Signing up for Medicare is a significant milestone for many Americans as it marks a new chapter in healthcare coverage. Whether you’re approaching 65 or considering a change in your current healthcare plan, understanding the ins and outs of Medicare is crucial. Here are the top 10 things you should know about signing up for Medicare.

1. Know the Enrollment Periods

There are specific times when you can sign up for Medicare. The Initial Enrollment Period (IEP) begins three months before you turn 65 and ends three months after the month you turn 65. If you miss this window, you can sign up during the General Enrollment Period (GEP), which runs from January 1 to March 31 each year, with coverage starting July 1. There’s also a Special Enrollment Period (SEP) for those who have certain life events, such as losing employer coverage.

2. Understand the Different Parts of Medicare

Medicare is divided into parts:

• Part A covers hospital insurance and is usually premium-free if you or your spouse paid Medicare taxes while working.
• Part B covers medical insurance and requires a monthly premium.
• Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B) and is offered by private insurance companies.
• Part D provides prescription drug coverage and is also offered through private insurance companies.

3. Consider Medigap

Medigap, or Medicare Supplement Insurance, is an additional policy you can purchase from a private company to cover some of the healthcare costs not covered by Original Medicare, like copayments, coinsurance, and deductibles.

4. Check for Qualification Before 65

Individuals with certain disabilities or permanent kidney failure (end-stage renal disease, or ESRD) may qualify for Medicare before age 65.

5. Be Aware of Penalties

If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. Similarly, late enrollment in Part D can also result in a penalty unless you have other credible prescription drug coverage.

6. Review Your Current Coverage

If you’re still working and have coverage through your employer, you may want to compare your current insurance with Medicare to decide which is more beneficial. You might be able to delay Part B without penalty if you have employer coverage.

7. Know That Medicare Doesn’t Cover Everything

Medicare doesn’t cover certain types of care, including long-term care, most dental care, eye examinations related to prescribing glasses, dentures, cosmetic surgery, acupuncture, and hearing aids and exams for fitting them. You’ll need to plan for these costs yourself or consider additional insurance.

8. Understand the Costs

Besides premiums for certain parts of Medicare, you’ll also have deductibles and copayments. Costs can vary based on the coverage you choose and your income, so it’s essential to budget for these expenses.

9. Keep an Eye on Enrollment Changes

Medicare enrollment guidelines and costs can change each year. Stay informed about any changes by visiting the official Medicare website or consulting with a Medicare advisor.

10. Seek Assistance if Needed

Signing up for Medicare can be complex. If you need help, free resources are available. You can contact the State Health Insurance Assistance Program (SHIP) for free one-on-one assistance, or consult with a trusted insurance agent who specializes in Medicare.

Remember, the more informed you are about Medicare, the better choices you’ll make for your healthcare needs. Don’t hesitate to reach out to the various resources available to you to ensure that you make the best decision for your situation.

There are a number of ways to fill gaps in your Medicare coverage and/or to get assistance with Medicare costs:

1. Job-based insurance: If you or your spouse is still working, and you have insurance through that job, it may work with Medicare to cover your health care costs. You should find out whether your employer insurance is primary or secondary to Medicare. Primary insurance is health insurance that pays first on a claim for care. Secondary insurance pays after primary insurance—but may not pay at all in the absence of primary insurance.
2. Retiree insurance: Some employers provide health insurance to retirees and their spouses to fill in the gaps of Medicare coverage. Retiree insurance always pays secondary to Medicare.
3. Veterans Affairs (VA) benefits: If you are a veteran and qualify for VA benefits, health care and prescription drugs that you get through the VA may be the cheapest. The VA may also cover services that Medicare will not cover for you. VA benefits do not work with Medicare, and if you receive care outside of a VA facility you might need Medicare. Medicare does not pay for any care at a VA facility.
4. Supplemental insurance (Medigap): A Medigap policy provides insurance through a private insurance company and helps fill the cost-sharing gaps in Original Medicare, for instance by helping pay for Medicare deductibles, coinsurances, and copayments. Depending on where you live, you have up to 10 different Medigap plans to choose from: A, B, C, D, F, G, K, L, M, and N. (Note that plans in Wisconsin, Massachusetts, and Minnesota have different names.) Each type of Medigap offers a different set of benefits. Premiums vary, depending on the plan you choose and the company you buy it from.
5. Stand-alone Medicare private drug plan (Part D): If you have Original Medicare and want Medicare drug coverage, you need to sign up for a private drug plan (PDP). All Medicare drug plans have different costs and a different list of drugs that they cover (known as the formulary). Make sure the plan you choose covers the drugs you need at a cost you can afford. Also know that if you do not sign up for a Part D plan when you first become eligible, you may incur a premium penalty later on.
6. Medicare Advantage Plan: These plans contract with the federal government to provide Medicare benefits. They must provide at least the same set of benefits offered by Original Medicare, but may have different rules, costs, and restrictions. For instance, Medicare Advantage Plans may require that you see health care providers in their network, and/or that you get a referral from your doctor before seeing specialists. Some private health plans offer extra, Medicare-excluded benefits, such as vision or dental care. While premiums may be low, service costs may be higher than in Original Medicare for certain services (or vice-versa). You also may pay more for your care if you do not follow the plan rules. Medicare Advantage Plans must have annual limits on out-of-pocket costs. Although these limits are usually high, they should protect you from excessive costs if you need a lot of health care. Benefit packages may change every year, so it is important to review your current coverage and options annually.

