ALMOST 65? WHAT YOU NEED TO KNOW ABOUT AGING IN TO MEDICARE

Author

Millennium Physician Group- FL

For more information about the author, click to view their website: Millennium Physician Group

Posted on

Jul 12, 2023

Book/Edition

Florida - Sarasota, Bradenton & Charlotte Counties , Florida - Southwest

share-this
Share This

WHAT YOU NEED TO KNOW ABOUT AGING IN TO MEDICARE

Most people look forward to becoming eligible for Medicare, but “aging in” to the program can be intimidating. There’s a lot to learn! We hit the streets to find out what some Medicare-age folks really think of the whole process.  

Rebecca knows the basics, “I know that when I turned 65, I was able to partake of Medicare that I had paid into for years.” 

And Linda found the process a bit confusing, “It should be a lot more simple,” she says. “I’m just saying it would be easier for all of us.” 

Deborah is a healthcare provider and she admits it could be more clear, “I think right now, in terms of my contemporaries, my peers, that will be going on Medicare, they don’t necessarily understand it.” 

Definitely do your research, because you generally only have seven months to sign up for Medicare the first time. Your Initial Enrollment Period, or IEP, begins three months prior to the month of your 65th birthday, includes the month of your birthday, and ends three months after your birthday month. Of course, there are exceptions, like continuing to work past 65, or being covered under a spouse’s plan, or moving states – even counties. Procrastinate and you could end up paying a penalty of an additional monthly fee for life. 

Some Medicare-age folks who’ve already been through the process of enrolling shared their advice:  

“Maybe start a little early, just so you can get questions answered before the last minute.” 

Piers adds, “Perhaps not the simplest thing, but I found somebody who could help me understand the various letters of the alphabet and it then became clear.” 

 Easy as A, B, C, D. There are four parts to Medicare: Parts A and B, or “Original Medicare” are managed by the federal government. Part A is hospital coverage and  

Part B is so-called doctor coverage. But this combo is not your only choice. 

You also have the option to enroll in a Medicare Advantage Plan or Medicare Part C. These plans are administered by commercial insurers and are backed by Medicare. They are often low-to-no cost, limit out-of-pocket expenses, and offer additional coverage like prescription drugs, vision and dental, gym memberships, transportation, or stipends for over-the-counter needs. Only need prescription drug coverage? Then a Medicare Part D Plan is for you. 

Even learning the lingo can be a lot. Just ask Linda, “It is overwhelming and confusing,” she says. 

 “Trying to figure out the donuts and all that stuff,” adds her Medicare-age counterpart. 

That’s where Millennium Medicare Connect and our trusted Medicare Navigators at Healthshare360 can help. You have questions and we’ve got your answers.  

Linda offers some final words of wisdom, “Be patient and it’s a journey, but you can get your answers.”  

Connect with us today at YourMedicareConnect.com  

 Resources: Medicare.gov 

Other Articles You May Like

What Seniors Need To Know About Changes to Medicare

Congress recently made significant changes to Medicare's Part D prescription drug benefit as part of the Inflation Reduction Act. While some changes aim to help seniors afford their medications, others may have unintended consequences.On the positive side, insulin costs are now capped at $35 per month for Medicare beneficiaries. This has already provided relief for many seniors with diabetes.Starting in 2025, out-of-pocket Part D drug costs will be capped at $2,000 annually. Seniors will also have the option to spread these costs throughout the year through the new Medicare Prescription Payment Plan. These changes can benefit seniors who rely on multiple brand-name medicines or have fixed incomes.However, awareness of the new payment plan is low. Medicare could do more to inform seniors about this option, which requires opting in. Seniors should consider contacting their Part D insurers during open enrollment if they would benefit from spreading out pharmacy costs.The law's drug price negotiation provision has led to some unintended effects on drug development. At least 36 research programs and 22 experimental drugs have been discontinued as a result.Part D premiums have also increased. This year, standalone Part D plans were set to cost 21% more on average compared to last year. Many seniors switched to lower-cost options as a result. The number of available plans has decreased by about 25% since 2020.Some insurers have moved certain medications to tiers requiring higher out-of-pocket costs, restricting access to previously covered drugs. New rules like step therapy requirements have also been implemented, potentially making it harder for patients to access drugs their doctors recommend.It's important for seniors to understand these changes and their potential impacts on drug access before Medicare's open enrollment period begins in October.  Contact Carleen Lachman, Independent Insurance Specialist at 724-571-4688 to learn more.  

