Part D Prescription Drug Plans Archives - Medicare Life Health

Medicare Easy Pay

Carly H. Cummings — Sat, 11 Jan 2020 07:57:00 +0000

Medicare Easy Pay – What is it & How do I get it?

Medicare Easy Pay is the automatic payment system set up by CMS to pay your Medicare Premiums.

CMS (The Centers for Medicare & Medicaid Services) offers Medicare Easy Pay for Part A and Part B Premium Payments from a checking account or a savings account. (Most people get Part A at no cost, so people typically use Easy Pay for just Part B premiums.)

If you sign-up for Easy Pay, then your premiums will be automatically deducted from the account you specify.

How Do You Sign-up for Medicare Easy Pay?

Well, I wish I could send you straight to a website with a secure enrollment option, all done online. However, it does not exist at this time. Instead, you will have to fill out a paper enrollment form and mail it in.

Enroll By Mail

Mail a completed Authorization Agreement for Pre-authorized Payments form [PDF, 117 KB] (SF-5510) to:
Medicare Premium Collection Center
PO Box 979098
St. Louis, MO 63197-9000
From Medicare.gov

In addition, if you are already signed-up for Easy Pay, but you want to make a change, this is also the address you will send the same form into. Just add the changes you want to make on that same form you would send in for new Easy Pay Enrollment.

Enroll in Person

Alternatively, you can also go to your local Medicare / Social Security office and make an appointment to submit your information through the office.

Railroad Benefits Differences

If you are with the Railroad, your options are different. You will need to send your payments in by mail, or set-up a “bill-pay” option with your bank for them to monthly mail the money into this address:

RRB, Medicare Premium Payments
PO Box 979024
St. Louis, MO 63197-9000

If you are retiring with Railroad Retirement, please read our about your benefits and choices with Medicare here.

How Does Medicare Easy Pay Work?

After you sign-up for Medicare Easy Pay by sending in your enrollment application, then the Center for Medicare and Medicaid Services (CMS) will take 6 – 8 weeks to process your application.

Remember, it is important to pay any billed premiums in the mean time.

Then, when you are set-up, CMS will monthly send you a Monthly Statement, called a “Medicare Premium Bill.” However, this is just for your reference, and you will not have to pay it when you are set-up for Easy Pay as it will be deducted from your account monthly now. CMS has a diagram to help you read this document here.

Medicare.gov also states that premiums typically come out of your checking or savings account around the 20th of the month.

Medicare and Medicaid Difference Guide

Carly H. Cummings — Thu, 09 Jan 2020 17:50:31 +0000

Medicare and Medicaid Difference Guide

The Medicare and Medicaid Difference Guide helps you understanding both services, so you can make the best decisions for yourself and your loved ones.

The United States has two separate national health care systems: Medicare and Medicaid. The government created the two programs for two different kinds of people. However, they often overlap. Let’s look at both programs, including their similarities and difference. We will also look at who needs or qualifies for each program.

Let’s Start with Medicare vs Medicaid.

What is Medicare?

Medicare is the U.S. national health care program that provides seniors age 65 and older, and some disabled people, with health insurance.

The U.S. government started the program in 1966. The Centers for Medicare and Medicaid Services runs these programs. Medicare also covers people with end stage renal disease and amyotrophic lateral sclerosis.

Medicare does not cover all of the costs associated with health care. As a result, people with Medicare will also use a Medicare Supplement Insurance Plan (Medigap Plan) or a Medicare Advantage Insurance Plan to round out their care coverage.

Please read our Ultimate Guide article on “What is Medicare.“

What is Medicaid?

Medicaid is the United States National Health Care System that provides health coverage to over 64.7 Million People.

The program was created for people with low-incomes that cannot afford, or do not have access to, private healthcare insurance.

How are the programs similar?

The programs are both National Health Care Systems. In fact, they are the only two nationalized heath care systems the United States has. Many other countries around the world have much more extensive national coverage for their citizens. The U.S. has a limited program for specific age, income, and health groups, and the rest of the country relies on private health insurance.

In addition, both programs cover specific hospital services, doctor services, and other health care related services.

