Medicare Part A
- Hospital Insurance Coverage
- If your Social Security is already turned on, you will be automatically enrolled in Part A.
- Most people do not pay a Part A premium because they’ve spent years paying into Medicare taxes.
- Part A covers INPATIENT services, think hospital admission.
Medicare Part B
- Medical Insurance Coverage
- Part B covers outpatient services
- Part B has a monthly premium that is paid out of your Social Security, if your Social Security payments have not started you will be billed quarterly.
- There is a $240 deductible followed by 20% coinsurance once your deductible is met.
Medicare Part C - Medicare Advantage
- Medicare Advantage Plans are provided through Private Insurance companies and combines Parts A & B with additional services
- With Advantage plans there is low or no monthly premiums but copayments for services
Medicare Part D
- Prescription Drug Coverage
- Must be enrolled in Parts A & B
- 2025 Update: The elimination of the Coverage Gap Phase, a max out of pocket of $2,000 for drug coverage annually
- IRMAA: High earners are required to pay a higher monthly premium for drug coverage
Medicare Supplements (Medigap)
- Purchasing a Medicare Supplements through private insurance helps fill the gaps in coverage between Parts A & B.
- Coverage includes Part A & B Deductibles, Part B Excess Charges, Foreign Travel and Home Health Care.
- Medicare Supplements have a monthly premium but you do not receive a bill for services.
Penalties
- Part B Penalty: When you lose credible group coverage (employer health insurance with +20 employees) you have 63 days to enroll in Part B and submit Proof of Coverage without having a 10% penalty on your Part B premium for every 12 months you were eligible but did not enroll.
- Part D Penalty: Late enrollment penalty is determined annually and is based on 1% of the national Part D average cost. Compounds every month that you were eligible for Part D but not enrolled.
Next Steps
- Schedule a Medicare Consultation with our office to go over your options and find the right Supplemental or Advantage plan for you. Consultations are no cost, and we can assist in Part A & B enrollment and filing group loss of coverage paperwork.
