Medicare doesn’t have to be complicated Medicare 101 Casanova Ins Discover the benefits of getting Medicare with:
What is Medicare? Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). Casanova Ins casanovains.com 1
Who can get Medicare? You must also meet one of the following requirements: • Age 65 • Younger than 65 with a qualifying disability • Any age with a diagnosis of end-stage renal disease or ALS (Amyotrophic Lateral Sclerosis) U.S. citizens and legal residents: Legal residents must live in the U.S. for at least 5 years in a row, including the 5 years just before applying for Medicare. Casanova Ins casanovains.com 2
How Medicare Works What are the different parts of Medicare? Medicare Part A (Hospital Insurance) helps cover: • Inpatient care hospitals • Skilled nursing facility care • Hospice care • Home health care Medicare Part B (Medical Insurance) helps cover: • Services from doctors • Outpatient care • Home health care • Durable medical equipment • Many preventive services • Diagnostic Lab and X-Ray • Physical and Occupational Therapy Casanova Ins casanovains.com 3
How Medicare Works Medicare Part C (Medicare Advantage): • Includes all benefits and services covered under Part A and Part B • Usually includes Medicare prescription drug coverage (Part D) as part of the plan • Run by Medicare-approved private insurance companies that follow rules set by the Center for Medicare and Medicaid Services (CMS) • May include extra benefits and services for an extra cost Medicare Part D (Medicare prescription drug coverage): • Helps cover the cost of prescription drugs • Run by Medicare-approved private insurance companies that follow rules set by the Center for Medicare and Medicaid Services (CMS) May help lower your prescription drug costs and help protect against higher costs in the future Casanova Ins casanovains.com 4
Signing Up for Medicare Part A & Part B Some people get Part A and Part B automatically Casanova Ins casanovains.com 5
Signing Up for Medicare Part A & Part B • If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65. (if your birthday is the first day of the month, Part A and Part B will start the first day of the prior month.) • If you are 65 and disabled, you’ll automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. • If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you’ll get Part A and Part B automatically the month your Social Security disability benefits begin. Casanova Ins casanovains.com 6
Signing Up for Medicare Part A & Part B Some people have to sign up for Part A and/or Part B • If you are 65 or older and covered by an employer group plan, you do not have to enroll in Medicare. • If you are close to 65, but not getting Social Security or Railroad Retirement Board (RRB) benefits, you’ll need to sign up for Medicare. Contact Social Security 3 months before you turn 65. You can also apply for Part A and Part B at medicare.gov or call SS at 1-800-772-1213. • If you worked for a railroad, contact the RRB. In most cases, if you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. Casanova Ins casanovains.com 7
Signing Up for Medicare Part A & Part B If I’m not automatically enrolled, when can I sign up? Initial Enrollment Period • Your |nitial Enrollment Period (IEP) is 7 months long. It includes your 65th birthday month plus the 3 months before and the 3 months after. It begins and ends 1 month earlier if your birthday is on the first. You may enroll in Part A, Part B or both. You may also choose to join a Medicare Advantage plan (Part C) or a prescription drug plan (Part D). • Your effective date will be the first day of your birthday month. If you were born on the first of the month, your effective date will be the first day of the previous month. Casanova Ins casanovains.com 8
Signing Up for Medicare Part A & Part B • If you don’t sign up for Parts A and B when first eligible, you may be subject to a late enrollment penalty for as long as you have the coverage. The penalty is 10% for every 12 month period you went without coverage. • If you enroll in Part A and/or Part B the month you turn 65 or during the last 3 months of your Initial Enrollment Period the start date for your Medicare coverage will be delayed. Casanova Ins casanovains.com 9
Signing Up for Medicare Part A & Part B For example: If you sign up for Part A (if you have to buy it) and/or Part B in this month: Coverage stars: * The month you turn 65 1 month after you sign up * 1 month you turn 65 2 months after you sign up * 2 months you turn 65 3 months after you sign up * 3 months you turn 65 4 months after you sign up Casanova Ins casanovains.com 10
Signing Up for Medicare Part A & Part B Special Enrollment Period If you (or your spouse) are still working, you may have a chance to sign up for Medicare during a Special Enrollment Period. • Anytime you’re still covered by the group health plan • During the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first. Casanova Ins casanovains.com 11
Signing Up for Medicare Part A & Part B General Enrollment Period • If you didn’t sign up for Part A (if you have to buy it) and/or Part B (for which you must pay premiums) during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can sign up between January 1—March 31 each year. Your coverage won’t start until July 1 of that year, and you may have to pay a higher Part A and/or Part B premium for late enrollment. Casanova Ins casanovains.com 12
Signing Up for Medicare Part A & Part B Should I get Part B? This information can help you decide if you should get Part B: • Employer or union coverage—If you or your spouse (or family member if you’re disabled) is still working and you have health coverage through that employer or union, contact your employer or union benefits administrator to find out how your coverage works with Medicare. This includes federal or state employment, coverage through the Health Insurance Marketplace Small Business Health Options Program (SHOP), and active-duty military service. It might be to your advantage to delay Part B enrollment. Casanova Ins casanovains.com 13
Signing Up for Medicare Part A & Part B Part B Monthly Premium The standard Part B premium amount in 2 020 is $1 44.60 or higher depending on your income. Social Security will tell you the exact amount you’ll pay for Part B in 2020 . You pay the standard premium amount if: • You enrolled in Part B for the first time in 2020 . • You don’t get Social Security benefits. • You’re directly billed for your Part B premiums. • You have Medicare and Medicaid, and Medicaid pays your premiums (Your state will pay the standard premium amount of $ 144.60 ) • Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. casanovains.com 14 Casanova Ins
Signing Up for Medicare Part A & Part B How much does Part B cost? You pay If your yearly income in 201 8 was (in 2020 ) File individual File joint File married & separate tax return tax return tax return $ 87,000 or less $ 174,000 or less $ 87,000 or less $ 144.60 above $ 87 , 000 above $ 174,000 up $ 202.40 N/A up to $ 109,000 to $ 218,000 above $ 109,000 above $ 218,000 $ 289.20 N/A up to $ 136,000 up to $ 272,000 above $ 136,000 above $ 272,000 $ 376.20 N/A up to $ 163,000 up to $ 326,000 above $ 163,000 above $ 326,000 above $ 87,000 $ 462.70 and less than $ 413,000 and less than $500,000 and less than $750,000 $ 413,000 and above $ 491.60 $500,000 or above $750,000 and above casanovains.com 15 Casanova Ins
Signing Up for Medicare Part A & Part B Part D Monthly Premium You pay If your yearly income in 201 8 was (in 20 20 ) File individual File joint File married & separate tax return tax return tax return $87,000 or less $174,000 or less $ 87,000 or less Your Plan Premium above $ 87,000 above $ 174 ,000 $ 12.20 + Your Plan N/A up to $ 109,000 up to $ 218,000 Premium above $ 109,000 up above $21 8 ,000 $31. 50 + Your Plan N/A to $ 136,000 up to $ 272,000 Premium above $1 36,000 above $ 272,000 $ 50 . 70 + Your Plan N/A up to $16 3,000 up to $ 326,000 Premium above $ 163,000 above $32 6 ,000 above $ 87,000 $70. 00 + Your Plan and less than $41 3 ,000 and less than $500,000 and less than $750,000 Premium $ 76 .40 + Your $41 3 ,000 or above $500,000 or above $750,000 or above Plan Premium casanovains.com 16 Casanova Ins
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