How do I change my Medicare coverage?

The process for changing your Medicare coverage depends on the type of plan you have. For Medicare Advantage and Part-D, unless you qualify for a Special Enrollment Period (SEP), you can switch to any other Medicare Advantage plan available in your area during the Annual Enrollment Period (AEP). AEP takes place every year from October 15th through December 7th. Any changes made during AEP will be effective January 1st of the following year. You can also make one change during the Open Enrollment Period (OEP), which runs from January 1st through March 31st every year. The change will be effective the 1st of the following month. If you have a Medicare Supplement plan, you can make a change any time during the year. However, you may be subject to medical underwriting and could be declined or receive a higher rate based on your health status. To make a change to your overage, contact your Medicare expert at Kevin Leinum Medicare Agent. The experts at Kevin Leinum Medicare Agent help you understand the many parts of Medicare and determine the right fit for you.
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Do I need a Part A or a Part B if I’m still working?

If you are still working at 65 and have health insurance through your employer or a union, the answer depends on the size of the company you work for. If your employer has fewer than 20 employees, Medicare is your primary insurance. In this case, you will need both Part A & B since Medicare will pay first, with your group insurance paying secondary. If your company has more than 20 employees, there is no need to enroll in Part A or Part B as your employer group insurance will be primary. When you stop working, or your employer group coverage ends, you have an 8-month Special Enrollment Period to sign up for Medicare. One important thing to be aware of is if you choose COBRA after you stop working and do not enroll in Medicare Part A and Part B, you may have to pay a late enrollment penalty when your COBRA ends and you enroll in Medicare. You will also have to wait until the Medicare General Enrollment Period (January 1st to March 31st every year) to enroll, which may cause a gap in your health care coverage. If you are unsure about what you need to do when turning 65, call Medicare Agent Kevin Leinum and he will review your situation and provide guidance on what you should do.

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You may incur a Part D late enrollment penalty

You may incur a Part D late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of the following: A Medicare Prescription Drug Plan (Part D) A Medicare Advantage Plan (Part C) (like an HMO or PPO) or another Medicare health plan that offers Medicare prescription drug coverage Creditable prescription drug coverage The Part D late enrollment penalty is an amount added to your Medicare Part D monthly premium once you enroll in a Part D plan. The amount of the late enrollment penalty is calculated based on how long you went without Part D or creditable prescription drug coverage. The penalty is calculated by multiplying 1% of the “national base beneficiary premium” ($32.74 in 2020, $33.06 in 2021) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The national base beneficiary premium can change from year to year, so your penalty amount may change as well. To avoid any penalties, get in touch with a Medicare expert from Kevin Leinum Medicare Agent several months before you turn 65 or if you are over 65 and are going to lose your employer group health insurance.

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Is it necessary to sign up for Medicare at 65 if I’m still working?

This is a common situation, but if you have any special circumstances, you will want to talk to a Medicare expert to avoid any problems. If you continue to work past your 65th birthday and are covered under a group health plan based on current employment, you will probably want to defer enrollment into Medicare. Once you retire, you will be given an eight-month Special Enrollment Period that begins the month after employment ends or your group health insurance ends, whichever happens first. As long as you enroll during this Special Enrollment Period, you won’t be assessed with any late enrollment penalties. Kevin Leinum Medicare Agent – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give us a call to discuss the options available to you.

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What are my options if I can’t afford Medicare and drug coverage premiums?

There are some options available to you if you can’t afford your Medicare or Part D premiums. For Part D, there is something called Extra Help or Low-Income Subsidy (LIS). LIS can help some low-income Medicare beneficiaries with their Part-D costs. To qualify for LIS, you must be enrolled in Medicare and be below certain income and assets limits. LIS extra help can reduce not only your Part D premiums but also your copays, coinsurance and even reduce or eliminate the Part-D late enrollment penalty. LIS applies to stand-alone Part-D plans and the Part-D segment of MAPD plans. To determine if you are eligible for LIS, contact an independent Medicare agent or call the Social Security Administration. In addition to these programs that help with premiums and out-of-pocket costs (deductibles, copays, coinsurance), other programs can help with the cost of individual prescription drugs. Call Kevin Leinum Medicare Agent – your local Medicare Expert about what Medicare covers or how enrolling in a Medicare Advantage or Medicare Supplement plan can improve your coverage and reduce your out-of-pocket costs.

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What does Medicare Part B cover?

Medicare Part B (medical insurance) covers medical services provided by doctors, nurses, and other health care professionals. Part B coverage includes outpatient care, ambulance services, preventive services, and durable medical equipment. It also covers part-time home care and rehabilitative services, including physical therapy. Medicare Part B covers: Medically necessary services: Services provided by doctors, nurses, and other health care professionals or supplies needed to diagnose or treat your medical condition and meet accepted standards of medical practice. Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts Medicare assignment. Most people will pay the standard Part B premium of $148.50 in 2021 but based on your income; you could pay more due to the Income Related Monthly Adjustment Amount (IRMAA). Kevin Leinum Medicare Agent – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give us a call at 619.886.5665 to discuss the options available to you.

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What does Medicare Part A cover?

Is there a premium I have to pay? At a high-level, Medicare Part A (Hospital Insurance) covers the following: Hospital care of inpatient. Conditioned home health services. Nursing facility care provided that custodial care isn’t the only care required. Hospice care. Medicare Part A covers hospital expenses that are critical for your inpatient care, including semi-private room, nursing services, meals, medications included in your inpatient treatment, and other related services and supplies from the hospital. Part A also has critical inpatient care provided through: Critical access hospitals. Acute care hospitals. Long-term care hospitals. Mental health care. Inpatient rehabilitation facilities. Participation in a clinical research study. In most cases, you won’t have to pay a monthly premium for Medicare Part A Hospital Insurance if you and your spouse paid Medicare taxes for at least 40 quarters (equal to about ten years of working). If you do not meet the qualifications for a premium-free Part A, you can buy it. Call Kevin Leinum Medicare Agent – your local Medicare Expert about what Medicare covers or how enrolling in a Medicare Advantage or Medicare Supplement plan can improve your coverage and reduce your out-of-pocket costs.

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ADDRESS

8144 La Mesa Blvd
La Mesa, Ca. 91942

PHONE

(619) 886-5665

We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This is a proprietary website and is not associated, endorsed, or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program, please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov.

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