Caring for aging parents comes with plenty of challenges on its own. The last thing you want to worry about is your parents’ health insurance needs. Finding the right plan, though, isn’t always as simple as it sounds. Whether your parents are facing medical complications, transitioning to a nursing home, or simply needing help navigating technology to enroll, there are several factors you should consider before they stick with basic Medicare.

Understanding Original Medicare vs Medicare Advantage

Medicare Parts A and B, also known as Original Medicare, offer hospital coverage and outpatient coverage respectively. You can learn more about what Part A and Part B cover exactly by reading this article.

With Original Medicare, you pay for services as you get them. While Medicare will cover a lot of costs, you could still be responsible for deductibles, copayments, and coinsurance. On its own, Original Medicare will not cover supplemental healthcare (such as hearing, vision, or dental care) or prescription drugs.

Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare. This plan bundles your Medicare coverage, including Parts A and B and usually Part D prescription drug coverage. Medicare Advantage can also cover things that Original Medicare does not, like vision, dental, and hearing insurance.

While Medicare Advantage has several benefits over Original Medicare, there are also a few other considerations that need to be made before choosing one Medicare option over another. If your parent has specific doctors or medical needs, you will need to check to make sure those healthcare providers are in-network and whether or not they will need a referral to see certain specialists.

If a Medicare Advantage plan covers all of your parents’ providers and services, however, then it can be a great option for anyone looking for a “one-stop shop” option for their health insurance needs.

Factoring in Medicare Part D

Medicare Part D provides coverage for prescription drug costs. This plan is offered by private insurance carriers and is available for purchase as a separate stand alone plan for those with Original Medicare or can also be included as part of a Medicare Advantage plan.

Policies vary by cost and which medications they cover, but even the least expensive prescription drug plans cover most of the generic and brand name drugs generally needed by people on Medicare. 

Even if your parents are not currently taking any expensive medications, it is still wise to be enrolled in at least an inexpensive drug plan as there are high financial penalties for adding it later.

Don’t Forget About Medicare Supplement Plans

A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs that Original Medicare does not cover. This may include copayments, coinsurance, and deductibles. 

Not everything falls under Medigap, however. A supplement plan may not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

With a supplement plan, healthcare costs will first be covered by Original Medicare and any leftover may be covered by the Medigap plan. 

Making the Best Decision for Your Parents

Finding the right Medicare plan for your parents begins by reviewing their situation and estimating their future healthcare needs. 

Trusting a professional is another way to make sure you find the best options for their needs. By consulting a Medicare advisor, you get:

Want to make sure your parents have the best Medicare coverage for their healthcare needs? Our local advisors have decades of experience supporting Medicare beneficiaries in finding the right coverage.

You've worked your entire life, and now it's time to finally enjoy your retirement years. 

We all look forward to retirement, but when this new chapter of life begins, so do new experiences. You might be surprised by what you don’t know about retirement – from social security benefits to retirement age itself. 

Don’t stay in the dark! Gain peace of mind heading into retirement by familiarizing yourself with these little known retirement facts. 

Full Retirement Age is Not 65

While technically you can start claiming Social Security benefits at age 62, the full retirement age at which you become eligible to claim all of your Social Security benefits starts at age 66. For people born in 1960 or after the full retirement age will be 67.

The Social Security Administration’s increase in retirement age is a result of the rise in life expectancy – the idea is that if people are living longer, there is evidence to back the rise in the retirement age. 

Regardless of the retirement age requirements, be sure to keep in mind that you still become eligible for Medicare benefits three months before your 65th birthday.

Waiting Until Full Retirement Age to Enroll in Medicare Could Cost You

Waiting until full retirement age to enroll in Medicare could be costly for you. 

While people age 65 aren’t eligible for full retirement, they are eligible for full Medicare benefits.

It is essential to enroll in Medicare benefits as soon as you become eligible to ensure you avoid paying penalties on your monthly premium for Medicare Part B and Part D.

You should enroll for them during your Initial Enrollment Period (IEP). The IEP is the seven-month window around your 65th birthday (three months before and the three months after your birth month). 

If you miss your window, you could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual or General Enrollment Periods, which at specific times of the year.

Some States Tax Social Security Benefits

If you've qualified for Social Security benefits, you probably have taken some solstice in the fact that you will receive a Social Security check each month for the rest of your life. 

Although that is true, your state might tax your benefits. 

