Medicare Made Easy
A simple guide to understanding Medicare and your available options
What is Medicare?
Medicare is a federal health insurance program for people...
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Ages 65 and older
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Under age 65 with certain disabilities
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Any age with end-stage renal disease or kidney failure
Original Medicare provides a menu of benefits, but it isn't a complete package and although deductibles, coinsurance and copays are competitive, there are no limits to the amount of money you can spend out of pocket, which could leave you responsible for paying thousands in out of pocket costs.
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The Big Question?
You may be wondering "Do I need to enroll in Medicare?" and for most people turning 65, the answer is yes.
However, it still depends on your exact situation. Before we proceed with simplifying your understanding of Medicare, it's important that we determine when you need to take action.
Click the button to be redirected to Medicare's eligibility tool, where you can answer a few short questions and estimate your deadline to enroll into Medicare without any future re-occurring penalties.
Once completed, write your results down - you'll specifically want your Initial Enrollment Period dates.
Medicare Part A
helps cover costs associated with inpatient hospitalization, skilled nursing, hospice and blood services.
There is no yearly limit on annual out of pocket costs.
For most people, Part A premiums start at $0/mo
A
Inpatient Hospitalization
You Pay
Hospital Deductible: $1,600 / Benefit period
Part A Inpatient Deductible
Days 1–60: $0 coinsurance
Part A Inpatient Deductible
Days 61–90: $400 coinsurance per day
Days 91 and beyond: $800 coinsurance per each
Each day after lifetime reserve days
: All costs
A
Skilled Nursing, Hospice & Blood
You Pay
Skilled Nursing Confinement
Days 1 - 20
$0
Daily Skilled Nursing Copay
Days 21 - 100
$200
Skilled Nursing Coinsurance
Days 101+
100%
Hospice Care
Certified Terminal
Respite Care
0%
5%
Daily Skilled Nursing Copay
Pints 1 - 3
Pints 3+
100%
0%
Medicare Part B
helps cover costs associated with physician services, outpatient care, blood, tests and supplies.
Part B also has no yearly limit on annual out of pocket costs.
For most people, Part B premiums start at $174.70/mo
B
Physician, Outpatient Care & Labs
You Pay
Part B Deductible
Annual (2023)
$226
Medical Expenses
Coinsurance
20%
Outpatient Hospital Services
Minimum Coinsurance
Additional Hospital Costs
20%
100%
Excess Doctor Charges
Max 15% of Approved Amount
100%
Medical Expenses
Coinsurance
0%
B
Home Healthcare & Blood
You Pay
Home Healthcare
Costs For Care
Durable Medical Equipment
0%
20%
Blood
Pints 1 - 3
Pints 3+
100%
20%
Covering the Gaps of Original Medicare
There are 2 main ways to cover the gaps with Original Medicare. Both options have their advantages, depending on what you personally find valuable. Luckily, both options are easy to understand, so relax and take a deep breath, this is going to be easier than you think.
Medicare Supplement
Also known as Medigap
Important questions to consider...
Do I have freedom to choose my providers/hospitals?
Do I need referrals to see a specialist?
Can my plan benefits change?
Is coverage guaranteed renewable if premiums are paid?
Does it include prescription drug coverage?
Medicare Advantage
Also known as Part C
Medicare Supplement
Medicare Advantage
Yes
No
No
No
Yes, if HMO
Yes
Yes
No
Purchase Seperately
Usually, Yes
Now hang on, let's not get ahead of ourselves...
Medigap plans generally charge more in monthly premiums than the alternative, Medicare Advantage.
It's important to shop both options carefully and make sure you stay with a price that you can comfortably afford.
Additionally, Medicare Supplement and Medicare Advantage plans vary by insurance company. Premiums, deductibles and out of pocket costs can vary by plan, and in some cases if you make the wrong decision now and want to change in the future, you may be subject to health underwriting, meaning not everyone will be accepted.
It's important to make the right decision today to help avoid these risks in the future.