Medicare has four parts. First, Medicare Part A, also known as “Hospital Insurance,” helps with coverage regarding: inpatient care, home health care, nursing facilities, and hospice.

Second, there is Medicare Part B, also known as “Medical Insurance.” Part B helps with coverage related to doctor and other provider services, including: doctors visits, health care providers, outpatient, prevention services, and medical equipment. Medicare Beneficiaries pay for Part B.

Finally, Medicare has a Prescription Drug Program that is administered by private insurance carriers. Click here to lean more about What Medicare Covers and Medicare Parts A, B, C and D are.

Both Medicaid and Medicare Advantage Plans can be set up as managed care plans with networks of doctors and hospitals members have access to. If you would like to learn more about how these networks work, please read, HMO vs PPO – Which is Better?

How are the programs different?

One of the biggest differences between the two programs is who runs them. Medicare is run on a national level, by the Federal government. On the other hand, Medicaid is run by each state individually.

Of course, the biggest difference is the the different populations the programs serve:

Medicare – For Seniors over age 65, and some disabled people
Medicaid – For people with low income and few resources

Medicare and Medicaid Differences in Beneficiaries – Who Gets What Program?

The U.S. government created Medicare and Medicaid to take care of different “vulnerable” populations – the poor, the disabled, and the elderly. Let’s look at each program and population.

Who should get Medicare?

Anyone who is a citizen or qualified resident of the U.S. can enroll in Medicare when they turn 65 years old. There is a seven month window of time starting three months before turning 65, the month of your birthday, and then three months after your birthday month.

How do I Sign-up for Medicare?

First, you may be automatically signed-up if you are already receiving Social Security (SS) or Railroad Retirement (RRB).
Second, if you are not already receiving SS or RRB benefits, you must sign up for it when you turn 65 years old.
Conversely, if you are not ready for Medicare when you turn 65, you must notify the government that you want to delay your benefits. If you do delay, it must be because you have credible coverage in place. An example of this would be an employer plan.
Click here to read more about Medicare, including where to go to enroll.
From Our Article What is Medicare? A Guide to All Medicare Basics

Supplemental Medicare Insurance Options

Medicare picks up about 80% of the health care costs for its beneficiaries. For the other 20%, seniors turn to either Medicare Supplements (aka Medigap Plans) or Medicare Advantage Plans. Click here to read our article on Medicare Advantage vs. Medigap, or see the informational articles below.

Who should get Medicaid?

Medicaid is for people with limited income and resources. Medicaid is run on a state level, not on a federal level. As a result, in order to qualify for Medicaid, you will need to determine what your state defines as a qualifying income level.

How Do You Enroll in Medicaid?

Again, since Medicaid is run by State Governments, you will need to contact your state’s agency to start see if you qualify to enroll.

You can find a list of State Agencies here on the Medicaid.gov website.

Who Can Get Both Medicare and Medicaid?

People of any age who have certain qualified disabilities and people over 65, who are also below their states Medicaid income levels, can qualify for both Medicare and Medicaid.

For example, Henry is a 55 year-old disabled man who is also unemployed and living below the poverty level set by his state. Consequently, he would most likely qualify for both Medicaid (because of his income level) and Medicare (because of his qualified disability).

People that qualify for both programs are called “Dual Eligible.”

Who Can Help?

Navigating one (let alone both) of these systems can be confusing. But there is help available.

If you need help with Medicaid or need to enroll in Medicaid only, then contact your state agency directly.

If you need help enrolling in Medicare, then you can contact CMS and Social Security in the following ways:
- BY PHONE: If you need to sign-up for Medicare, you can call Social Security at 1-800-772-1213.
- ONLINE: Additionally, you can also visit CMS online at ssa.gov/benefits/medicare if you need to sign yourself up.
- RAILROAD: Finally, if you are on Railroad Retirement Benefits, you will need to notify the local Railroad Board (RRB) office before you turn 65 that you would like to sign-up for Medicare. You can sign-up 3 months before you turn 65 even if you are not planning on retiring at 65. You can read more about Railroad requirements in our article here.

