Intro to Medicare
You qualify for Medicare if:
You qualify for Medicare if:
You qualify for Medicare if:
- You are 65 and you or your spouse have at least a 10 year work history, or
- You are under 65 and have been on Social Security disability for at least two years, or
- You have end-stage renal disease or ALS
The parts of Medicare
You qualify for Medicare if:
You qualify for Medicare if:
- Part A - covers hospitalization, skilled nursing and homecare
- Part B - covers doctor visits and outpatient medical care
- Part C - a name for Medicare Advantage plans
- Part D - covers prescription drug benefits
What Medicare pays:
You qualify for Medicare if:
- Part A – $0 monthly premium for most people. After a $1676 deductible per benefit period, Part A pays hospital costs for first 60 days. For days 61- 90 you pay a daily $419 copay. For days 91-150 (lifetime reserve days) you pay a daily $838 copay. For skilled nursing, Part A pays for the first 20 days. For days 21-100 you pay a $209.50 copay per day.
- Part B – for 2025 - Has a $185 per month premium for most people. After a $257 deductible, Part B pays for 80% of the approved costs and you pay the other 20%.
- Part C – Managed insurance plans through private companies that pay at least as much as Medicare pays. Usually has extra benefits such as gym memberships, Dental, Vision and Hearing.
- Part D – Deductibles and copays vary by plan.
a few more details
As you approach age 65, you have a 7 month window to apply for Medicare – the three months before your birthday month, your birthday month, and the three months after (If your birthday is on the first day of the month, Medicare considers the month before your birthday to be your birthday month). There’s a penalty for applying late for Part B. The penalty is waived if you have employer coverage from your or your spouse’s job.
While Medicare alone is pretty good coverage, Part A does have its $1676 deductible and Part B only pays 80% of the bill. Most people choose to protect themselves further, either by purchasing a Medicare Supplement insurance policy (Medigap) and a Part D drug plan, or by choosing to enroll in a Medicare Advantage plan. Most Medicare Advantage plans include a drug plan.
I can help you choose the plan or plans that fit your needs and your budget.
