security but can also be paid directly to the government if you are not already collecting.  The best way to find this out is to check with Social Security to find out your cost and find out how you will pay for the monthly charge.  Here is the link to the current chart on Medicare.gov:

https://www.medicare.gov/your-medicare-costs/part-b-costs

 

Supplements are paid directly to the insurance company you choose:  Premiums vary significantly depending upon which supplement you choose, but most choose the F or the G plan which can run $100-200/month.

Part D plans are paid directly paid to the insurance company you choose:  These premiums can range significantly usually from $20-$100/month and also come with some hefty out of pockets to be aware of for those who are on expensive drugs.  The best way to determine the cost of your drugs is to look on the Medicare.gov website and enter in your personal information.

 

Part D IRMAA is paid to the government: The costs increases dramatically if your income is higher than $85,000/yr due to Income Related Adustment (IRMAA).  This is usually taken out of social security but can also be paid directly to the government if you are not already collecting.  The best way to find this out is to check with Social Security to find out your cost and find out how you will pay for the monthly charge.  Here is the link to the current chart on Medicare.gov:

https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/monthly-premium-for-drug-plans

 

 

Costs of Medicare Advantage

 

 

What does Medicare Advantage cost? This can differ per person and depends upon your income and which type of plan you choose.  Many people are surprised to find out that wealthier people may much more for Medicare.  Here are the general components:

 

 

The equation is  Part A + B + D + IRMAA adjustments for B, D + Premium for Medicare Advantage Plan= Total Cost.

This usually ends up being a free plan without IRMAA with much higher out of pocket risk.

 

Medicare Part A and B is paid to the government:  This will cost the average person around $135/month and will be paid whether you choose Traditional Medicare or Medicare Advantage.

 

Part B IRMAA is paid to the government:  The costs increases dramatically if your income is higher than $85,000/yr due to Income Related Adustment (IRMAA).  This is usually taken out of social security but can also be paid directly to the government if you are not already collecting.  The best way to find this out is to check with Social Security to find out your cost and find out how you will pay for the monthly charge.  Here is the link to the current chart on Medicare.gov:

 

https://www.medicare.gov/your-medicare-costs/part-b-costs

 

 

Medicare Advantage plan premiums are paid directly to the insurance company you choose:  These premiums can range significantly usually from $0-$300/month and also come with some hefty out of pockets to be aware of for those who are on expensive drugs or have chronic conditions.  The best way to determine the cost of your drugs is to look on the Medicare.gov website and enter in your personal information.

 

Part D IRMAA is paid to the government: The cost increases dramatically if your income is higher than $85,000/yr due to Income Related Adjustment (IRMAA).  This is usually taken out of social security but can also be paid directly to the government if you are not already collecting.  The best way to find this out is to check with Social Security to find out your cost and find out how you will pay for the monthly charge.  Please call with any questions. It’s what we do.

239-200-0411