Finally, if you need help finding a Medicare Supplement or Medicare Insurance Plan, or if you are dual eligible for both Medicare and Medicaid, then please contact an Insurance Agent. An Independent Medicare Insurance Agent will help you explore your options, and help you make the right choice for your unique situation.
- You can contact your author Carly Cummings here, for assistance if you live in Nebraska or Iowa.
- Or, if you live in all other 48 states, you can find an agent in your area here.

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The post Medicare and Medicaid Difference Guide appeared first on Medicare Life Health.

What is the Medicare Donut Hole?

Carly H. Cummings — Sun, 08 Dec 2019 16:10:47 +0000

What is the Medicare Donut Hole?

The Medicare Donut Hole (or Doughnut Hole) is a coverage gap in the Part D Prescription Drug Plan where beneficiaries could pay more for their drugs.

The Center for Medicare and Medicaid Services (CMS) calls the coverage gap a “temporary limit” on what their drug plan will cover.

Why Did My Drugs Get More Expensive this Month?

During Medicare’s Annual Enrollment Period (AEP) this year I was stationed at a pharmacy a few hours a week to answer people’s questions.

One gentleman came up to me and said, “The Pharmacist sent me over to you to ask you: Why did my drugs cost more this month? I get the same drugs each month, but this month, they cost me more!”

Yes sir, you have reached the Medicare Donut Hole in your Part D Prescription Drug Coverage. It was November, and this gentleman had been able to make it his other five years on Medicare without reaching the coverage gap.

However, this year, his drug costs were a little higher, and he hit the gap before the end of the year.

Will I hit the Coverage Gap?

The price changes in the coverage gap can be a shock if you have not experienced it before. So, let’s go over a little more information to prepare you for what might come.

When Does the Donut Hole Begin?

In 2020, the Part D Coverage Gap begins when you and your plan have spent $4,020 on prescription drugs. (In 2019, it was $3,820.) Thus, if you only spend $1,000 a year on drugs, the donut hole will not affect you.

Who Does the Coverage Gap Not Apply to?

People who pay less than $4,020 in drugs each year.
In addition, people who get extra help in paying for their drug plans (for example, low income subsidies and Medicaid beneficiaies) will not enter into the coverage gap.

When Does the Donut Hole End?

In addition, you may be wondering, when does medicare donut hole end? It ends once you and your drug plan have spent $6,350 in 2020 ($5,100 in 2019). You are then out of the coverage gap and have entered into Catastrophic Coverage.

During Catastrophic Coverage you will pay a much smaller amount of money for your drugs. This includes smaller co-insurances and smaller co-payments for the rest of the calendar year.

What am I Paying in the Coverage Gap (Medicare Doughnut Hole)?

As of 2020, Medicare will pay for 75% of BOTH brand name and generic drugs in the coverage gap. As a result, you will pay 25% of the cost of your drugs in the coverage gap.

However, there is a generic to brand name drug difference in what counts towards your out-of-pocket costs to get your out of the donut hole:

For generics, only your copayment counts towards getting you out of the coverage gap.
Conversely, with brand name drugs, 95% of the total price of the drug (your co-payment and what your plan pays) counts towards your out-of-pocket costs to help you reach the end of the gap.

There are some Medicare drug plans that includes coverage in the gap. According to CMS, ” you may get a discount after your plan’s coverage has been applied to the drug’s price. The discount for brand-name drugs will apply to the remaining amount that you owe.” You will need to speak to your plan to learn more.

What Costs Counts Towards the Coverage Gap?

Here are the costs that apply to your out-of-pocket expenses:

First, Your Annual Drug Plan Deductible
Second, Your Co-insurance and Co-Payments
Third, Your Discount on Brand-name Drugs in the Donut Hole Coverage Gap
Finally, Your Costs in the Coverage Gap

Here is what does not apply:

Your Plan Premiums
Any Pharmacy Dispensing Fees
Any Drugs Not-Covered by Medicare Part D

Need More Information on Part D Drug Coverage?

Start with our Simple Introduction to Part D Coverage here.

Read about late fees and penalties that may apply to Part D here.

Need to Switch your Drug Plan? You can do this during Annual Enrollment Period (AEP) each year.