Healthcare and Hidden Limitations

Health insurance jargon can be the hardest to understand for consumers. Thats why you have a broker who goes to work for you and explains your policy options with clarity. However, not all brokers work ethically. You may not have an insurance broker who values you and may not elaborate on your policy limitations. The omission of these limits is illegal and should result in the termination of that broker. In contrast, the insured typically doesnt take legal action, and the broker makes his or her desired commission.This is not to say that all health insurance brokers operate in this zone of immorality. Just as with any profession, there are good and rotten eggs. Your moral compass and ability to judge a persons intention is a significant factor people can typically smell a sleazy salesperson. Below, are the most common limitations obscurely mentioned in health insurance policies. This information should adequately equip you for when you are asking questions of your broker.Heres a screenshot from the summary of the benefits of an insurance carriers product:*Note these limitations do not exist in all policies. Ask your broker.The list of benefits above is towards the end of the policy summary. Most people are interested in seven factors when it comes to their health insurance:Deductible/coinsurance/max out of pocket, doctor visits/specialists/urgent care, the network, prescription coverage, preventative/wellness coverage, emergency room fees, and ambulatory services. If your insurance broker goes over those seven things, this is how the policy would look and sound:Choice of $500-$10,000 deductible/max out of pocket (1 million in coverage)Choice of 70/30, 80/20, or 100/0 coinsuranceUnlimited $25 copay to doctor, specialist, and urgent carePHCS Network (PPO)$50 copay for annual wellness/preventative checkupER subject to deductible and coinsuranceAmbulatory services (above) $500 per transportMost people would agree that those seven things sound fantastic for health coverage. You have all your daily doctor needs taken care of and one million dollars in coverage, right? Wrong, let me show you a scary breakdown if you had an appendectomy while being covered by this policy.On average, the Fair Price for an Appendectomy lies somewhere between $7,000 and $25,000 (may vary due to zip code). If there are complications, it could be upwards of $35,000 or more. Heres a breakdown of the services and their estimated costs. You can always check on any surgery, and its price by visiting Healthcare Bluebook.Hospital Services for a 2-day admission, itll cost roughly $9,700.Physician Services the fee for procedure and routine postoperative care costs around $1,400.Anesthesia the price for an average surgery time of 1 hour and 15 minutes costs about $750.This cost adds up to the lower end of about $11,000 for an appendectomy. If you look above at the example policy, youll see that for the entire coverage term an appendectomy will be given a $2,500 coverage benefit. Even though your plan has a deductible, coinsurance, and max out of pocket; theres a specific limitation for appendicitis. With this knowledge, the insured will be left an $8,500 bill as an out of pocket expense! Keep in mind; these numbers are on the low end with no complications.Of course, its always better to have health insurance instead of going uninsured. With insurance, that remaining $8,500 for the appendectomy may negotiate to a lower bill. Policygenius.com does a great job explaining the functionality of network negotiated rates. Without insurance, you would be paying the almost full retail price for your medical surgery, which is a terrifying thought!

Can I Just Purchase Insurance Myself?

