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Caring for aging parents comes with plenty of challenges on its own. The last thing you want to worry about is your parents’ health insurance needs. Finding the right plan, though, isn’t always as simple as it sounds. Whether your parents are facing medical complications, transitioning to a nursing home, or simply needing help navigating technology to enroll, there are several factors you should consider before they stick with basic Medicare.

Understanding Original Medicare vs Medicare Advantage

Medicare Parts A and B, also known as Original Medicare, offer hospital coverage and outpatient coverage respectively. You can learn more about what Part A and Part B cover exactly by reading this article.

With Original Medicare, you pay for services as you get them. While Medicare will cover a lot of costs, you could still be responsible for deductibles, copayments, and coinsurance. On its own, Original Medicare will not cover supplemental healthcare (such as hearing, vision, or dental care) or prescription drugs.

Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare. This plan bundles your Medicare coverage, including Parts A and B and usually Part D prescription drug coverage. Medicare Advantage can also cover things that Original Medicare does not, like vision, dental, and hearing insurance.

While Medicare Advantage has several benefits over Original Medicare, there are also a few other considerations that need to be made before choosing one Medicare option over another. If your parent has specific doctors or medical needs, you will need to check to make sure those healthcare providers are in-network and whether or not they will need a referral to see certain specialists.

If a Medicare Advantage plan covers all of your parents’ providers and services, however, then it can be a great option for anyone looking for a “one-stop shop” option for their health insurance needs.

Factoring in Medicare Part D

Medicare Part D provides coverage for prescription drug costs. This plan is offered by private insurance carriers and is available for purchase as a separate stand alone plan for those with Original Medicare or can also be included as part of a Medicare Advantage plan.

Policies vary by cost and which medications they cover, but even the least expensive prescription drug plans cover most of the generic and brand name drugs generally needed by people on Medicare. 

Even if your parents are not currently taking any expensive medications, it is still wise to be enrolled in at least an inexpensive drug plan as there are high financial penalties for adding it later.

Don’t Forget About Medicare Supplement Plans

A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs that Original Medicare does not cover. This may include copayments, coinsurance, and deductibles. 

Not everything falls under Medigap, however. A supplement plan may not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

With a supplement plan, healthcare costs will first be covered by Original Medicare and any leftover may be covered by the Medigap plan. 

Making the Best Decision for Your Parents

Finding the right Medicare plan for your parents begins by reviewing their situation and estimating their future healthcare needs. 

Trusting a professional is another way to make sure you find the best options for their needs. By consulting a Medicare advisor, you get:

Want to make sure your parents have the best Medicare coverage for their healthcare needs? Our local advisors have decades of experience supporting Medicare beneficiaries in finding the right coverage.

Turning 65 this year? Well, we’re here to make sure that life keeps getting better with age. These 6 steps can help to ensure that you’re on track to take easy street through the next steps of your life:

Schedule A Physical And Routine Screenings

You might be under the impression that medical screenings are for diagnosing issues once symptoms present themselves. 

This is absolutely not the case. Individuals who schedule routine physicals and screenings can get an early diagnosis if they are developing a medical condition – increasing the likelihood of success for medical intervention and thus life expectancy.

Regularly scheduling tests creates a basis for physicians to compare results as time passes, which helps them get a more well-rounded perspective of your individual needs. 

Talk to your doctor to determine which regular screenings you should take based upon your age, family medical history, and more. While you’re at it, also talk to your doctor about what Medicare plans they accept. This will be important to know when you select a Medicare plan when you turn 65.

Consider Your Long-Term Health Coverage Needs

As you age, your medical coverage needs will change. For example, if you have risk factors for certain diseases, you might want to consider the need to treat those if they do, in fact, develop later in life. 

Being proactive starts by having the right conversations with your doctor to determine how to best plan for your future health so that you're covered – regardless of what life throws your way.

One important factor to take into account when considering your long-term health is having the right healthcare coverage. Choosing a plan simply based on their current health needs is one mistake many newly eligible Medicare beneficiaries make. Talking with your doctor as well as a Medicare advisor can help you prepare for the future.

Review Your Finances (Taxes, Retirement, Etc.)

While financial planning may feel overwhelming, it's important to have a handle on your finances in this stage of life.

Budgeting

Start by making sure you have a budget to grasp the full range of expenses you will have each month. 

Financial planners suggest that you need to replace 80% of your income once you retire. Likely, your Social Security benefits will not meet that benchmark. Social Security provides a standard of living comparable to the bottom quarter of earners in the United States. If your standard of living requires an income higher than $30,000 a year, you need to consider how you will supplement your benefits. 

