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What is Medicare?
Federal Health Insurance
Medicare is our country's federal health insurance program for people age 65 or older.
People younger than age 65 with certain disabilities, permanent kidney failure, or ALS (Lou Gehrig's disease), can also qualify for Medicare.
The program is often called Original Medicare and has two parts:
Part A Hospital insurance
Part B Medical insurance
Medicare helps with the cost of health care, but it doesn't cover all medical expenses or the cost of most long-term care.
You have choices for how to get additional Medicare coverage when enrolled in original Medicare part A and Part B.
Although the Centers for Medicare & Medicaid Services (CMS) is the agency in charge of the Medicare program, Social Security processes your application for Original Medicare (Part A and Part B).
Learn More
We are trained and certified with the top Medicare Insurance carriers and can answer your questions.
Who can get Medicare?
Medicare Eligibility
U.S. citizens and legal residents. Legal residents must live in the U.S. for the 5 years just before applying for Medicare.
You Must also meet one of the following:
- Age 65 or older
- Younger than 65 with a qualifying disability
- Any age with a diagnosis of end-stage renal disease or ALS
What does Medicare cover?
Original Medicare (Parts A & B)
- Part A covers inpatient hospital and skilled nursing care but there is a deductible
- Part B covers 80% of doctor visits and outpatient care charges after a deductible that you pay.
- There is No max out of pocket limits and no Rx drug coverage.
You can choose private plans to get more coverage
- Part C - Medicare Advantage plans combine Part A & B plus they often include drug coverage and other benefits you don't get with Original Medicare. (Hearing/Dental/Vision/Fitness)
- Part D - Medicare prescription drug plans help pay for medications. You can get them as a stand alone or as part of the Medicare Advantage plan.
- Med Supp - Medicare Supplement Insurance (MEDIGAP) helps pay some or all costs not paid by Original Medicare.
Medicare enrollment periods
Medicare Enrollment Periods and Change Periods
What does Medicare cost?
Part A costs (2021)
You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes for a certain amount of time while working. (Contact Social Security for more information about your Part A premium)
Part B costs (2021)
Most people will pay the standard premium of $148.50 per month for Part B. If your modified adjusted gross income is above a certain amount ($88,000 for Ind. tax return or $176,000 for joint tax return), you may pay an income related monthly adjustment amount. Note that if your modified adjusted in gross income is above this amount you will also pay an adjusted amount for your Part D prescription drug coverage.
Part C - Medicare Advantage costs
Advantage plans are offered by private companies that are contracted by Medicare. Advantage plans MUST provide everything that Original Medicare Part A & B cover. Plus they usually include Part D prescription drug coverage. These plans can be HMO or PPO type plans and can have premiums as low as $0 to $40 per month. To be eligible for an Advantage plan you must have Part A & B so those premiums will always be paid to Medicare. Most Advantage plans also include many additional benefits such as Hearing/Vision/Dental/Fitness and more.
What if i work past 65?
You Still Have an Initial Enrollment Period (IEP)
- Your IEP happens when you turn 65 whether you continue to work or not.
- You have Medicare decisions to make wen if you have employer coverage (yours and your spouse's)
Be Proactive
- Make sure you know your IEP dates
- Medicare will notify you only if you are receiving social security or Railroad Retirement Board benefits.
- You may need to sign up for Medicare yourself by contacting Social Security.
- Call us to answer your questions about your choices and Medicare enrollment.
Medicare May work with employer coverage
- You may want to enroll in Just Part A. It's premium if free for most people
- Some employers require you to take full Medicare benefits (Part A and Part B) at age 65.
- Check your employer plan benefits administrator before making MEDICARE DECISIONS.
Medicare late enrollment penalties
PART A Late Enrollment
People who pay a Part A premium (most don’t) could pay an additional 10% of the premium amount. The penalty is charged every month for twice the number of years enrollment was delayed.
PART B Late Enrollment
You could pay an additional 10% of the premium amount for each full 12-month period enrollment is delayed. The penalty is charged every month for as long as you have Part B.
PART D Late Enrollment
You could pay an additional 1% of the average Part D premium for each month you delay enrollment. The penalty is charged every month for as long as you’re enrolled in Part D.
Why select us as your agents?
Lewis Insurance Agency is an independent agency that is family owned. Our main goal is to help people with their Medicare options and we specialize in Medicare Insurance.
Because we are independent agents we provide non-biased consultation to you as our clients. We are contracted and certified with the most the Major Medicare Insurance carriers and can answer all your questions about Medicare Plans.