What are Medicare Penalties for Late Enrollment?

Medicare late enrollment penalties can increase your monthly premium substantially for the rest of your life. The government can penalize you each month that you maintain your Medicare coverage. It’s essential to understand your options and how these late enrollment penalties work to avoid costly premiums in retirement. There are certain times you can enroll in Medicare, and the first enrollment period is a seven-month window around your 65th birthday, and this window is three months before and after you turn 65. The good news is if you’re receiving Social Security benefits, you will be enrolled in Medicare when you turn 65 automatically. You may be subject to a 10% penalty for each 12-month period you delayed enrollment that you don’t enroll in Part B during the initial open enrollment period. You generally cannot remove it once you have a Part B penalty. And for most, this means the rest of their life. There is good news, though – you may put off enrollment in Medicare Part B and avoid a penalty if you have “creditable coverage.” Kevin Leinum- 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 is Medicare’s Extra Help Program?

Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. The Social Security Administration estimates that Extra Help is worth about $5,100 per year in 2022. To qualify for Extra Help, you must be receiving Medicare and have limited resources and income. You must also reside in one of the 50 states or the District of Columbia. This program assists low-income Medicare beneficiaries in paying for Medicare prescription drug insurance premiums, deductibles, and coinsurance. It also helps with the cost of prescription drugs not covered by Medicare Part D . The program is available to people with limited income and resources who do not qualify for Medicaid and who have not yet enrolled in Medicare Part D . The state Medicaid agency administers the program. It is funded jointly by the state and the federal government. To participate, you must also have coverage with one of the following Medicare health plans: Medicare Advantage Part C – Prescription Drug Plan; a stand-alone prescription drug plan (PDP); or Medicare Advantage Part C – HMO Medicare Advantage plan with a prescription drug benefit (MA-PD). Call Kevin Leinum – 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’s the difference between Medicare Advantage Plans and Medicare Supplement Plans?

Medicare Advantage Plans (MA-PPO/HMO) are sold by insurance companies while Medicare Supplement plans (Medigap) are sold by insurance companies and private insurance companies. The plans are very similar, and the advantages are essentially the same. However, some plans are better than others, so it is important to do a little homework before you make a final decision. Medicare Advantage plans are health plan options for Medicare beneficiaries. They are available in four different categories: HMO, HMO-POS, PPO, and PFFS. The benefit design of the Medicare Advantage plan options is standardized, with an emphasis on preferred provider organization (PPO) and private fee-for-service (PFFS) plans. The government sets the rules for Medicare Advantage plans, and private health insurance companies offer the plans to Medicare beneficiaries. The plans must cover all of Medicare’s Part A and Part B benefit requirements. They also must offer coverage for Medicare’s Part D prescription drug benefit, which is called Medicare Part D. The plans must provide at least the same coverage as the standard Medicare fee-for-service program with respect to the Part D benefit. Medicare Advantage plans may charge premiums, copayments, and deductibles. Call Kevin Leinum your local Medicare expert for more information.

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When is Medicare secondary to my insurance?

The Medicare brochure titled “Medicare & Other Health Benefits: Your Guide to Who Pays First” describes this in detail. In summary, if you have Medicare and other health insurance (like from a group health plan, retiree coverage, or Medicaid), each type of coverage is called a “payer.” When there’s more than one payer, “coordination of benefits” rules decide who pays first. The “primary payer” pays what it owes on your bills first and then sends the rest to the “secondary payer” (supplemental payer) to pay. In some rare cases, there may also be a third payer. If the insurance company doesn’t pay the claim (usually within 120 days), your doctor or other providers may bill Medicare. Medicare may make a conditional payment to pay the bill and then later recover any payments the primary payer should’ve made. Kevin Leinum – 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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Do Medicare Quotes Vary from Agency to Agency?

Licensed agents help Medicare beneficiaries choose the proper coverage. Agents are licensed and registered individuals to solicit and enroll people into insurance products. Agencies provide administrative support such as marketing, technology infrastructure, compliance, and other services for agents. Medicare plans contract with agencies to reach and enroll beneficiaries. Agents earn commissions directly from insurers. Independent agents and agencies represent multiple (but not necessarily all) insurers and help beneficiaries compare and enroll in options in their area. They represent both plans and beneficiaries in this capacity, with compensation tied exclusively to enrollments with contracted insurers. As a result, agents may choose between their income and beneficiaries’ needs. Therefore – yes – Medicare quotes do vary from agency to agency. Call Kevin Leinum – 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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I’m a Veteran and have Veterans’ benefits. Can I get Medicare?

If you have (or can get) both Medicare and Veterans’ benefits, you can get treatment under either program. Generally, Medicare and the U.S. Department of Veterans Affairs (VA) can’t pay for the same service or items. Medicare pays for Medicare-covered services or items. The VA pays for VA-authorized services or items. Each time you get health care or see a doctor, you must choose which benefits to use. For the VA to pay for services, you must go to a VA facility or have the VA authorize services in a non-VA facility. If the VA authorizes services in a non-VA hospital but didn’t authorize all of the services you get during your hospital stay, then Medicare may pay for any Medicare-covered services the VA didn’t authorize. Kevin Leinum – 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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Do you sign us up for Medicare, or do we do that?

You can sign up for a Medicare plan yourself; however, there are some excellent reasons not to do this. We can sign you up to help you avoid the following issues. Medicare is confusing. One mistake can lead to substantial lifetime penalties or even the inability to get coverage. Choosing the wrong plan can leave you with an overpriced plan without the ability to change plans. Medicare plans and pricing change every year, and insurance companies do not send you notifications about those changes, but we will. Being brokers, we work for you – not a specific insurance company. The insurance companies pay us, but we don’t have a particular loyalty to one company over another. Medicare rates go up each year, and Part D drug plans change. We work on your behalf to find cost-saving options when the rates change. We also help with comparing the Part D drug plans. Finally, since everyone pays the same premium whether they have an agent or not, it does not cost you extra to use us. Therefore you’re paying for our assistance whether another broker or we help you or not! Call Kevin Leinum – 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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Must I enroll in Medicare at age 65?

No. You are not required to enroll in Medicare when you become eligible. However, if you do not enroll, it may be challenging to receive all of your Medicare benefits. There are two main parts of Medicare to be aware of for this discussion – Part A, which is coverage for inpatient hospitalization services, and Part B, which is coverage for outpatient services (doctors, medical tests, etc.). Medicare Part A: Assuming you collect Social Security when you turn 65 (you needn’t be collecting it, only eligible to), there will be no premium associated with Medicare Part A (thus no penalty if you delay claiming it). Medicare Part B: There is a monthly premium associated with Part B, but if you have “creditable” healthcare coverage from an employer when you turn 65, you can defer enrolling in Part B until your employer coverage ends, and there will be no Late Enrollment Penalty for waiting. Kevin Leinum – 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 do Medicare prescription drug plans in my area cost?

There are 2 ways to get Medicare drug coverage: 1. Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) to join a separate Medicare drug plan. You must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) to join a separate Medicare drug plan. 2. Medicare Advantage Plan (Part C) or other Medicare Health Plan with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage. To join a Medicare drug plan, Medicare Advantage Plan, or other Medicare health plan with drug coverage, you must be a United States citizen or lawfully present in the United States. Visit Medicare.gov/plan-compare to get specific Medicare drug plan and Medicare Advantage Plan costs, and call the plans you’re interested in to get more details. For help comparing plan costs, contact your State Health Insurance Assistance Program (SHIP). Kevin Leinum – 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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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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