Or, just start at the beginning, with “What is Medicare?” to get an overview of the Medicare Program.

For Part D Sign-up Assistance

Finally, if you are just aging into Medicare and need a Drug Plan.
- Contact us here if you live in Nebraska or Iowa.
- Or, find an agent here for other states.

The post What is the Medicare Donut Hole? appeared first on Medicare Life Health.

Medicare and You 2020 & 2021

Carly H. Cummings — Fri, 25 Oct 2019 16:22:36 +0000

Medicare and You 2020 & 2021 Guidebook – Read This First

Your Introduction to the Medicare and You 2020 & 2021 Book, and where to get a copy.

The Medicare and You 2021 Guidebook details what you need to know about Medicare benefits for the current year. In it you will find the basics of Medicare, how to get it, and what changes the program is implementing in the calendar year.

However, it is 120 pages long and very detailed. It is also very dry and technical.

So, if you are trying to learn more about Medicare – without falling asleep in the process – we have on-topic website article suggestions for you here that follow the elements of the Medicare and You 2020 Guide.

Where to find the guide

If you would like to follow along with the Guide itself, you can find it online here: Medicare & You Handbook 2021

If you need a physical copy of the Medicare and You 2020 guide, you can request one here: 1-800-MEDICARE (1-800-633-4227)

What is included in the Medicare and You 2021 Guidebook?

Here we will outline the sections of the guidebook and give you relevant articles that discuss the various Medicare elements and benefits.

What are the Parts of Medicare?

Intro Section (page 5)

The Medicare and You book starts out with summarizing parts A, B, and D and what they include.

Medicare Part A – Hospital Insurance
Part B – Medicare Insurance
Part D – Drug Coverage

Medicare Part C is discussed in the next section.

Related Article: For an illustrated overview of the four parts of Medicare, visit our medicare parts infographic and article “Medicare Parts A B C D.”

What are my Medicare options?

Intro Section on Original vs Medicare Advantage (pages 6-8)

Many online comparisons are between Medicare Supplements and Medicare Advantage plans as those are the additions that are in your hands to choose.

However, all these comparisons are in their simplest form between having Original Medicare vs Medicare Advantage. This section does a side-by-side comparison of the two (with or without a supplement).

Related Article: For a more in-depth discussion to help you decide what Medicare options are right for you, please read the “Medicare Advantage vs Medicare Supplements” article here.

How do I get Medicare?

“Section 1: Signing up for Medicare” (pages 15-24)

People get Medicare in different ways. Some are signed-up for it automatically if you are already receiving Social Security or Railroad Retirement. Some people must sign up for it when they turn 65 (or delay it if they are not ready at 65).

This section gives you people to call (Social Security at 1-800-772-1213) and places to visit (online at ssa.gov/benefits/medicare) if you need to sign yourself up.

Other topics covered include, when to sign-up, what to sign-up for, and what does each part cost?

Related Articles:

Read this article to discover what Medicare will cost you.
Also, read this article to learn more about any Medicare Late Fees and Penalties.
If you need help in deciding what to sign-up for, we suggest this article on speaking with a licensed insurance professional.
Finally, if you want to learn more about the Annual Enrollment Period, please see this article.

Hey, Medicare and You 2021, Will Medicare Cover My…?

“Section 2: Find out if Medicare covers your test, service or item” (pages 25-50)

This section lists all Medicare Benefits you will receive if you are signed-up for both Medicare Parts A and B. These benefits are universal, meaning they are the standards of care you will receive whether you are receiving Medicare from the federal government or through a private carrier with a Medicare Advantage Plan.

If you are looking to see if a specific benefit is included in Medicare, this is the section to search for it.

This section also reminds you of what is not included in Medicare, such as Long-Term Care insurance. In addition, Original Medicare does NOT include many services that ARE covered by Medicare Advantage Plans. These include dental care, eye exams, hearing benefits, and fitness programs.

2020 New Offering Alert: One interesting change noted in the Medicare and You 2020 book is that many Medicare Advantage programs are now offering “telehealth” benefits where you can see a provider at home instead of at their facility. The guidebook notes that this is typically beyond what Original Medicare can offer.