Additionally, turning 65 also means you become eligible for Medicare, which impacts your finances in more ways than you may realize. For example, there are different Medicare plan options, including plans with $0 premiums but high out of pocket costs or vice versa. 

Choosing a plan that fits your budget needs in this stage of life is important. You may be eligible for Medicare costs savings programs or a Medicare Supplement plan that helps cover your out of pocket expenses, like copays, deductibles, and coinsurance. 

If you’re concerned about how Medicare will impact your finances, consider meeting with a Medicare advisor

Taxes and More

Beyond basic expenses, it’s also important to understand your taxes in this stage of life. 

For example, where you live can impact what taxes you pay in retirement. Some states offer better tax implications for seniors, such as Florida and New Hampshire – if you’re considering moving when you retire check out the best states for seniors to retire in.

Furthermore, your taxes can impact your Medicare costs. If your adjusted gross income (AGI) reported on your taxes is above a certain level, you may incur a surcharge on your Medicare Part B and Part D plan premiums. This surcharge, referred to as IRMAA, can significantly impact your health coverage costs. 

The surprising part?

IRMAA is based on your taxes from 2 years prior! For this reason, it’s important to understand how IRMAA works and what you might be able to do to avoid the costly surcharge.

Ultimately, it’s crucial that you have a full picture of your finances as you enter this new stage of life.

Get Ready For Medicare – Find A Medicare Advisor For This Next Stage Of Life

It is essential to enroll in Medicare benefits as soon as you become eligible during your Initial Enrollment Period (IEP). 

The IEP is the seven-month window around your 65th birthday (three months before and the three months after). If you miss your window, you could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual Enrollment Period.

If you have entered your Medicare eligibility window, schedule an appointment with a Medicare Advisor in your community who can help you in this transition. 

Not eligible yet, but turning 65 in the near future? Explore more of our Medicare Resources. We cover everything from Medicare Advantage to Part D Prescription Drug plans and more! Being familiar with the ins and outs of Medicare will help you make the best decision when you do become eligible.

As our parents age, we often take on more responsibilities to help care for their needs. In this stage of life there can be both great joys as well as new challenges.

Taking care of aging parents introduces us to all sorts of new encounters – and one of those is learning how Medicare works. 

Medicare can be confusing. With all of the information available on the topic, you might find yourself unsure of where to start. The following 5 tips for helping your parents with their Medicare benefits will help you navigate through the confusion.

#1  Brush up on the Basics of Medicare

To be a resource for your parents as they enroll in Medicare coverage, first you need to know the basics of how Medicare works. We’ll start by answering “What are the different parts of Medicare?”

Medicare Part A

Medicare A acts as hospital insurance and covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. When you help your parents sign up for Medicare they will automatically be enrolled in Part A. 

Most people qualify for Part A premium-free. If one of your parents paid Medicare taxes while working, then they don’t have to pay a monthly premium for Part A (this is the most common scenario). 

Hospital expenses aren’t completely free, though, with Part A Medicare insurance. 

Medicare charges a deductible each time a beneficiary is admitted to the hospital. The deductible cost changes every year. In 2021 the deductible was $1,484. If this cost is a concern, consider looking into a Medicare Supplement plan.

Medicare Part B

Medicare B acts as general medical insurance and covers certain doctors' services, outpatient care, and preventative services. Preventative services covered by Medicare Part B include annual wellness visits, diabetes screenings, flu shots, and many other screenings and tests.

Unlike Medicare Part A, Part B comes at a cost. 

The monthly premium for Medicare Part B changes each year. In 2021 the premium started at $148.50 and increased for people with higher incomes. Additionally, there is an annual deductible and beneficiaries pay a percentage of the bills for doctor visits and other outpatient services.

Technically, your parent does not have to sign up for Part B. But, if they’re not covered by other qualifying insurance and do not sign-up for Part B when they first enroll in Medicare, then they will incur a costly penalty for as long as they’re in the program.

Medicare Part D

Wait… is there a Medicare Part C? We’ll come back to that in a moment. First, it’s important to know that Medicare Part D covers prescription drugs and is purchased in addition to Medicare Parts A & B.

Medicare Part D plans are offered by private insurance companies approved by Medicare. Every Medicare Part D plan is different, including which prescriptions are covered, which pharmacies are in-network, and what the out of pocket costs are for prescriptions. 

If you want to take a deep-dive into prescription drug coverage, we recommend taking a look at this article about the details of Medicare Part D.

Medicare Part C (Also Known as Medicare Advantage)

Parts A, B, and D of Medicare can be combined through Medicare Advantage Plans (aka Part C).