There are also several programs for beneficiaries with limited incomes.

© 2021 Medicare Rights Center. Used with permission.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2021 FMG Suite.

According to the Kaiser Family Foundation, the average person covered by Medicare has out-of-pocket medical expenses in excess of $5,500 a year. Premium costs accounted for 28% of the total, while long-term facility costs, medical supplies, prescription drugs, and dental care claim the rest.¹

With healthcare expenses in the spotlight, it’s incumbent upon us to make sure our retirement strategy anticipates these costs.

But that’s not enough.

Remember, healthcare coverage (including Medicare) typically does not cover extended medical care. And it’s a prospect we shouldn’t overlook.

The Department of Health & Human Services estimates that about 70% of people will need extended care at some point in their lives.²

These annual costs can range widely based on geographic location, from over $63,000 in Oklahoma to nearly $300,000 in Alaska.³ When workers were surveyed, only 16% said they were “very confident” they would have enough money to pay for long-term care in retirement.⁴

Finally, you may want to consider a Medigap policy, which may help cover some healthcare costs not covered by Medicare.

Ensuring that you are appropriately insured for your medical costs may help strengthen the foundation of your retirement.

1. MedicareResources.org, March 20, 2018 (Based on 2013 data, which is the latest available.)
2. Department of Health & Human Services, 2017
3. Genworth Cost of Care Survey, 2017
4. 2018 Retirement Confidence Survey, Employee Benefit Research Institute

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG Suite is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2021 FMG Suite.

Once you turn 65, the world of Medicare opens to you, and you also gain access to its offshoot supplemental programs. You likely know about Part A, Part B, Medicare Advantage, and other sections, but you may not know about the senior fitness offering “SilverSneakers.”

SilverSneakers is a versatile and free fitness plan for Medicare recipients. Not every insurance company that has Medicare Advantage or other Medicare Supplement Insurance plans has SilverSneakers as a choice. But it’s definitely worth asking about whenever you add or change your coverage.

SilverSneakers grants free access to over 14,000 gyms across America. Call ahead to find out if your local gym participates. You might also inquire if their location offers special SilverSneakers classes. These fitness sessions are designed for Medicare-aged students.¹

Not all SilverSneakers’ benefits are centered around the gym, however. For those who prefer different types of exercise, FLEX, a feature within SilverSneakers, holds meetups at community centers, public parks, and places of worship. They provide fitness opportunities that might not be available at your gym, such as hiking groups, yoga, and swimming.¹

SilverSneakers also offers health seminars, wellness events, and other community-building options for their members. The emphasis is on getting engaged and getting moving.

Remember, though, that not all plans offer SilverSneakers. Communicate carefully when doing your research and make a selection that covers your needed treatments and prescriptions first. Any extras should be secondary. It’s also important to remember that SilverSneakers’ availability may vary from year to year and even be canceled to make room for other features. Make your decisions with that knowledge and your overall health needs in mind.¹

1. BoomerBenefits.com, July 25, 2018

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2020 FMG Suite.

Medicare Advantage, sometimes known as “Part C,” is something of a catch-all choice for those who are ready to sign up for Medicare. Rather than being one plan (featuring solely government programs), Medicare Advantage plans are offered by private insurers in conjunction with the Medicare program.

WHAT’S IN THEM?

In addition to signing up for Medicare Part A (hospital stays) and Part B (medical coverage), Medicare Advantage plans offer their subscribers extra features. This frequently, but not always, includes the Medicare Part D prescription drug plan.¹

In some cases, Medicare Advantage plans offer coverage for areas not normally offered within regular Medicare plans. This can include dental, hearing, and vision insurance.¹

WHAT ARE THE RULES?

