Boomer's and Medicare

Do you know much about Medicare?  Are you turning 65 soon?

Medicare can be difficult to understand and The Health Insurance Shoppe is here to help.

The only part of Medicare that is free is Part A, which is either entitled to a beneficiary at age 65 or requires a premium if the beneficiary has not paid Social Security Taxes.

Part A covers hospital services and leaves the beneficiary to pay up to the $1,162  deductible for days 1-60 in the hospital.  This covers all facility services that are covered by Medicare.  After 60 days the beneficiary is responsible to pay a fixed dollar amount for the remainder of the year.

Medicare Part B, covering physician services is not entitled and requires a monthly premium that can be deducted from a beneficiaries Social Security check.  The standard monthly Part B premium if you are single and filed an individual tax return with a Modified Adjusted Gross Income (MAGI) $85,000 or less, or married and filed a joint tax return with a MAGI less than $170,000 is $115.40.  For incomes that are above there will be an increase in premium up to $253.70, bringing the highest monthly total to $369.10 per beneficiary.


Part B benefits require the beneficiary to pay the first $162 (deductible) in Medicare approved amounts before paying 20%, leaving Medicare to pay 80% with no out-of-pocket maximum.  Part B does not cover the excess charges physicians charge above Medicare, leaving this expense to the beneficiary.


Now, when a beneficiary turns 65 and current private coverage (employer provided, individual) is in place, Medicare Part B does not need to be elected as current coverage is considered credible for Part B.  At this time the beneficiary will want to compare the cost of Medicare Part B premiums to their current, making sure that current coverage is considered credible.  If credible coverage is not in place a penalty will be imposed for each month that goes by and the beneficiary did not enroll when eligible for Part B.


***Both Medicare Part A and Part B are provided by the Center of Medicare and Medicaid Services (CMS).


Lastly, there is Medicare Part D, providing coverage for prescription drugs that is obtained in the private market.  A penalty fee can be implied when a beneficiary does not enroll when eligible, provided there is no credible prescription drug coverage.  Part D premiums begin can start at $30/m and be as high as $90/m, still leaving the beneficiary with out-of-pocket costs.  ***As with Part B, additional premium is required dependent on the beneficiaries MAGI.  At the most, $69.10 can be added to the monthly Part D premiums.


So....When a boomer hits 65 they can be expected to pay at least $145/m for Part B and Part D coverage, with $468/m on the high end.


All of the above was discussion on parts of Medicare.  Please look for the next blog on Medicare Supplements, also known as plans.


I hope that this was informative and all questions can be directed to the shoppe.


-Jordan