Medicare Advantage plans are offered by private insurers approved by Medicare. These plans are great because they bundle all of the coverage under a single plan. They also often include additional coverage not offered by Original Medicare such as dental and vision.

What do Medicare Advantage plans cost?

Beneficiaries enrolled in Medicare Advantage pay both a premium for their Part C plan as well as the standard Part B premium. 

While paying two monthly premiums may seem costly, often beneficiaries save on their overall healthcare expenses. Some Medicare Advantage plans even have a $0 premium or may help pay for Part B premiums.

Another Important Basic to Note

It's important to note that your parents must enroll in Medicare benefits during their Initial Enrollment Period (IEP). 

The IEP is the seven-month window around their 65th birthday (three months before and the three months after their birth month). If they miss their window, they could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual or General Enrollment Periods, which at specific times of the year.

#2 Complete an Authorization to Disclose Personal Health Information Form

Like other personal health information, there are regulations around what can and cannot be shared with someone other than the patient unless authorized. 

If your parent would like you to speak to Medicare on their behalf, they will need to complete an Authorization to Disclose Personal Health Information form

Without this form, a Medicare representative will be unable to speak directly with you regarding your parent's program options. 

For complete information, visit the Centers for Medicare and Medicaid Services website.

#3 Know Your Parents' Specific Health Needs

Oftentimes, the best Medicare plan for your parents will be based on their healthcare needs.

Talk with your parents to understand what their health needs are. Knowing what they are hoping to get out of their Medicare coverage can help narrow down their options. Of course, each plan’s coverage varies and talking to a Medicare expert will help ensure your parent is enrolled in the best plan for their needs.

Ask your parent the essential questions: 

Allow those questions to transform into a conversation in which you can fully understand your parent's position. 

#4 Check with Their Important Healthcare Providers

It is best to be proactive with their healthcare providers to avoid any hold-ups with your parent's care. 

A little-known fact is that health care providers must enroll in the Medicare Program to receive payment for covered services from Medicare. So, be sure to check with them to ensure that they are enrolled in the Medicare program. 

Additionally, some plans only cover services provided by doctors who are in-network. If your parent has a preferred provider, it’s important to make sure that they are in-network for the plan when doing a plan search. Our Medicare Advisors, for example, can search for plans by doctor to ensure that they only show you options that cover the desired physician. 

#5 Enlist the Help of a Medicare Expert

There's a lot of information out there about Medicare. If you're feeling overwhelmed while trying to help your loved one find the right Medicare plan, you're not alone. 

With all of the responsibilities that come with helping an aging parent, navigating the complexities of Medicare shouldn’t consume all of your time and energy. Consider turning to an experienced advisor who can help you compare options and guide you through the enrollment process. If you're simply looking for more information, learn more about how to help enroll your parent in Medicare.

Turning 65 soon? Congratulations! While we hope you're planning a big party to celebrate, we also want to make sure you're planning for another important marker of turning 65: Medicare enrollment. Of course, planning for Medicare isn't nearly as fun as planning a celebration, but we're here to make it as easy as possible. In this article we cover everything you need to know about Medicare when you turn 65.

Medicare Eligibility Begins 3 months Before Your 65th Birthday

If you have questions regarding your eligibility for Medicare coverage, the Medicare age limit, or about the program in general, then you’re not alone. Many seniors are inundated with Medicare information, yet still left with questions. The first thing you need to know is that Medicare eligibility begins three months before your 65th birthday.

Medicare is generally available for any individual approaching or at the age of 65. Though, in some cases, people under the age of 65 might qualify because of specific disabilities. You can check your eligibility using our Medicare Eligibility Check.

If You Miss Your Initial Enrollment Window, You Could Experience a Gap in Coverage

It is imperative that you enroll in your Medicare benefits during your Initial Enrollment Period (IEP). The IEP is the seven-month window around your 65th birthday (three months before and the three months after your birthday month).

If you miss your window, you could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual Election Period or Open Enrollment Period, which occur at specific times of the year.

Some specific instances allow an individual to qualify for a Special Election Period (SEP), such as losing employer coverage or moving. But those circumstances are limited – so it’s best to make sure you’ve enrolled within your specific window.

Medicare Has Multiple Parts

You might be wondering precisely what Medicare is. Essentially, it is a federal health insurance program with multiple types of coverage.

Did You Know That Some Individuals Qualify for Medicare Premium-Free?

You can get Part A Medicare premium-free if you meet one of the following requirements:

There is a premium for Parts B & D, but this can be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.

