Medicare 101

Medicare Help and Enrollment Strategies

GolferOCMedicare helps you make the best decision when choosing your Orange County Medicare Insurance.  We bring ease to the Medicare Insurance process, allowing you to understand how Medicare works and helping you find the Medicare Insurance plan that’s right for you.

We provide free assistance so you don’t have to learn it all yourself.  We sit down with you, either in person, on the phone or via email and show you how the whole system works.

It will all become crystal clear once you sit down with us and we talk with you personally about your particular situation.

Medicare has four distinct parts

Medicare Part A

Medicare Part A covers you if you are admitted, as an “In-patient”, to a hospital, skilled nursing facility or institution.  Part A is free for most people and you are entitled to Part A if you are a US citizen and you’ve worked 40 or more quarters (your spouses working quarters apply to you if you have not worked).  Part A has a deductible and, once you’ve reached your deductible it covers you at 80%.  You are responsible for the 20%, which is why you’ll want to consider obtaining Medicare Insurance (which typically takes care of your deductibles and the 20%).

Medicare Part B

Medicare Part B is NOT free.  Most citizens pay a monthly premium of $121.80 for Part B.  But, if you make more money you may need to pay more for your Part B.

Medicare Part B covers you for all services performed outside of a hospital setting.  Think “out-patient”.  Everything from a routine MD Office Visit, Lab work, Physical Therapy, CT Scans, MRI’s, etc, etc, etc.  Part B has a deductible as well, and covers you at 80%.  You are responsible for 20%, which, again, is why you’ll want to consider obtaining Medicare Insurance.

Medicare Part C

Medicare Part C is also known as the Medicare Advantage program.  Most HMO’s you see advertised on TV are a part of the Medicare Advantage program.  Think SCAN, Blue Shield’s 65+, AARP’s Medicare Complete, etc.  These Medicare HMO’s often have ZERO premium but require that you make co-payments for certain services.  You also MUST use your Primary Care Physician for all services and he/she will give you a referral to a specialist should you need one.

Medicare Part C is NOT a requirement.  It is just a Medicare Insurance option for you to consider that will help offset the Medicare deductibles and the 20% that you would be responsible for if you did not have a Medicare Insurance plan in place.

Medicare Part D

Medicare Part D, or the Prescription Drug program, is just that.  You must obtain a prescription drug plan whether you are currently on medications or not.  The Federal Government requires all Medicare beneficiaries to obtain a Part D drug plan, otherwise you will be responsible for a “late enrollment penalty” if you fail to get a Part D plan and decide to activate one later.

There are some things to consider when deciding which plans you’ll need and which plans you won’t need.  For instance, if you are still working and your employer provides “creditable coverage” you may NOT need to get Medicare Part B OR Medicare Part D.  These are things that we can help you determine so please feel free to contact us to review your particular situation.

Medicare Supplement Insurance plans

Another insurance option to consider is a Medicare Supplement Insurance plan (rather than a Part C Medicare Advantage Plan).  A Medicare Supplement plan will often pay for most, if not all, of the balance that Medicare does not pay.  There are NO co-pays or deductibles and you can use ANY doctor in the USA, as long as that doctor accepts Medicare.

It’s hard to understand all the intricate details of Medicare and the insurances available by reading about it, which is why we offer free advise and provide Medicare education to you without obligation.  Please take advantage of our free service and schedule an appointment today.

Don’t try and tackle Medicare alone!

Contact us and let us be your guide. We provide a no obligation free consultation! We’ve been helping people just like you for over 30 years and feel confident that we can help you make the best decision for yourself regarding your Medicare Insurance needs.

Call today at (714) 729-3161.

2016 Medicare Part B Premiums Announced

We first heard that Medicare Part B premiums were expected to increase in 2016. Then it was released this may not be the case. Today the Centers for Medicare and Medicaid Services (CMS) has announced the 2016 Medicare Part B premiums. Existing Part B recipients paying for Part B through Social Security = $104.90 (no change in 2016) Existing Part B recipients paying for Part B directly … [Read more...]

Increase in Medicare Part B Premiums May Not Happen

Due to a bipartisan budget deal seniors may not have to worry about the increase in Medicare Part B premiums. The article below by Robert Powell from USA Today talks about what seniors can expect in upcoming Medicare Part B changes. Budget proposal could mean no 52% jump in Medicare Part B premiums Millions of Medicare recipients bracing for a 52% premium increase are one step away … [Read more...]

Medicare Part B Premium Is Expected To Increase In 2016

Almost one third of Medicare Part B recipients are expected to see a 52% Medicare Part B premium increase in 2016. The anticipated rise in premium fees are due to Social Security and Medicare rules. In 2015 there has been little to no inflation and Social Security cannot pay the cost-of-living increase next year, 2016. Because of this the Medicare program must equally extend the premium cost … [Read more...]

Medicare Part D

Medicare Part D is also referred to as prescription drug coverage and is available through private insurance companies. You must live in the area that a specific Medicare Prescription Drug Plan services in order to be eligible. How Much Does Medicare Part D Cost? The various insurance companies offer different drug coverage plans so your premiums and out-of-pocket expenses will differ. … [Read more...]

Medicare Part C

If you qualify you can choose to enroll in a Medicare Part C plan. This plan is also known as a Medicare Advantage plan. Personal health insurance companies offer Medicare Part C (Medicare Advantage) as well as Medicare Part A and Part B coverage. Let us help you compare Medicare insurance plans that suit your individual needs and budget. What’s Covered by Medicare Part C? In all types of … [Read more...]

Medicare Part B

Medicare Part B covers you for all services performed outside of a hospital setting and is NOT free. You will receive coverage for Medicare Part A and Part B through a private health insurance company, if you have a Medicare Advantage Plan. What’s Covered by Medicare Part B? Medicare Part B covers various services and equipment that are essential to treating your health/medical condition. … [Read more...]

Medicare Part D Gap or Donut Hole

The Medicare Part D prescription drug Coverage Gap or Donut Hole, is the phase of your Medicare Part D benefit where there is a significant gap in your prescription drug coverage. During this phase, you have to pay more for your name brand medications, until you reach the catastrophic coverage phase where you will then have very small copays for those same name brand drugs. When your total … [Read more...]

Medicare is confusing – a Medicare insurance agent can help

Using a Medicare insurance agent can help you understand a somewhat confusing Medicare system and guide you in your Medicare insurance decisions. According to the New York Times, for millions of older Americans, Medicare's Annual Election Period is time to sift through the mind-boggling array of Medicare plans. There is an average of 29 drug plans to digest, and about 18 options for Medicare … [Read more...]

Should I activate Medicare Part B?

Before you Activate Medicare Part B make sure you are signed up for Medicare Part A You should sign up for Medicare Part A even if you are still working and have insurance through your employer as most people get Medicare Part A for free. Activate Medicare Part B Medicare Part B comes with a whole different set of rules you must understand before activating it. You’ll pay a premium when you … [Read more...]

When can I enroll in Medicare?

You can enroll in Medicare after your 65th birthday Your Initial Enrollment Period (IEP) starts three months before your 65th birthday, includes your birth month and ends 3 months after your 65th birthday. You have a total of 7 months to enroll in Medicare. Social Security & Auto Enrollment in Medicare Are you currently receiving social security benefits? If you are already receiving … [Read more...]