Medicare pays for a fixed amount of your health care to the company offering your Medicare Advantage (MA) plan. Beyond that, each MA plan requires different out-of-pocket fees. Those fees can vary from plan to plan.¹

Depending on your plan, you may have different rules you need to follow when seeking a medical referral to get treatment from a specialist or if you are seeking non-urgent care (even from health care providers within the plan).

It’s also important to remember that rules, requirements, and features may change from year to year. It will be important to make sure that those changes line up with any treatment that you need.

WHAT ABOUT MY PRESCRIPTIONS?

While most MA plans offer Part D coverage for prescription drugs, some don’t. One example would be for Medicare Medical Savings Account plans. In cases where the plan can’t or chooses not to offer prescription drug coverage, you have the ability to join a separate Medicare Prescription Drug Plan.¹

You will likely have a number of questions and concerns as you examine your options for Medicare Advantage plans. Discuss these with a trusted financial professional who can help you make choices that may best fit your lifestyle.

1. Medicare.gov, July 21, 2020

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2020 FMG Suite.

In a 2020 survey, 36% of all workers reported they were either “not too” or “not at all” confident that they would have enough money to pay for their medical expenses in retirement. Regardless of your confidence, however, being aware of potential health care costs during retirement may allow you to understand what you can pay for and what you can’t.¹

HEALTH-CARE BREAKDOWN

A retired household faces three types of health care expenses.

1. The premiums for Medicare Part B (which covers physician and outpatient services) and Part D (which covers drug-related expenses). Typically, Part B and Part D are taken out of a person’s Social Security check before it is mailed, so the premium cost is often overlooked by retirement-minded individuals.
2. Copayments related to Medicare-covered services that are not paid by Medicare Supplement Insurance plans (also known as “Medigap”) or other health insurance.
3. Costs associated with dental care, eyeglasses, and hearing aids – which are typically not covered by Medicare or other insurance programs.

IT ALL ADDS UP

According to a HealthView Services study a 65-year-old healthy couple (male living to age 87; female, age 89), can expect their lifetime health care expenses to add up to around $606,337.²

Should you expect to pay this amount? Possibly. Seeing the results of one study may help you make some critical decisions when creating a strategy for retirement. Without a solid approach, health care expenses may add up quickly and alter your retirement spending.

PREPARED FOR THE FUTURE?

Workers were asked how much they have saved and invested for retirement – excluding their residence and defined benefit plans.

Source Employee Benefit Research Institute, 2020

1. Employee Benefit Research Institute, 2020
2. HealthView Services, 2019

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG Suite is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2020 FMG Suite.

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Medicare coverage can be a critical component for living a healthy life in retirement, as well as for maintaining your financial independence during these years. Yet, as important as it is, Medicare does not cover the full range of healthcare expenses you may experience in your golden years.

To fill the holes that exist in Medicare, Medigap insurance can be purchased by individuals over 65 to supplement Medicare.

A Medigap policy is designed to cover expenses such as copayments, coinsurance and even deductibles—the so-called gaps in Medicare. Coinsurance is only covered after you have paid the deductible, unless you select a Medigap policy that also covers the deductible.

From A to N

Medigap is private health insurance that must follow federal and state laws designed to protect you. In most states, you can only purchase standardized coverage packages, or Plans, each of which is identified by the letters A through N.

These standardized packages must offer the same basic benefits regardless of which insurance company is offering it. Cost is usually the only difference between Medigap policies with the same letter.

All insurance companies are required to offer the Plan A standardized package. Each Medigap plan option (A-N) will differ on the benefits offered and the percentage of coverage for these Medicare gaps.

To get a better understanding of what each of these plans offers, go to www.medicare.gov and click on the “Supplements & Other Insurance” tab at the top of the page. Then click on “How to Compare Medigap Policies.”

AN EARLY START AT 65

You must have Medicare Parts A and B to buy a Medigap policy, and the best time to buy Medigap insurance is within the first six months you are both 65 or older and enrolled in Medicare Part B. By doing this you will not need to undergo a medical underwriting. For those with existing health conditions, this enables them to buy a policy at the same price that is charged for people in good health.

A separate Medigap policy must be purchased for each spouse. If you are nearing retirement, or have already discovered that these Medicare gaps can be expensive, it may be time to determine if a Medigap policy is right for you. You can get a quote from us right HERE!

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG Suite is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2019 FMG Suite.