Senior 65+ Insurance

Medicare is a federal medical insurance and medical prescription drug program for:

• People who are age 65 or older
• Certain younger people with disabilities
• People with End-stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

Medicare Insurance Plans and Prescription Plans are offered by insurance companies and other private companies approved by Medicare.

Medicare Part A = Hospital Insurance

Hospital insurance covers inpatient hospital care, skilled nursing facility, hospice care, lab tests, surgery, and some home health care.

Medicare Part B = Medical Insurance

Covers certain doctor’s services, outpatient care, medical supplies, and preventative services.

Medicare Part C = Medicare Advantage Plans

Medicare Advantage (also known as Part C) is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Part D is prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Medicare Part D = Prescription Drug Plans

Medicare Drug Coverage helps pay for your prescription drugs, may lower your costs, and may protect against higher costs. To get Medicare drug coverage, you must join a Medicare approved plan that offers drug coverage. Each plan can vary ion cost and specific drugs covered, but must give at least a standard level of coverage set by Medicare. Medicare coverage includes generic and brand name drugs. Different plans cover different prescription drugs in different way. The list of prescription drugs they cover is called a formulary and they place drugs into different “cost tiers” on their formularies. These plans also have different monthly premiums. Also, how much you pay for each drug will depend on the plan that you choose.

“Original Medicare” may make sense for you if you have continuing coverage from a former employer, Union, or Medicaid, or under other circumstances.

With “Original Medicare” you pay for services as you get them. When you get services, you’ll pay a deductible at the start of each year, and you usually pay 20% o the cost of the Medicare-approved service, called coinsurance. If you want drug coverage, you can add a separate plan (Part D). Original Medicare pays for much, but not all, of the cost for covered services and supplies.

A Medicare Supplement Insurance (Medigap Policy) can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Some Medigap policies also cover services that “original Medicare” doesn’t cover, like medical care when you travel outside the U.S.

Medicare supplement plans assist with health care costs that Original Medicare may not cover. Original Medicare pays for much, but not all, of the cost for covered services and supplies. A Medicare Supplement Insurance (Medigap Policy) can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Some Medigap policies also cover services that “original Medicare” doesn’t cover, like medical care when you travel outside the U.S.

If you are already receiving your Social Security benefits, then you will be automatically enrolled in Medicare Parts A & B.

If you are not receiving your Social Security benefits, then you should sign up for Medicare 3 months before your 65th birthday using the online application at the Social Security Administration website:  ssa.gov

Don’t worry, Neldal Insurance is here to help you. Make an appointment with us and we can help you sort it all out.

Bring your red, white, and blue Medicare card, all other insurance cards you have, and any Medicare health or drug plan enrollment documents or cards that you have to your appointment with your Neldal Insurance agent, and we can help you sort it out.

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. Use the online application at the Social Security Administration website:  ssa.gov

If you are employed by a company with more than 20 employees, you should sign up for Part A when you turn 65. You do not need to enroll in a supplement or prescription drug coverage until you lose your employee group insurance.

If you are employed by a company that has less than 20 employees, you should sign up for Parts A and B when you turn 65. There is no need to enroll in a supplement or prescription drug coverage until you lose your employee group insurance.

If this seems confusing, don’t worry! Just make an appointment with us and we will help you get the combination of parts, plans and coverages that you need!

You could be subject to penalties that you will be required to pay for as long as you are on Medicare.

If you enroll in a supplemental policy during your open enrollment period, then NO, you do not have to answer medical questions.

No. You will need to enroll in a stand-alone prescription drug plan.

If your doctor accepts Medicare, then yes, you can keep your doctor.