Related Article: To see the basics of what Medicare Covers, please see our article “Medicare Parts A B C D.”

What exactly is Original Medicare?

“Section 3: Original Medicare” (pages 51-54)

The Original Medicare section explains how our Federal Health Insurance for Seniors works. If you have Original Medicare, with or without a supplement, you are a beneficiary of a nationalized health care system and the government is the primary payer of your health benefits.

Read this section to learn how that works and how to use your benefits once you are on Medicare.

Related Article: Read “What is Medicare?“

What is Medicare Advantage?

“Section 4: Medicare Advantage Plans & other options”

The other option than being on Original Medicare is to be on a Medicare Advantage Plan. In this case, a private insurance company becomes your primary payer and main contact. Medicare Advantage (MA/MAPD) Plans are called “bundled plans” because they combine parts A, B and D to form one “Plan C.”

They often have reduced costs for premium payments, with some of them even offering “$0” monthly premiums. In addition, they often include extra benefits, not included by government Medicare, such as dental, hearing and eye care. ““Silver Sneakers” and similar fitness/wellness programs are also often an included benefit.

Related Articles:

To read more: “What is Medicare Advantage?”
Plus, to read about when you can join an MA/MAPD plan, please read here about AEP.
Finally, if you would like to compare Original Medicare + Medigap and MA, please read this.

What is a Medicare Supplement / Medigap Plan?

“Section 5: Medicare Supplement Insurance (Medigap) policies” (pages 69-72)

CLICK HERE to see more about the various Medigap plans and what they offer.

When you opt for keeping Original Medicare (instead of a Medicare Advantage Plan) you will most likely want to pair that with not just a stand-alone drug plan, but also with a Medigap Plan. These plans are also called Medicare Supplement Plans.

They are supplemental insurance plans that pick up paying where Original Medicare leaves off – such as with the 20% coinsurance, co-pays and deductibles.

The government sets the requirements for each supplement plan and then the private insurance companies decide what price they can offer for each plan in each market they are in. These plans are labeled with letters, and offer the exact same benefits no matter what private insurance company you choose.

Related Article: For more information, please read this article on Medicare Supplement Insurance.

What is Part D?

“Section 6: Medicare Prescription Drug Coverage (Part D)” (pages 73-82)

Read this section to learn how Medicare Drug Plans work, where to get one, and when you can get one / switch them.

Remember, that if you opt for a Medicare Advantage Plan, you will most likely have your drug plan included (which is called a MAPD plan).

Related Articles:

Please visit this article on Part D Prescription Drug Insurance.
Or to learn about the various costs, click here.
Finally, if you are worried about Part D late enrollment penalties, please read this.

Can I get help paying for medical costs?

“Section 7: Get help paying your health & prescription drug costs” (pages 83-88)

The government has set up several ways for Medicare Beneficiaries to get help in paying for their health insurance. Read this section to see if you qualify for the various tiers of assistance.

How can I protect myself?

“Section 8: Know your rights & protect yourself from fraud” (pages 89-100)

The U.S. government understands that health insurance can be confusing, and there are people out there that will try to take advantage of this confusion. Read this section to know how to protect yourself from health care and insurance fraud.

In addition, Section 8 also explains your rights under Medicare and how to make an appeal if you decide your rights have been violated. The Medicare and You 2020 book defines an appeal as “…the action you can take if you disagree with a coverage or payment decision by Medicare or your Medicare plan.”

How do I get my questions answered?

“Section 9: Get more information” (pages 101-112)

Next, if you have questions related to Original Medicare, the handbook offers you the following numbers to call:

1-800-MEDICARE (1-800-633-4227)
TTY users call 1-877-486-2048
Get information 24 hours a day, including weekends
Medicare and You 2021

Additionally, for questions regarding insurance plans like Supplement (Medigap) or Medicare Advantage (MA/MAPD) then we suggested talking to a licensed insurance professional.

If you are lucky enough to live in our headquarters of Nebraska or our neighboring state of Iowa, you can contact us here.

Related Article: Please see our Frequently Asked Questions page, and if you have a question, please leave it in the comments section or email us. Thanks!

What does this word mean?