Original Medicare Might Not be the Best Option for You 

Medicare Advantage is basically an all-in-one alternative to Medicare itself. Medicare Advantage plans are a simple way for you to gain more out of Medicare. If you choose to enroll in a Medicare Advantage Plan, you’ll still have Medicare while receiving access to additional coverage such as dental, vision, and more.

In addition, the plans have a history of the higher average quality of health outcomes in participants. As a result, they have been strongly supported by the Medicare Trust Fund and others who legislate our healthcare nationally.

Click here to learn more about what Medicare Advantage plans cover. 

Need a set of reminders to help make sure you don't forget about your Medicare enrollment window? We've got your back! Click here to see our top reminders for seniors turning 65.

We hope this information aids you as your make plans to enroll in Medicare. Nevertheless, it's not uncommon to have questions about Medicare. That's what we're here for! Find a local advisor who can help you understand your Medicare options today.

As we age, our health needs change, and older adults, especially, face many challenges when it comes to taking care of their health. Among the most challenging is navigating the government-sponsored healthcare coverage program for seniors. The golden years of retirement can be overshadowed by the bombardment of telephone calls and excess junk mail all about Medicare. It’s no wonder so many older adults get confused when it comes to making the right choices for their healthcare coverage and therefore rely on outside help.

About 19% of Americans act as caretakers for a spouse, parent, grandparent, or community member; and the majority of individuals being cared for rely on Medicare or Medicaid. Even adult children whose parents and grandparents are still independent often end up helping their loved one navigate the healthcare system.

One of the first steps to being able to help your parent, grandparent, or other loved one enroll in Medicare is to understand the process. Keep reading to learn more about the different parts of Medicare, how Medicare enrollment works, and how to find the Medicare plan that best fits your loved one’s needs.

The Different Parts of Medicare

Medicare is a complex system that can be difficult to fully understand, especially when there is a wealth of information available. We’ll start simple by defining Medicare and all its basic parts.

Medicare is the U.S. government’s largest health insurance program that provides affordable healthcare coverage to eligible adults. With Medicare, there are a few different options for how to get coverage. 

Original Medicare

Medicare Parts A and B, or Original Medicare, offer hospital coverage and outpatient coverage respectively. Part A pays for room and board at the hospital and some other healthcare facilities. Part B includes almost everything that Part A doesn’t cover, like doctor visits, medical equipment, lab work, surgeries, therapy, and more.

With Original Medicare, the recipient pays for services as they get them. While Medicare will cover a lot of costs, your loved one could still be responsible for deductibles, copayments, and coinsurance. However, they may also be eligible for Medigap, supplemental insurance, to help cover those costs. If your loved one needs prescription drug coverage, they can also apply for Medicare Part D.

Medicare Part D

Medicare Part D provides coverage for prescription drug costs. This plan is offered by private insurance carriers and is available for purchase as a separate stand-alone plan for those with Original Medicare or can also be included as part of a Medicare Advantage plan.

Medicare Advantage

Medicare Part C, or Medicare Advantage, is an optional, low-cost alternative to Original Medicare offered by private, Medicare-approved insurance companies. These “all-in-one” plans bundle Medicare coverage, including Parts A and B and usually Part D prescription drug coverage as well. Medicare Advantage can also cover things that Original Medicare does not, like vision, dental, and hearing insurance.

Medicare Supplements (Medigap)

A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs that Original Medicare does not cover. This may include copayments, coinsurance, and deductibles. Not everything falls under Medigap, however. A supplement plan may not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing. Medicare Supplement plans are offered by private insurance carriers.

Medicare Eligibility & Enrollment Periods

There are multiple Medicare enrollment periods that your parent or loved one may be eligible for. Individuals become eligible for Medicare when they turn 65. Younger adults who are disabled or have End-Stage Renal Disease may also be eligible for Medicare.

It is important to do your research and know the date cutoff for their enrollment period in order to make sure they are enrolled without any penalties.

Initial Enrollment Period: IEP begins three months before your 65th birthday and ends three months after the month that you turn 65. In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you will have to pay a late enrollment fee for as long as you have Part B and could have a gap in your health coverage.

Annual Enrollment Period: AEP begins October 15 and ends December 7 each year. During this time, beneficiaries are able to make changes to their existing Medicare plans.

Open Enrollment Period: OEP allows beneficiaries to make a one-time change to their Medicare Advantage Plan from January 1 through March 31. During this time, you can also sign up for Medicare if you missed your window, but fees and gaps in coverage may apply.

Special Enrollment Periods: SEPs are available under certain circumstances throughout the year, such as moving out of your existing plan’s service area or retiring from a job that previously provided your benefits. Generally, there are no late fees associated with signing up for Medicare during an SEP, but the eligibility requirements vary.

