Medicare Information You Need

Open enrollment for Medicare begins October 15th and ends December 7th. Do you know all of your options?

Medicare Basics: Medicare is for people ages 65 and older and others with certain disabilities. Most people are automatically enrolled in traditional Medicare which includes Parts A and B. While Medicare Parts A and B cover some of your healthcare needs, they do not cover everything. To help pay for the costs not covered by traditional Medicare, such as prescription drug costs, additional Medicare options are available.

Parts of Medicare:

Part A: Hospital Coverage: Part A helps cover your inpatient care in hospitals, including critical access hospitals and long-term care hospitals. Most people automatically get Part A without having to pay a monthly premium. You will be responsible for paying a deductible and some coinsurance amounts. The Part A deductible amount for 2024 is $1,632.00 for each benefit period, plus you will be responsible for paying coinsurance after day 60 of an inpatient stay.

Part B: Medical Coverage: Part B helps cover medical costs like doctors’ services and outpatient care when they are medically necessary. Part B will pay 80% of your covered services after you pay your deductible. Most people pay a Medicare Part B monthly premium which is taken out of their Social Security check, plus the yearly deductible, and the remaining 20% of your covered services. In 2024, the typical monthly premium is $174.70 and the yearly deductible is $240.00.

FOR MORE INFORMATION ON PART A AND PART B COVERAGE and COSTS, PLEASE VISIT:

Medicare Information

Part C: Medicare Advantage Plans: Part C coverage is provided by Medicare Advantage plans and includes all of Parts A and B as well as extra benefits. If you choose a Medicare Advantage plan, you opt out of traditional Medicare, but your Part B premium will still be deducted from your Social Security check each month. Many of these plans will also charge a monthly premium in addition to the Part B premium. The advantage of these plans is that they replace Part A, Part B and Part D and you will not need a supplemental plan. While they offer more benefits and covered services, you will be required to see one of their participating providers. Their rules can change each year so it is important for you to read all information that is sent to you from your plan. When you belong to a Medicare Advantage plan, there is no need to use your Medicare ID card. You will be given a new ID card from your Advantage plan.

Part D: Prescription Drug Coverage: Part D coverage is designed to help lower your prescription drug costs. Part D coverage is available in standalone plans or may be included with a Medicare Advantage plan.

3 Medicare options to consider:

Option 1: You can rely on traditional Medicare Parts A and B to provide your coverage. It’s important to understand that both of these parts have premiums, deductibles, and coinsurance amounts that must be paid by you.

Option 2: You can purchase a Medicare Supplement plan in addition to traditional Medicare to pay for some of the things not covered by Medicare Part A and Part B alone. Medicare Supplement plans are sold by private insurance companies and have no affiliation with Medicare. The supplement plans typically do not have any prescription drug coverage. This must be purchased separately if you have traditional Medicare Part A and B and a supplement. It is important to shop around for these plans because each of them will have a different cost.

Option 3: You can choose a Medicare Advantage plan to provide the same coverage as Medicare Parts A and B, plus more benefits and services including Part D prescription drug coverage, vision, hearing and dental coverage. Medicare Advantage plans provide these benefits through a contract with the government. Because of this, if there is a premium due, it may be lower than what you would have to pay for a supplement plan. You will not need a Medicare Supplement plan if you choose a Medicare Advantage plan. You will have to pay your Part B premium amount, the Advantage plan premium if there is one, and possibly a copay and/or coinsurance.

FOR MORE INFORMATION ON MEDICARE, MEDICARE SUPPLEMENT and MEDICARE ADVANTAGE PLANS, PLEASE CONTACT:

www.ncshiip.com or call 1-855-408-1212 and select option 1

Important Information:

• Seniors’ Health Insurance Information Program (SHIIP) is a division of the North Carolina Department of Insurance. They have trained experts who can answer all of your questions about Medicare and other insurance. They will be happy to schedule a one-on-one counseling session with you to review all options that are available to you in your county. This is a free service available to you.
• Federal regulations prohibit insurance agents from contacting you unless you have extended an invitation. There are lots of good insurance agents that will assist you in finding the right coverage for you.
• If you invite an insurance agent to your home, ask a friend or relative to be with you. Insurance is complicated and having another set of eyes and ears is helpful.
• Don’t be afraid to ask questions before you enroll with a plan. You should never feel pressured to sign.
• Don’t assume that your physician accepts the plan you want to enroll in. Call your physician and ask.
• Call us if you need more help. 336 274 6515