Medicare Basics

Who is Eligible?

Medicare is a health insurance program for people aged 65 or older, people under the age of 65 with certain disabilities, and people of all ages with End-Stage Renal Disease.

Part A Hospital Insurance

Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals. This includes critical access to hospitals and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and a portion of home health care. Beneficiaries must meet certain conditions to receive these benefits.

  • Part A Cost – There is not a premium if someone has worked 40 quarters (10 years) in the United States. If you have not, you can purchase Part A; the premium is based on how long you have worked (2023 premiums, $506 monthly if less than 30 quarters, and $278 for people who have worked 30-39 quarters).
  • How do you enroll in Medicare Part A?
    o   If you are receiving Social Security benefits when you turn age 65, you will receive your Medicare Card two to three months prior.
    o   If you are not receiving Social Security benefits when you turn age 65, you must sign up for Part A for it to be activated.

Part B Medical Insurance

Medicare Part B (Medical Insurance) helps cover doctors’ services and outpatient care. It also covers some medical services that Part A does not cover. This includes some services of physical/occupational therapists as well as a portion of home health care. Part B helps pay for the covered services/supplies when they are medically necessary.

  • Part B Cost – Premiums for Part B are based on the Income Related Monthly Adjustment Amount (IRMAA).
  • How do you enroll in Medicare Part B?
    o First, let’s determine if you need Part B. If you are participating in an employer-based health plan, you do not need to enroll in Part B, unless they require it.
    o If you are turning age 65, and do not have group insurance provided through employment or retiring and loosing employer-based coverage you need to enroll in Part B timely to avoid any penalties.
    o When enrolling in Part B, we can assist you with instructions on how to complete the process. When turning age 65, you need to complete the process online with Social Security. If you are age 65+ and loosing group health coverage, you must complete the Part B application forms. We can assist you with this process.

Part C (Medicare Advantage)

Part C is a Medicare Advantage plan that is provided by an insurance company that is an alternative to Original Medicare.

Part D (Prescription Drug Plan - PDP)

Part D includes benefits for prescription drugs which help the covering of costs for prescriptions; Plan D is issued by insurance companies.

Our Process

  • First, let’s have a conversation about your current and future needs for Medicare.
  • Secondly, we will gather some information to properly research the best plans for your needs.
  • Thirdly, we will provide you with several proposals from multiple carriers which include all types of plans.
  • Next, our proposal will provide the estimated costs for utilizing the proposed plans (which are based on your current medical situation).
  • If you choose to select a plan with us, it is important to note that there is no charge for our services. You will pay the same as if you enrolled directly with a carrier.
  • After you enroll with us, we will continuously work with you. In order to make sure you are properly enrolled in the best plan that suits all your needs.

Several Things to consider
when choosing a Medicare Plan

  • Now that I am Medicare Eligible or need to choose a Medicare plan what is the best plan for me?

    * Stay on the Group Health Plan?
    * Change to a Medicare Supplement?
    * Change to a Medicare Advantage plan?

    There are benefits to all three options but ultimately it comes down to the following considerations:
    • Physician and facility acceptance
    • Prescription drug utilization
    • Out of pocket cost from utilizing the benefits
    • Premium cost

We want to be your Medicare Partner providing Medicare Education along with the knowledge of all plans available.

Let’s have a conversation about Medicare and Coverage Options

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Individual Insurance Solutions, LLC

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Individual Insurance Solutions, LLC is an independent insurance agency offering a personalized approach for coverage to individuals, employers, and employees of employers to bring them an individual insurance education.

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