You may be approaching age 65 or are on Medicare Insurance and have questions or concerns about what coverage is right for you. It is important to know your benefits when enrolling for medicare insurance in Elk River and the rest of Minnesota.
Medicare Insurance is a federal health insurance program for disabled individuals 65 or older. They must be disabled, have amyotrophic lateral sclerosis (ALS), or have end-stage renal disease (ESRD).
Medicare covers some health care costs like inpatient and outpatient hospital care, doctors’ visits, preventative services, skilled nursing, home health care, prescriptions, and hospice.
Most people get Part A for free, but some will need to pay for this coverage. To be eligible for premium-free, you must be 65 or older and have at least 40 calendar quarters of work in any job where you paid the Federal Insurance Contributions Act (FICA).
You may be eligible if you are already receiving Social Security or Railroad Retirement Benefits (RRB) based on disability. In this case, you would be entitled to Medicare Part A after 24 months of receiving disability benefits.
Individuals whose disability is ALS are entitled to Part A benefits the first month they are entitled to Social Security or RRB disability benefits. Individuals with ESRD are also entitled to Part A Medicare following certain conditions.
Parts of Medicare
Medicare Insurance is organized in four different parts:
Part A is hospital insurance and covers inpatient hospital stays, skilled nursing, some home health, and hospice. Most people do not pay for Part A.
Part B is medical insurance and covers physician visits, outpatient services, preventive services, and some home health visits. Everyone pays a monthly premium for Part B.
In 1997 Medicare enrollees had the choice of opting in for Medicare Advantage, also referred to Medicare Part C. Through the Medicare Advantage program, beneficiaries enroll in a private health plan typically including Part D benefits.
Part D is coverage for outpatient prescription drugs through private plans that contract with Medicare. Part D can be included in Medicare Advantage Plans (Part C) or a stand-alone prescription plan.
Medicare Insurance Supplement Plans (Medigap) policies are sold through private insurance companies. Medigap plans are an additional coverage option for Original Medicare Insurance. Parts A and B insurance only cover 80%. Adding a Medigap Insurance plan covers the remaining 20% eliminating additional out-of-pocket costs.
Medicare Insurance Initial Enrollment Period (IEP) is a 7-month period that begins three months before the month of your birthday, includes the month of your birthday, and three months following your birthday month. Coverage begins based on when you enroll during IEP.
You may be at the point of retirement and leaving your group health plan or your spouse's group health plan. At this point, you would qualify for a Special Enrollment Period (SEP) for Medicare Insurance.
During the General Election Period (GEP) between January 1st through March 31st, you may also enroll in Medicare Insurance. Coverage would begin July 1st of that same year. It is important to note if the enrollee doesn’t sign up for Part A, Part B, and Part D when they become eligible, there may be fees or a penalty in addition to the premium.
If you don’t qualify for Medicare benefits and you are 65 or older, you can buy them. You would pay a monthly premium for Part A, Hospital Insurance.
The rate for Part A depends on the number of credits you have. In 2022, if your total earned credits is less than 30 earned credits you would pay the monthly maximum of $499. If you have 30-39 credits, you will pay $274 monthly. If you buy Part A you must buy Part B. Currently, the monthly premium for Part B is $170.10 for individuals with a yearly income of $91,000 or $182,000 for those filing a joint return.
Rates are higher for individuals with a higher income. You may enroll in Part D prescription drug coverage if you are enrolled in either part A or B. You must be enrolled in Parts A and B to enroll in a Medicare Advantage plan or buy a Medigap supplemental plan.
Patriot Insurance Brokers can help guide you in finding the right Medicare Insurance in Waite Park, Elk River, and the surrounding areas. We make Medicare simple! We work with many nationally recognized companies to offer a variety of choices and assist with plans that are most suitable for YOU.