You can, but should you?Theres a dark stain over the insurance industry for consumers searching for quotes online. Families and individuals are aware they need to carry health and life protection but dread entering their information online, consequently experiencing the bombardment of phone calls that follow. Its so bad some people would instead go without coverage than speak with a broker over the phone. When in reality, all it takes is working smarter, not harder.Some people will advise you to buy your own auto, home, health, life, or any other insurance. They will tell you horror stories about the number of calls youll receive if you submit information online. They will present a convincing argument, and youll be tempted to accept their advice. I urge you to resist that temptation.Its no surprise that many people are turning to self quoting websites and applications. The appeal is undeniable. Theres nothing inherently wrong about this approach, and it does save the consumer the headache of having to speak to countless agents. However, should you buy insurance without speaking to a licensed broker? Its fine to quote yourself and see whats out there in terms of options, but then proceeding to purchase that insurance without educational guidance is extremely risky for the consumer. When you use past experiences, personal knowledge, and stories heard from friends to make an informed decision on your insurance; the result tends to be medical debt or bankruptcy.A licensed agent or broker has a fiduciary responsibility to you. They are mandated by state and federal law to undergo licensed certification. While you may not have had pleasant experiences in the past, having a broker perform a needs analysis to personalize the policy is a better alternative. Just like any other profession, some paid attention during class, and others did not. It isnt appropriate to blanket statement all insurance brokers as untrustworthy.Heres your solution to avoid entering your information online. Instead, reach out to family members and friends. Ask them whom they use for their insurance needs and their experience with their broker. If you cant find a family or friend who uses a local agent or broker; reach out to colleagues and people within your circle of influence for guidance. By doing so, you are acquiring a real person who is aware of your personal needs and whom others trust. Its an ideal win-win situation between a trusted broker and client. You leave feeling confident in your policy because you are informed, and youve supported a local small business owner and their family. It may not be the fastest solution, but should it?When the world is more efficient, were all happy. Quicker load times, faster test results, high-speed internet. The need for convenience and expedience permeates everything we do. Theres relief in knowing you can quote and compare prices without receiving dozens of calls.However, when you go to purchase your insurance slow down, consult a professional, ask questions, and then fill out your application with the knowledge youre protected and supported.

Local Services By This Author

Millennium Physician Group

Primary Care Providers for Seniors 19531 Cochran Blvd, Port Charlotte, Florida, 33948

Millennium Physician Group, established in Port Charlotte, Florida, in 2008 and now headquartered in Fort Myers, has emerged as the premier independent physician group in the Southeast, boasting a network of over 800 healthcare providers. Our commitment to delivering exceptional care is reflected in our comprehensive range of services, which span primary care, specialty care, walk-in centers, radiology and lab services, physician therapy, telehealth, wellness programs, home health, hospital care, and more.At Millennium Physician Group, we prioritize a patient-centric approach, striving to create a truly connected healthcare experience for individuals across the region. Our philosophy is rooted in value-based care, and we consistently engage our physicians to ensure the highest standards of quality and service. By offering a coordinated and comprehensive continuum of care, we aim to be Your Connection to a Healthier Life.With a dedication to excellence and a commitment to innovation, Millennium Physician Group continues to set the standard for healthcare delivery in the Southeast. We are honored to serve our communities and remain steadfast in our mission to improve the health and well-being of every patient we have the privilege to care for.To see a full list of locations near your, please Click Here

Millennium Physician Group

Primary Care Providers for Seniors 6321 Daniels Parkway, Fort Myers, Florida, 33912

Millennium Physician Group is a leading provider of comprehensive healthcare services in Florida. With a network of over 400 healthcare providers, we are committed to delivering personalized, high-quality care to our patients. Our team includes primary care physicians, specialists, and advanced practitioners who work together to ensure our patients receive the best possible care.At Millennium Physician Group, we offer a wide range of services, including primary care, cardiology, dermatology, gastroenterology, and more. Whether you need routine preventive care or treatment for a complex medical condition, our team is here to help. We also offer telehealth services, allowing you to access care from the comfort of your home.With locations across Florida, including Fort Myers, Naples, and Port Charlotte, we strive to make healthcare convenient and accessible for our patients. Our goal is to help you live a healthier life and achieve your wellness goals. Visit our website to learn more about our services and find a location near you.

Millennium Physician Group

Physicians 19531 Cochran Blvd, Port Charlotte, Florida, 33948

Millennium Physician Group, established in Port Charlotte, Florida, in 2008 and now headquartered in Fort Myers, has emerged as the premier independent physician group in the Southeast, boasting a network of over 800 healthcare providers. Our commitment to delivering exceptional care is reflected in our comprehensive range of services, which span primary care, specialty care, walk-in centers, radiology and lab services, physician therapy, telehealth, wellness programs, home health, hospital care, and more.At Millennium Physician Group, we prioritize a patient-centric approach, striving to create a truly connected healthcare experience for individuals across the region. Our philosophy is rooted in value-based care, and we consistently engage our physicians to ensure the highest standards of quality and service. By offering a coordinated and comprehensive continuum of care, we aim to be Your Connection to a Healthier Life.With a dedication to excellence and a commitment to innovation, Millennium Physician Group continues to set the standard for healthcare delivery in the Southeast. We are honored to serve our communities and remain steadfast in our mission to improve the health and well-being of every patient we have the privilege to care for.To see a full list of locations near your, please Click Here