How are Medicare and Social Security Related?

Because of the close relationship between Medicare and Social Security, people often confuse these two programs. Although there are connections between Medicare and Social Security, they are two separate government programs. Medicare – Individuals over 65, people with chronic illnesses, and those with end-stage renal disease are covered by Medicare. Social Security – a government pension available to people older than 62 who have chronic disabilities. Social Security benefits are also available to Medicare recipients and vice versa. Besides eligibility, Medicare and Social Security overlap in a few other ways. Enrollment: Both programs require initial enrollment through the Social Security Administration. The Social Security Administration is the place to go to enroll in a Medicare plan or defer your Medicare coverage (for example, to return to an employer plan). Premiums: Medicare premium increases are based on Social Security pension amounts. Part B premiums are typically deducted automatically from Social Security pensions. Eligibility: People who receive Social Security Disability (SSD) benefits are automatically enrolled in Medicare. Similarly, if a person is collecting Social Security when they turn 65, they are automatically enrolled in Medicare (although they can defer Medicare if they have other coverage). Call Kevin Leinum your local Medicare expert for more information.

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What changes to Medicare Part D are expected in 2023?

According to the US Government Centers for Medicare & Medicaid Services (CMS), the average monthly premium for standard Medicare Part D coverage is currently projected to be $31.50 in 2023 which is a decrease of 1.8% from $32.08 in 2022. Before Medicare Open Enrollment, when beneficiaries can select plans for the upcoming benefit year, CMS releases the projected average monthly Part D premium, calculated based on plan bids submitted to CMS. To help Part D plan sponsors prepare for Medicare Open Enrollment, CMS also provides additional information, such as the Part D national average monthly bid amount. Medicare Open Enrollment for coverage beginning January 1, 2023, will run from October 15 to December 7, 2022. CMS anticipates releasing the 2023 Medicare Advantage and Part D premium and cost-sharing information in September 2022. Call Kevin Leinum your local Medicare expert for more information. Kevin Leinum makes Medicare Easy!

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Can I use Medicare out-of-state?

Any doctor or hospital accepting Medicare anywhere in the United States is covered under original Medicare. When a person has Medicare Advantage, their coverage is usually region-specific, and their plan type will determine whether the coverage extends out of state. People participating in Health Maintenance Organizations (HMOs) must use certain healthcare providers. Out-of-network services, such as those located in another state, are rarely covered. Out-of-state care may be covered by a Preferred Provider Organization (PPO). To find out if a plan covers you, carefully read the documentation or contact your provider. Let expert Kevin Leinum help you understand the many parts of Medicare and determine the right fit for you. Give me a call to discuss the options available to you.

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When is the best time to enroll in Medicare?

To get Medicare coverage by turning 65, enroll during the open enrollment period around your 65th birthday – preferably three months before. Once you turn 65, you’ll have to pay a small premium for Medicare coverage until the end of your life. It’s generally recommended that people wait until they turn 65 before enrolling in Medicare. This is also why we don’t recommend people enroll in Medicare until after they turn 65 because people are currently paying out-of-pocket for this coverage. In addition to the above, I recommend that people enroll in Medicare only if they live in a high-risk area because most of our studies have shown that it’s better (and cheaper) to save money on your health insurance premiums by signing up through Health Savings Accounts (HSAs). HSAs are low-cost and low deductible health savings accounts (HSAs) designed to help you afford your health insurance premiums when you retire and start saving for health care costs. Kevin Leinum – your local Medicare expert can help you understand the many parts of Medicare and determine the right fit for you. Give me a call at 619.886.5665 to discuss the options available to you.

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What is an attained-age Medicare policy?

Your attained age is based on the current year, and the years you’ve lived. So if you were born on December 2, 1952, your attained age in the summer of 2022 would be 69 years. But on your actual birthday during the same year, your attained age would be 70. Some insurance companies use a person’s age to price their policies. For instance, it’s one of three rating methods used to determine rates for Medicare supplemental insurance or Medigap. If you are given a quote for an insurance policy, and your age is used as one of the factors, rates will likely increase depending on how old you are. When you buy an insurance policy, the company will base the rates on how old you are. For example, when you buy a 20-year term life insurance policy, companies will base your rates on how old you are. Let expert Kevin Leinum help you understand the many parts of Medicare and determine the right fit for you. Give me a call at 619.886.5665 to discuss the options available to you.

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What is the downside to Medicare Advantage plans?