“Section 10: Definitions” (pages 113-116)

Do you just live to read a good glossary? Well, here you go. You will find here definitions to all the health care and insurance lingo you need to know to navigate your health care effectively.

Related Article: Feel free to look through all our Medicare Articles. They are all listed on this page.

Medicare and You 2020/2021 Handbook Review

We hope our review of the 2020 & 2021 Medicare and You Book has been helpful.

Our one hope for next year is that the book might be more helpful in pointing beneficiaries towards ways to find LICENSED independent insurance professionals that can help them in making decisions. These agents are the only ones required to stay licensed, tested and up to date on the plans that are out there. Moreover, this applies especially for the Medicare Advantage approved agents as they have to be re-tested every year on changes.

Finally, we are MedicareLifeHealth.com just don’t understand how people can be offering advice on plans – that change yearly – they have not be certified to explain.

Our advice? Find yourself a good agent, and make them work for you.

Further Medicare and You 2021 Topic Relevant Reading

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The post Medicare and You 2020 & 2021 appeared first on Medicare Life Health.

How Much Does Medicare Cost?

Carly H. Cummings — Mon, 26 Aug 2019 19:47:53 +0000

How Much Does Medicare Cost?

Medicare costs can be different person to person, depending on which type of plan you choose. After you have a basic understanding of Medicare and it’s basic components, you will want to know how much does Medicare cost? The answer is, it depends on how you structure it. Let’s break down what you could be paying.

Medicare Costs Broken Down & Made Simple

When you set up your Medicare, you will decide if:

You just want Original Medicare (Parts A & B) and a Prescription Drug Plan (Part D).
You want Original Medicare plus a Medigap Plan (Aka a Medicare Supplement) and a Prescription Drug Plan.
Or you want a Medicare Advantage Plan (Part C) that may or may not include a Prescription Drug Plan.

Your costs will also be different if you get help in any way from any state or federal programs.

How Much Original Medicare Costs

Medicare Part A – For most people, there is not a cost or premium you pay for Part A. Your Part A is premium free if you worked in the US and paid Medicare taxes for at least 30 quarters. (You will pay up to $471 a month depending on your work history for Part A if you do not meet the premium free requirements in 2021).
- There is also a $1,484 yearly deductible for Part A services and coinsurance tiers on hospital stays.
Medicare Part B – You will pay a premium for Part B. In 2021, the standard premium is $148.50 per month. If you make more than $85,000 a year in retirement, you will pay more on an income dependent scale.
- There is also a $1203 Part B deductible and a 20% coinsurance (co-pay) for most approved services.
- Late penalties may also apply to Part B (and less commonly, Part A) if you do not sign-up when you are first eligible.

How Much Prescription Drug Costs

Medicare Part D – Prescription Drug Coverage needs to be obtained from a private insurance company. Each company will price their service differently and you can shop for the best plan and price for you. In addition, you will pay more for your Part D coverage, on a sliding scale, if you make more than $85,000 a year while on Medicare.

Other costs to consider with your Part D coverage are co-pays and coinsurance, in addition to deductibles.

Click here to learn about “What is the Medicare Donut Hole?“

There are also late enrollment penalties associated with not signing up for Part D coverage when you are first eligible if you do not have “credible coverage.”

How Much Medicare Supplements or Medicare Advantage Plans Cost

On top of your Original Medicare, you will need to make a decision to either participate in a Medicare Advantage (Part C) plan or to consider having a Medigap (Medicare Supplement) Plan. If you need help deciding on which one is best for your needs, please read our article on Medicare Advantage Vs. Medicare Supplements.

Medicare Supplement Plan Costs – Medicare Supplements will each have a different cost depending on the Letter Plan you choose and the company you go with. The government decides what benefits are offered by each letter plan. Then, each private insurance company decides what price they can offer for each plan in each market. It is a good idea to compare multiple plans by multiple carriers (insurance companies) in your area before choosing a plan. An independent insurance agent will be able to help you do this.
Here are a Few Medigap Articles to tell you more:
- What is Medicare Plan F?
- Is Medicare Plan F Going Away?
Medicare Advantage (MA/MAPD) Costs – Part C, or Medicare Advantage Plans are also offered by private insurance companies and stand in place of Original Medicare. In addition, they often include Part D Prescription Drug Coverage. Some of these plans have low or zero premium plan options. A few even cover Part B premiums. All of them are required to have max out of pocket expenditures and deductibles. It is a good idea to talk to an independent insurance agent on MAPD plans in your area to help you choose your best option.

