Hal September 13, 2017 4 Comments

Medicare for Baby Boomers

by Danielle Kunkle

An Introduction to Medicare for Baby Boomers

The wave of baby boomers began their entry into Medicare a few years ago. As more than 10,000 people now age into Medicare at 65 every day, Medicare and supplemental insurance companies have begun to offer online enrollment opportunities to this group of technology-savvy Medicare beneficiaries.

Here’s what Baby Boomers need to know about who is eligible for Medicare, how and where to enroll, and what benefits you can expect.

Eligibility

Most people become eligible for Medicare at age 65. However, Medicare is also offered to people with End Stage Renal Failure and people on Social Security disability when they reach their 24th month of SSDI benefits.

You do not have to be on Social Security benefits to qualify for Medicare. The two programs have separate and distinct enrollment windows. You are eligible for Medicare at age 65 even if you have delayed your enrollment into SS income benefits.

Enrolling into Medicare

The initial enrollment window for people turning 65 begins 3 months before your 65th birthday and extends through your birth month and the 3 months after you have turned 65. If you enroll during this 7-month window, you will not be subject to any late penalties

How and Where to Enroll

For decades, new Medicare beneficiaries have enrolled in Medicare in person down at the Social Security office. Today, however, the Social Security office also offers enrollment via mail or online.

To enroll by mail, call Social Security at 1-800-772-1213 and request an application be mailed to you. You will receive and complete the necessary forms and return them to the Social Security office. This may take a few weeks, so use this option only if you are enrolling into Medicare early in the 7-month window.

Perhaps the easiest way to enroll is to visit www.ssa.gov/medicare. You can sign up for your benefits here in just a few minutes, and your new Medicare card will arrive in the mail shortly thereafter.

It’s important to also mention that if you take your Social Security early prior to turning 65, you will be automatically enrolled in Medicare Parts A and B when you turn 65.

What to Enroll in, What It Covers and What It Costs

The two parts of Medicare in which you enroll in via Social Security are Parts A and B.

Part A covers your inpatient hospital benefits and skilled nursing. Most people do not pay anything for Part A at 65 because your taxes during your working years included a pre-payment of your hospital coverage. If you or your spouse worked 10 years in the U.S., you are paid up.

Though Medicare covers the largest share, you will be responsible for a deductible. If your stay in the hospital is longer than 60 days, you will also begin paying an expensive daily copay.

Part B covers about 80% your outpatient medical benefits after you pay a small annual deductible. You will pay a monthly premium for Part B. In 2017, this cost $134/month for most new enrollees. Some people with higher incomes will pay a higher amount that is based on your modified adjusted household gross income.

Part A and B are your Original Medicare benefits, and they are the only two parts of Medicare that you enroll in at Social Security. Parts C and D are optional coverage that is offered by private insurance companies. You will enroll in those directly with the insurance companies who offer them.

Additional Coverage

Since Medicare has deductibles and coinsurance that are left for you to pay, most people supplement that coverage with Medigap plans or Medicare Advantage plans. Both types of plans are offered by private insurance companies to help you fill in the gaps.

Medigap Plans

A Medigap policy pays after Medicare first pays its share. Your providers will bill Medicare. Medicare will process the claim and pay their portion. Then they send the remainder on to your Medigap company.

There are 10 standardized Medigap policies available and 1 high deductible option. Most Medigap plans cover the 20% that Medicare Part B doesn’t pay for. You can then select one that covers the things you want to cover, such as your hospital and outpatient deductible, excess charges, foreign travel and a few other things.

While Medigap Plan F offers the most coverage, in recent years we have seen Plan G become very popular. You can learn more about what Plan G covers here.

Since Medigap plans do not include retail drugs, you can enroll in a standalone Part D drug plan to go alongside your Medigap plan. This is a pharmacy card that will give you access to medications at much lower cost than retail. It will also insure you against future catastrophic-level drug spending.

Medicare Advantage Plans

Medicare Advantage plans are another option for covering the gaps in Medicare. These are private plans that pay instead of Medicare. You enroll in the plan and agree to use the plan’s network to get your care at the lowest copays. Your providers will bill the plan for your treatment, and you will pay your share in the form of copays.

Not all doctors participate in Medicare Advantage plans, so it’s important to ask your providers which plans they participate in before enrolling into any Medicare Advantage plan. However, many Medicare Advantage plans have a rolled in Part D plan, which makes these plans convenient for some Medicare beneficiaries.

Conclusion

Learning about Medicare can feel a little stressful when you are new to this. The most important thing to know is that there are many different affordable options to help you get the coverage you need. To dive further into your Medicare coverage and supplement options, we recommend this post:

https://boomerbenefits.com/understanding-medicare/

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Danielle Kunkle is the co-founder of Boomer Benefits a licensed insurance agency specializing in Medicare-related insurance products. They help baby boomers learn the ropes of Medicare in 47 states. She is also the blogger-in-chief of the Boomer Benefits website’s blog.

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