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June 8, 2016

What are my Medicare coverage options when I turn 65?

What are my Medicare coverage options when I turn 65?

Well, you are soon turning 65 and are getting bombarded with a lot of mail from all the different insurance companies telling you to make a decision about your Medicare coverage but what are your options and how do you know which coverage works best for you?

Typically, you have about five options when choosing your Medicare coverage when you turn 65. So, here are those options. Choosing which option works best for you, will require a more in depth review by an independent Medicare specialist that can answer all your questions and be able to present the pros and cons of each of those options. If you live in Colorado, Medicareline Insurance can assist you with choosing the best Medicare coverage for you.

Option 1 – You don’t have to choose anything. Medicare is not mandatory insurance; however if you choose to be covered later on, you will most likely be charged a penalty fee for as long as you have Medicare.

Option 2 – You can sign up for Original Medicare only (Part A – hospital and Part B – outpatient) during your Initial Open Enrollment (7-month period). If you choose this option, this is the best time to make your decision to avoid any penalties. Most people who worked 10 years or 40 quarters will not pay a monthly premium for     Part A but will pay a monthly premium for Part B. If you choose only Original Medicare coverage there is no out of pocket maximum amount, which can be very costly if facing a catastrophic event such as a surgery or developing a health condition that requires ongoing and expensive treatment.

Option 3 – You can sign up for Original Medicare (Part A and Part B) and in addition purchase a Medicare Supplement Plan to cover for all the gaps left by the Original Medicare coverage. Those plans are also known as Medigap plans. Typically, Original Medicare will cover up to 80% of your Medicare approved charges, leaving you uncovered for the remaining 20% without an out of pocket maximum amount. The best time to choose a Medigap plan is 6 months after you turn 65 because you cannot be refused coverage for any preexisting conditions during this time frame. If you are outside this time frame, you can be denied a Medigap plan due to a preexisting condition unless you qualify for a special enrollment period.

If you choose a Medigap plan you will need to purchase a separate or stand alone prescription plan (Part D). The cost of a Medigap plan can range anywhere between $100-150/month depending on which plan you choose and where you live. This cost will be in addition to your Part B monthly premium and a Part D prescription plan.

Option 4 – You can sign up for Original Medicare (Part A and Part B) and choose a Medicare Advantage Plan (Part C). These plans are offered by private insurance companies just like Medigap plans but will cover you within specific networks. The cost of Medicare Advantage Plans can range between 0 to very low monthly premiums depending on what is available in your area. You will still need to pay for your Part B monthly premium. These advantage plans will typically include a prescription plan and other various benefits. You cannot have both a Medicare Advantage Plan and a Medigap plan at the same time. A careful review is needed to determine the pros and cons of a Medicare Advantage Plan before you make a decision.

Option 5 – If you or your spouse is still working after you turn 65 and receive creditable group coverage from your employer, you can delay Medicare coverage until you are ready to retire and come off the group coverage. The month after your employment or employer group coverage ends, you will have an 8 month period called a Special enrollment period to sign up for Medicare coverage. You should consult with your employer’s group coverage representative about how to transition into Medicare coverage.

If you have further questions about your Medicare options, you can always contact 
Medicareline Insurance in Colorado 

Phone: (719) 360-2795 
E-mail: [email protected]

An article by John A. Balota
Owner of Medicareline Insurance  

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