When you reach age 65, whether you are still working or took an early retirement, it’s time to educate yourself about Medicare.
“Medicare is a health insurance option that individuals have available to them when they are turning 65 or have been on disability for 24 months,” says Kathy Hirko, owner of KAZ Company in Independence, a business that helps people understand Medicare coverage plans.
Health care, in general, is confusing to most people — and Medicare is no different. Hirko provides some basics when venturing into the process.
CHOOSING YOUR PLAN
If you are collecting Social Security benefits and have turned 65, you might have already received your Medicare card.
There is an opportunity to enroll in Medicare three months before or after your 65th birthday. To apply for your benefits, contact Social Security by either phone, online or go to the local office.
There are different plans (A and B) for Medicare that cover 80 percent.
“You are paying into Medicare as you work,” Hirko says. “Part A (hospital coverage) is free to anyone who has worked 40 quarters. Part B is available and covers outpatient hospital, doctors, etc.”
People who use the Part B plan have to pay premiums. However, they can opt out during their enrollment period.
“They (might opt out) because they have coverage through work or don’t need to or want Part B,” she says. “More and more boomers are not ready to retire at age 65. You do not have to be retired to use Medicare and can continue to work. If you decide that you no longer want the company plan or are retiring, you would apply for Medicare A and B. “
Medicare can possibly cost less than the company plan. She says people should research the difference between plans.
Also, don’t forget prescriptions.
Hirko says the Part D prescription plan is required with Medicare, and you would have to pay a penalty if not enrolled in the plan.
COVERING THE 20 PERCENT
With Medicare only covering 80 per- cent, people still need to figure out a way to pay for the rest of their plan. There are a few options.
You have to make a decision if you want a supplement or an Advantage plan, Hirko says. A lot of people are confused about the difference between the two.
While the prescription plan is required, you have to decide if you want the supplement (sometimes referred to as Medigap), which means Medicare will pay for 80 percent and private insurance companies will pay for 20 percent.
In the Advantage plan, where Medicare rules still apply, the private insurance company provides the coverage and becomes the primary payer, not Medicare.
CHANGING YOUR PLAN
If you are currently on Medicare, you can change your plan between the open enrollment period Oct. 15 through Dec. 7.
“You should have received an Annual Notice of Change (ANOC),” Hirko says. “We do recommend for people to take a look at the changes.”
She also advises looking closely at medications.
“More and more boomers are not ready to retire at age 65.”
“Every plan has a formulary, which is a list of medications that are covered,” she says. “They might change, or they might not. Each plan has tiers which determine the copay for the medication. There’s a possibility (they) could go up or down.”
Companies like KAZ and other agencies can help with these changes.
“This impacts your health care, and we want you to make an educated decision,” Hirko says.
For more information, visit medicareplansneo.com or call 216-901-9300.