Coverage Questions

If you are considering a specific procedure, you many have questions about what Medicare covers, and what costs are associated with each service or procedure. Here are a few health care costs to consider in regards to how Medicare will cover them:

Ambulance Rides

Chiropractic Care

Acupuncture

Dentures

Cataracts

Rehab

Medicare Costs Summary

In summary, Medicare will cost you something, unless you are on full benefits from Medicaid. Moreover, you have already been paying into the Medicare system during your working career with Medicare taxes. Common set-up for Medicare beneficiaries include:

Having Original Medicare, Part A Premium Free, Part B Premium at $135.50 /month and a stand alone Part D Premium to pay. Then, adding on a Supplement Plan to cover the expenses Original Medicare does not pay.
Or having a Part C Medicare Advantage Plan that includes a drug plan with a premium to pay (sometimes a $0 premium). Most commonly, you will still pay your Part B premium with Medicare Advantage.

Get More Help Understanding How Much Medicare will Cost You

One good resource for learning more about the costs of Medicare is the Medicare and You Book published by the government every year. It is a large book, so please star with our Medicare and You User’s Guide to learn what it offers and to get a copy if you need one.

In addition, finding the best Medicare options for your budget can be a lot to take on, but hopefully this breakdown is helpful. I strongly suggest talking to a professional to help you in setting up your Medicare plan. As an independent agent myself, I suggest using an independent agent. They are not tied to one company, so they work for you, not one carrier and can help you in considering many different carriers and plans.

As always, if you live in Nebraska or Iowa, please give me a call, and I can help you out either in person or over the phone.
Carly Cummings, NE/IA Licensed Independent Insurance Agent for Life and Health.

The post How Much Does Medicare Cost? appeared first on Medicare Life Health.

Medicare Penalties For Late Enrollment

Carly H. Cummings — Mon, 12 Aug 2019 19:13:28 +0000

What are the Medicare Penalties for Late Enrollment?

There are two main Medicare penalties for late enrollment to be aware of when you are planning your health care in retirement. The first is the Part B late enrollment penalty, and the second is the Part D late enrollment penalty. Let’s look at both penalties and how you can avoid them.

If you need some definitions and background, please read the following articles:

Part B (and Part A) Late Enrollment Penalties

As you may recall, there are two parts to Original Medicare – Part A and Part B. Most people will get Part A without paying a monthly premium. Part B has a premium you pay for. As a result, the Part B late enrollment penalty is more common. Just to be through, we will cover both.

Part A – If you have to pay for Part A, and you don’t sign-up for it when you are first eligible, there is a late enrollment penalty: Premium price increase of 10% for “twice the number of years you could have had Part A, but didn’t sign up.”
Part B – If you do not sign-up for Part B when you are first eligible, there is an even steeper late enrollment penalty: Standard premium price increase of “10% for each full 12-month period that you could have had Part B, but didn’t sign up for it,” for as long as you have Part B.

When Do These Part A/B Late Enrollment Penalties Apply?

The Medicare Part A and B Late Enrollment Penalties apply to those people who do not have “credible” health care coverage when they age into Medicare at 65. What if you have health care with your employer at 65? Then, you will let the government know you will be delaying your use of Medicare until that coverage ends. In this case, you would not have a penalty.

Part D Late Enrollment Penalty

The Part D Prescription Drug Coverage part of Medicare also comes with a late enrollment penalty. It applies if you do not sign-up when you are first eligible or if you go 63 days or more without coverage at any point. In addition, late penalties are added to your Part D premium for as long as you have Part D.

How much you pay as a penalty can be calculated with a little basic math whipped up by the government:

Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($33.19 in 2019 and $32.74 in 2020) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
Straight from this page on Medicare.gov

When Does the Part D Late Enrollment Penalty Apply?