Finding the right Medicare plan

There are pros and cons to each Medicare plan, but the most important thing is to find the plan that best fits your parent or loved one’s needs. Determining this will depend on a few factors unique to their circumstance, such as where they live and what kind of care they expect to need. 

Here are a few other things to consider:

Cost: How high will the beneficiary’s out-of-pocket expenses be? This could include monthly premiums, deductibles, copayments, or coinsurance.

Benefits: Does the plan cover any additional healthcare services they need? For example, prescription drugs, vision, dental, or hearing insurance.

Convenience: Are the in-network providers conveniently located? Are their preferred healthcare providers in-network?

Needs: Have they required healthcare in the past few years? Do they anticipate an increased need for care? Do they often see specialists for a health condition?

All of these factors impact which plan is right for your loved one. And often two plans can seem very similar, yet the smallest difference can dramatically change their fit.

Working with an advisor

To make sure you get it right the first time, your best option may be to discuss your parent or loved one’s situation with a Medicare advisor. A professional can help you weed through the excess information and find the exact plan that will best serve your loved one.

If you're helping a loved one or parent enroll in Medicare our experienced Medicare Advisors are here to support you if you have a question. You can also explore more of our Medicare Resources to educate yourself on all things Medicare.

Happy Birthday! Turning 65 is a big milestone around here. Anyone turning 65 in 2021 (or with January 2022 birthdays) will become eligible for Medicare benefits by October of this year.

Unfortunately, it’s easy to get overwhelmed by the sheer amount of information out there about Medicare and choosing the right plan. There are multiple parts and certain requirements you have to adhere to—not to mention the onslaught of mail you’ll be getting this year! To help you keep everything straight, here are a 5 simple reminders for anyone turning 65 in 2021.

1. You May Automatically Be Enrolled in Medicare

Anyone within 3 months of turning 65 is eligible to enroll in Medicare, but depending on your circumstance, you will either be enrolled automatically in Medicare or you will have to sign up on your own.

If you already receive benefits from Social Security or the Railroad Retirement Board (RRB), or will receive benefits at least four months before you turn 65, you will automatically be enrolled in Medicare Parts A and B. 

The Social Security Administration or RRB will send you information regarding your Medicare coverage in the mail.

If you don’t currently receive benefits from Social Security or the RRB, however, you will have to sign up on your own.

2. Mark Your Calendar So You Don’t Miss Your Enrollment Window

Your Initial Enrollment Period (IEP) for Medicare is the seven-month window around your 65th birthday — the month of your birthday, the three months before, and the three months after. 

If you miss your window, you could face gaps in health insurance coverage and late enrollment penalties. Missing your IEP window also means you have to wait for another enrollment period such as the Annual Enrollment Period, which begins in October, or the General Enrollment Period, which begins in January.

Of course, there are special circumstances that make you eligible for a Special Election Period (SEP). Losing employer coverage or moving could both make you eligible for an SEP.

3. There Are Consequences For Not Enrolling In Medicare When You Become Eligible

You are technically not required to enroll in Medicare when you turn 65, but in most cases you will incur a penalty surcharge on your monthly premium that you will have to pay as long as you have Part B.

If you still have employer coverage when you turn 65, then the requirements are different. It’s important to talk to a Medicare specialist about your particular circumstance to ensure you don’t incur any unnecessary costs.

4. Explore All Your Medicare Options Before Choosing a Plan

Medicare can be confusing to first-time enrollees, as there are several different options offered. Not every plan, however, is right for every person. You have unique needs and the key is finding the best plan to fit those needs. Your Medicare options include these four parts:

Medicare Part A. This is part of Original Medicare that is for Hospital Insurance. This covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B. This is part of Original Medicare that is for Medical Insurance. This covers certain doctors’ services, outpatient care, and preventative services.

Medicare Part C. Part C, or Medicare Advantage, offers bundled plans that combine parts A, B, and even D for maximum coverage.

Medicare Part D. Part D is the prescription drug benefit component of Medicare. It must be added on to Original Medicare (Part A or B) or it can be included as part of a Medicare Advantage Plan.

5. Get an Expert Opinion Before You Enroll

Medicare can be confusing, overwhelming, and difficult to understand for anyone. If you are not sure where to go from here or what plan is best for you, talking to a Medicare expert can help get you going in the right direction.

If you’re entering your Medicare eligibility window, schedule an appointment with a Medicare Advisor in your community who can help you in this transition. 

Not eligible yet but will be in the near future? Explore more of our Medicare Resources. We cover everything from Medicare Advantage to Part D Prescription Drug plans and more!

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