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Medicare Overview
Medicare is a federal health insurance program for people 65 or older, under 65 who are on Social Security Disability Insurance (SSDI) and people with End-Stage Renal Disease.
Compare Medicare Insurance Plans
Are you new to Medicare? Not sure what plan to choose at the Annual Open Enrollment? McGregor Benefits is dedicated to helping you find a supplement, advantage plan, or drug plan that is right for you.
Need our help now? Happy with your health insurance plan, but want to work with our agency? We can help. Simply contact our office for a broker of record letter, which allows us to help you with all your plan questions and concerns all year.
Our service is free.
All you pay for is the premiums, which are the same with or without our help.
Medicare Important Dates
Turning 65 – When you first become eligible for Medicare at 65, you have a 7 month window to enroll in a Part C and or Part D plan. 3 months before your birthday, your birthday month and 3 months after.
October 15th- December 7th: Medicare Open Enrollment Period (OEP). This is one time of year you can make changes to your MedAdvantage and or Part D Prescription Drug plans for a January 1st effective date.
January 1st – February 14th: Annual Disenrollment Period (ADP). During this time you can drop a MedAdvantage to return to Original Medicare. Part D Prescription Drug plans may be purchased if a drug plan was part of the dropped MedAdvantage plan.
Eligible due to disability – When you first become eligible for Medicare due to a disability, you have a 7 month window to enroll in a Part C and or Part D plan. 3 months before your 25th month of disability , your disability month and 3 months after.
Medicare Overview
Medicare is a federal health insurance program for people 65 or older, under 65 who are on Social Security Disability Insurance (SSDI) and people with End-Stage Renal Disease.
Medicare has 4 parts. Two parts are from the federal government Part A and Part B. The other 2 parts, Part C and Part D are from private insurance companies.
When does my Medicare Begin?
Medicare typically starts the 1st day of your birthday month. If your 65th birthday is June 12th, your Medicare would start June 1st. If your birthday falls on the 1st of the month your Medicare would start the month before your birthday. If you delay enrollment in Medicare you may have a different effective date.
Tell me about the Medicare Parts
Part A
Part A covers inpatient hospital services, skilled nursing facilities, home health care and hospice.
Remember Part A benefits have limits on the number of days covered. Medicare does not usually cover your care in full and you can be responsible for deductibles, coinsurance or copays.
For most people Medicare Part A is $0. For some people if they did not work 40 quarters they may have to pay a premium. To enroll in Part A reach out to social security.
Part B
Part B covers outpatient services such as when you go to an office visit, get surgery (including in a hospital) and have labs done. Other coverages such as ambulance, preventative care, durable medical equipment and home health care also come under your Part B benefit.
The monthly Part B premium you will pay changes annually. It is based on your modified adjusted gross income two years prior. Some people in higher income brackets will pay more. To enroll in Part B contact Social Security.
Part C
Part C is Medicare Advantage plans. These are available from private insurance companies. To enroll in a MedAdvantage plan you have to be enrolled in Medicare Part A and Part B and live in the plans service area. Medicare Advantage plans do not use the Medicare network instead they have their own networks and providers. The plans can be HMOs, PPOs, PFFS, or SNPs. These plans also can include Part D drug coverage. Once enrolled you will pay a fee for most services.
Depending on where you live you may be able to purchase a Medicare Advantage plan Part C plan for $0
Part C is optional and some people choose to not enroll or enroll in a Medicare Supplement plan instead. We can help those in Washington enroll in Part C.
Part D
Part D is prescription drug coverage. These are available from private insurance companies. There are 20+ drug plans to choose from in Washington. Not every plan covers every drug. Our agents can help research and find the plan that meets your needs.
Part D Plans change annually, but typically, in Washington you can purchase a Part D plan for less than $12 a month. Those with higher incomes may have higher premiums for their Part D.
Part D is optional and some people choose to not enroll. However, if they want to enroll in the future they may have a Part D late enrollment penalty. McGregor Benefits can help you enroll in a Part D drug plan in Washington.
What about Supplements?
Supplements don’t come under any part. You can enroll in a Medicare Supplement also known as a Medigap plan as a way to cover the cost of your care. You can choose to enroll in a Medigap instead of a Part C Medicare Advantage plan. Our agents can enroll you in a Medicare Supplement plan.
This overview is a very high level review of Medicare. If you have any questions or would like a personalized review of your Medicare options please contact our office.
