MEDICARE INFORMATION

Medicare eligibility begins, for most, at age 65 as long as you or your spouse have worked for at least 10 years in the United States. 

If you are under 65, you can also qualify if you meet any of the below criteria: 

• You are permanently disabled and you have been receiving Social Security disability income benefits for 24 months.
• You have end-stage renal disease.
• You have Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease).

Part A covers inpatient care in a hospital, skilled nursing facility care, nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care), hospice care, home health care. 

• Premium: $0 
• Deductible: $1,632
• No out-of-pocket maximum. 

Part B covers outpatient services such as primary care visits, specialists visits, outpatient surgery, clinical research, ambulance services, durable medical equipment (DME), mental health, limited outpatient prescription drugs. 

• Premium: $174.70*
• Deductible: $240
• 20% coinsurance with no out-out-pocket maximum. 

*could be more based on income 

Part D is the Medicare Prescription Drug Benefit. There are number of different plans depending on the prescriptions you are taking. 

If you do not take Part D when you have Part B but choose to get Part D in the future, you will face a penalty if you do not have creditable coverage. 

Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. With Original Medicare, you are responsible for 20% of costs after your Part A & B deductibles with no out-of-pocket maximum. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like copayments, coinsurance and deductibles. 

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services. 

These plans usually offer additional benefits like dental, vision, hearing, OTC and transportation. 

The Insurance policy that pays you cash in the event of a covered hospitalization. You can also add on benefits for emergency room, outpatient surgery, ambulance, and cancer diagnosis.