If you are eligible for Medicare and do not have Part D coverage or other credible coverage (i.e. from an employer plan) for over 63 days, you will get a penalty. The penalty will not apply to those with credible coverage. This can be from work health plans, VA drug plans, and Part C (MAPD) plans. Of course, from Part D Prescription Drug Plans are credible coverage as well.

Late Enrollment Penalties Summary

In summary, you can avoid the Medicare late fees and penalties with a little bit of planning and research. One great resource for learning more about these penalties is the U.S. Government’s Medicare and You Guidebook. You can read our User’s Guide/Review of this book (and learn how to get a copy if you need one) here.

The post Medicare Penalties For Late Enrollment appeared first on Medicare Life Health.

Part D Prescription Drug Plans Archives - Medicare Life Health

Medicare Easy Pay

Medicare Easy Pay – What is it & How do I get it?

How Do You Sign-up for Medicare Easy Pay?

Enroll By Mail

Enroll in Person

Railroad Benefits Differences

How Does Medicare Easy Pay Work?

Further Reading

Medicare and Medicaid Difference Guide

Medicare and Medicaid Difference Guide

Let’s Start with Medicare vs Medicaid.

What is Medicare?

What is Medicaid?

How are the programs similar?

How are the programs different?

Medicare and Medicaid Differences in Beneficiaries – Who Gets What Program?

Who should get Medicare?

How do I Sign-up for Medicare?

Supplemental Medicare Insurance Options

Who should get Medicaid?

How Do You Enroll in Medicaid?

Who Can Get Both Medicare and Medicaid?

Who Can Help?

Further Helpful Reading

What is the Medicare Donut Hole?

What is the Medicare Donut Hole?

Why Did My Drugs Get More Expensive this Month?

Will I hit the Coverage Gap?

When Does the Donut Hole Begin?

Who Does the Coverage Gap Not Apply to?

When Does the Donut Hole End?

What am I Paying in the Coverage Gap (Medicare Doughnut Hole)?

What Costs Counts Towards the Coverage Gap?

Here are the costs that apply to your out-of-pocket expenses:

Here is what does not apply:

Need More Information on Part D Drug Coverage?

For Part D Sign-up Assistance

Medicare and You 2020 & 2021

Medicare and You 2020 & 2021 Guidebook – Read This First

Where to find the guide

What is included in the Medicare and You 2021 Guidebook?

What are the Parts of Medicare?

Intro Section (page 5)

What are my Medicare options?

Intro Section on Original vs Medicare Advantage (pages 6-8)

How do I get Medicare?

“Section 1: Signing up for Medicare” (pages 15-24)

Hey, Medicare and You 2021, Will Medicare Cover My…?

“Section 2: Find out if Medicare covers your test, service or item” (pages 25-50)

What exactly is Original Medicare?

“Section 3: Original Medicare” (pages 51-54)

What is Medicare Advantage?

“Section 4: Medicare Advantage Plans & other options”

What is a Medicare Supplement / Medigap Plan?

“Section 5: Medicare Supplement Insurance (Medigap) policies” (pages 69-72)

What is Part D?

“Section 6: Medicare Prescription Drug Coverage (Part D)” (pages 73-82)

Can I get help paying for medical costs?

“Section 7: Get help paying your health & prescription drug costs” (pages 83-88)

How can I protect myself?

“Section 8: Know your rights & protect yourself from fraud” (pages 89-100)

How do I get my questions answered?

“Section 9: Get more information” (pages 101-112)

What does this word mean?

“Section 10: Definitions” (pages 113-116)

Medicare and You 2020/2021 Handbook Review

Further Medicare and You 2021 Topic Relevant Reading

How Much Does Medicare Cost?

How Much Does Medicare Cost?

Medicare Costs Broken Down & Made Simple

How Much Original Medicare Costs

How Much Prescription Drug Costs

How Much Medicare Supplements or Medicare Advantage Plans Cost

Coverage Questions

Medicare Costs Summary

Get More Help Understanding How Much Medicare will Cost You

Medicare Penalties For Late Enrollment

What are the Medicare Penalties for Late Enrollment?

Part B (and Part A) Late Enrollment Penalties