Medicare Advantage plans generally offer a more extensive range of coverage than Original Medicare—such as vision, dental, and hearing benefits—they often come with costs that are much more variable than Original Medicare. With Original Medicare, the price and coverage are set and standardized across the board, though you’ll likely incur more charges compared to a Medicare Part D plan. Sick participants may find that medical care costs skyrocket under a Medicare Advantage plan due to copayments and out-of-pocket expenses. One of the issues with Medicare Advantage is your service area which can affect whether a plan is available in your area. Also, co-pays, coinsurance percentages, deductibles, and additional benefits can differ. One Medicare Advantage plan that includes prescription drug coverage might not have a medication you need in its formulary. Before enrolling in a Medicare Advantage plan, make sure you understand the cost and coverage it offers to make the best decision for your situation. Let expert Kevin Leinum help you understand the many parts of Medicare and determine the right fit for you. Give me a call to discuss the options available to you.

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What If I Haven’t Worked Long Enough To Qualify For Medicare?

You need to earn about 40 “credits” or “quarters” by paying Social Security and Medicare payroll taxes while working — equal to about ten years of work — to get Part A services without paying premiums. Your payroll taxes have already covered the premiums. Not having worked long enough to “qualify” means that you can’t receive benefits for Medicare Part A (hospital insurance) without paying premiums for them. It’s possible to qualify for premium-free Part A services if you don’t have enough credits based on your spouse’s work record. That is if you’re 65 or older and your spouse is at least 62. In some instances, you may qualify on the work record of a spouse who is dead or divorced. 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 me a call to discuss the options available to you.

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What Doesn’t Medicare Cover?

– Deductibles and coinsurance – If you opt for Original Medicare, both Medicare Part A (hospital insurance) and Part B (medical insurance) require out-of-pocket spending in the form of deductibles and coinsurance. If you have medical needs, this can get pricey, and there’s no out-of-pocket cap on Original Medicare spending. – Routine dental care – Although Medicare Part A covers some dental services you may get as part of a hospital stay, basic dental care like cleanings, X-rays and fillings aren’t covered. If you want coverage, you’ll have to purchase a separate dental policy. – Eye exams – Medicare doesn’t cover eye exams for glasses or contacts, or the eyeglasses or contacts themselves. Medicare Part B does cover one pair of glasses or contacts if you have cataract surgery. – Hearing aids – Medicare also doesn’t cover hearing aids or the exams required for hearing aids. – Prescription drugs – Original Medicare Parts A and B don’t offer coverage for prescription drugs. If you want prescription drug coverage, you must buy a Medicare Part D plan from a private insurance company or get prescription drug coverage from a Medicare Advantage plan that includes it. – Long-term care – Medicare does cover skilled nursing facility care if your doctor recommends it after a qualifying three-day inpatient hospital stay. In these circumstances, Medicare covers the first 100 days of care along with a daily coinsurance charge.

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How do I drop Part A & Part B Medicare Coverage?

Generally, you can only drop Part A (Hospital Insurance) if you have to pay a premium for it, also called Premium-Part A. There are some risks to dropping coverage: – Your costs for health care: You may have to pay all of the costs for services that Medicare covers, like hospital stays, doctors’ services, medical supplies, and preventive services. – Gap in coverage: If you change your mind and want to sign up again later, you may have to wait until the next General Enrollment Period (January 1-March 31 each year) to sign up. Your coverage won’t start until July 1. – Late enrollment penalty: If you don’t qualify for a Special Enrollment Period to get Medicare later, you’ll have to pay a monthly late enrollment penalty for as long as you have Part B coverage. The penalty goes up the longer you go without Part B coverage. If you have to pay a penalty for Part A, you’ll pay it for twice as long as you go without Part A coverage. To voluntarily terminate your Medicare Part B (medical insurance) you may need to have a personal interview. Also a Social Security representative will help you complete Form CMS 1763. 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 me a call to discuss the options available to you.

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What are the Medicare Enrollment periods?

– Initial enrollment period The initial enrollment period is a seven-month period that includes three months before you turn 65, your birthday month, and three months after you turn 65. – Annual election period The Medicare annual election period (AEP) happens every fall from Oct. 15 to Dec. 7. During this time, you can join, drop or change Medicare coverage. – Medicare Advantage open enrollment This one-time change takes place between Jan. 1 to March 31. You must already be enrolled in a Medicare Advantage plan on Jan. 1. – General enrollment period There is a three-month window from Jan. 1 through March 31 annually where you can enroll in Medicare Part A and Part B for the first time if you missed signing up when you were first eligible, and you are not eligible for a special enrollment period. – Special enrollment period In some cases, you may be able to enroll in or switch to a plan outside of the initial enrollment period. This includes changes in your life situation, such as: You retire and leave a health care plan through your employer or union. You move out of your current health plan’s service area. 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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La Mesa, Ca. 91942

PHONE

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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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