MEDICARE PARTS A , B and PDP PART D

MEDICARE PART A AND PART B

When you qualify for medicare, (aging in at age 65 or being on disability for 24 months) you may sign up for both PART A and PART B. We can help you with that. (Click here for PART A coverage information.) (Click here for PART B coverage.)

MEDICARE ADVANTAGE PLANS / SNPs (Special Needs Plans - click link below)

A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits. Medicare Advantage Plans include:

• Health Maintenance Organizations
• Preferred Provider Organizations
• Private Fee-for-Service Plans
• Special Needs Plans
• Medicare Medical Savings Account Plans

If you’re enrolled in a Medicare Advantage Plan:

• Most Medicare services are covered through the plan
• Medicare services aren’t paid for by Original Medicare

Most Medicare Advantage Plans offer prescription drug coverage.

MORE ABOUT PART B

 

 


PRESCRIPTION DRUG PLANS (PDP) - PART D

Medicare prescription drug coverage is an optional benefit.  Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to get Medicare drug coverage when you're first eligible, you'll likely pay a late enrollment penalty if you join later, unless one of these applies:
• You have other creditable prescription drug coverage
• You get Extra Help
Generally, you'll pay this penalty for as long as you have Medicare prescription drug coverage.


 

Extra Help for Prescriptions



If you meet certain income and resource limits, you may qualify for a program called Extra Help from Medicare to pay the prescription costs, premiums, deductibles, and coinsurance of Medicare prescription drug coverage. 

This year prescription costs are no more than $3.60 for each generic/$8.95 for each brand-name covered drug for those enrolled in the program.

Some people pay only a portion of their Medicare drug plan premiums and deductibles based on their income level. 

This year you may qualify if you have up to $19,140 in yearly income ($25,860 for a married couple) and up to $14,610 in resources ($29,160 for a married couple).


If you don't qualify for Extra Help, your state may have programs that can help with prescription costs. Contact your Medicaid office or your State Health Insurance Assistance Program (SHIP) for more information. Remember, you can reapply for Extra Help at any time if your income and resources change.

Countable resources include:

• Money in a checking or savings account

• Stocks

• Bonds

Countable resources DON'T include:

• Your home

• One car

• Burial plot

• Up to $1,500 for burial expenses if you have put that money aside

• Furniture

• Other household and personal items

Apply for Extra Help.

 

Some people automatically qualify for help with prescription costs

You automatically qualify for lower prescription costs through Extra Help if you have Medicare and meet any of these conditions:

• Have full Medicaid coverage

• Get help from your state Medicaid program paying your Part B premiums (from a Medicare Savings Program)

• Get Supplemental Security Income (SSI) benefits

Even if you automatically qualify this year, you may not qualify for Extra Help next year. Changes in your income or resources may cause you no longer to qualify for lower prescription drug costs through one of the programs listed above. You’ll get a notice (on grey paper) by the end of September if you no longer automatically qualify. Even if you get this notice, you may still qualify for help with prescription costs, but you need to apply to find out.

• If your copayment amounts change next year, you'll get a notice (on orange paper) in the mail in early October with the new amounts.

• If you don't get a notice from Medicare, you'll get the same level of Extra Help that you got for this year.

 

 


5 THINGS YOU MAY NOT KNOW ABOUT MEDICARE...*

1. WHAT IS MEDICARE?

• Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. LEARN MORE

 

2. WHEN CAN I ENROLL?

• There are only certain times when people can enroll in Medicare. Depending on the situation, some people may get Medicare automatically, and others need to apply for Medicare. The first time you can enroll is called your Initial Enrollment Period. Your 7-month Initial Enrollment Period usually: Begins 3 months before the month you turn 65, includes the month you turn 65 and ends 3 months after the month you turn 65.

If you don’t enroll when you’re first eligible, you may have to pay a Part B late enrollment penalty, and you may have a gap in coverage if you decide you want Part B later.

 

3. HOW MUCH WILL IT COST?

• Most people get premium-free Part A.

You usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called "premium-free Part A."

You can get premium-free Part A at 65 if:

You already get retirement benefits from Social Security or the Railroad Retirement Board.
You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
You or your spouse had Medicare-covered government employment.

If you're under 65, you can get premium-free Part A if:

You have Social Security or Railroad Retirement Board disability benefits for 24 months.
You have End-Stage Renal Disease (ESRD) and meet certain requirements.

4. DO I NEED ANYTHING ELSE BESIDES MEDICARE PART A AND PART B?

• Yes, you will also need a Prescription Drug Plan (PDP). When you qualify for Medicare Part A or Part B and don't have credible coverage for a Prescription Drug Plan you need to enroll in one. You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

 

   • A Medicare Prescription Drug Plan (Part D)

   • A Medicare Advantage Plan (Part C) (like an HMO or PPO)

   • Another Medicare health plan that offers Medicare prescription drug coverage

   • Creditable prescription drug coverage

 

5. HOW CAN I APPLY?

• If you are eligible to apply for MEDICARE, you may call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048. You can visit the website at https://www.medicare.gov. If you would like to speak to a health care professional at Medicaring For You, please call 215-668-2010 or email us at slsfinancialservice@gmail.com. We will be more than happy to answer your questions and help you pick a solution that is right for you. We Care.

 

Working with an agent

Medicare Insurance Agents and Brokers can provide information about health plans. 

CLICK HERE
Check list BEFORE you enroll

3 Months Before Your 65th Birthday: Did you enroll in Part A during your Initial Enrollment Period?

CLICK HERE
Your EXPERT guide to finding the RIGHT plan

We made it as easy as 1., 2., 3... to connect to your expert guide to finding the right plan.

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READY TO ENROLL

CONGRATULATIONS! You've compared plans and you are now ready to enroll. 

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