Those taxes could affect up to 85% of your total benefit if your individual income is over $34,000 per year ($44,000 per couple). Thirteen states currently impose taxes on Social Security benefits. Check with your state tax agency to see where your state stacks up to ensure you are realistic about the Social Security benefits you'll be able to use for day-to-day expenses.

Social Security Won't Likely Cover All Of Your Expenses

Retirement living has its benefits, but it’s not free. That’s why financial planners recommend building retirement savings and planning for the future. Financial planning is essential to ensure that you have the money you need to not simply “get by” but to enjoy your retirement.

Creating a budget is the best place to start. If you haven’t been diligent about budgeting in the past, now is a great time to start planning for your monthly expenses and long term goals.

Financial planners suggest that you need to replace 80% of your income once you retire. Likely, your Social Security benefits will not meet that benchmark. 

Social Security provides a standard of living comparable to the bottom quarter of earners in the United States. If your standard of living requires an income higher than $30,000 a year, you need to consider how you will supplement your benefits. 

Original Medicare Doesn't Cover Everything

Medicare parts A and B are considered Original Medicare. Medicare A is hospital insurance and covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Medicare B is general medical insurance and covers certain doctors' services, outpatient care, and preventative services. 

Healthcare services such as dental and vision care are not covered by Original Medicare.

If you need extra benefits like prescription drug coverage, dental, hearing, vision, and others, you should consider enrolling in Medicare Part C, also called Medicare Advantage

There are also a variety of Medicare Advantage plans available to meet your unique needs during retirement.
Understanding how Medicare works in retirement isn’t easy. Luckily, you’re not alone. If retirement is in your near future, make sure you're prepared by scheduling an appointment with a Medicare Advisor in your community.

Turning 65 soon? Congratulations! While we hope you're planning a big party to celebrate, we also want to make sure you're planning for another important marker of turning 65: Medicare enrollment. Of course, planning for Medicare isn't nearly as fun as planning a celebration, but we're here to make it as easy as possible. In this article we cover everything you need to know about Medicare when you turn 65.

Medicare Eligibility Begins 3 months Before Your 65th Birthday

If you have questions regarding your eligibility for Medicare coverage, the Medicare age limit, or about the program in general, then you’re not alone. Many seniors are inundated with Medicare information, yet still left with questions. The first thing you need to know is that Medicare eligibility begins three months before your 65th birthday.

Medicare is generally available for any individual approaching or at the age of 65. Though, in some cases, people under the age of 65 might qualify because of specific disabilities. You can check your eligibility using our Medicare Eligibility Check.

If You Miss Your Initial Enrollment Window, You Could Experience a Gap in Coverage

It is imperative that you enroll in your Medicare benefits during your Initial Enrollment Period (IEP). The IEP is the seven-month window around your 65th birthday (three months before and the three months after your birthday month).

If you miss your window, you could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual Election Period or Open Enrollment Period, which occur at specific times of the year.

Some specific instances allow an individual to qualify for a Special Election Period (SEP), such as losing employer coverage or moving. But those circumstances are limited – so it’s best to make sure you’ve enrolled within your specific window.

Medicare Has Multiple Parts

You might be wondering precisely what Medicare is. Essentially, it is a federal health insurance program with multiple types of coverage.

Did You Know That Some Individuals Qualify for Medicare Premium-Free?

You can get Part A Medicare premium-free if you meet one of the following requirements:

There is a premium for Parts B & D, but this can be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.

Original Medicare Might Not be the Best Option for You 

Medicare Advantage is basically an all-in-one alternative to Medicare itself. Medicare Advantage plans are a simple way for you to gain more out of Medicare. If you choose to enroll in a Medicare Advantage Plan, you’ll still have Medicare while receiving access to additional coverage such as dental, vision, and more.

In addition, the plans have a history of the higher average quality of health outcomes in participants. As a result, they have been strongly supported by the Medicare Trust Fund and others who legislate our healthcare nationally.

Click here to learn more about what Medicare Advantage plans cover. 

Need a set of reminders to help make sure you don't forget about your Medicare enrollment window? We've got your back! Click here to see our top reminders for seniors turning 65.

We hope this information aids you as your make plans to enroll in Medicare. Nevertheless, it's not uncommon to have questions about Medicare. That's what we're here for! Find a local advisor who can help you understand your Medicare options today.

Turning 65 this year? Well, we’re here to make sure that life keeps getting better with age. These 6 steps can help to ensure that you’re on track to take easy street through the next steps of your life:

Schedule A Physical And Routine Screenings

You might be under the impression that medical screenings are for diagnosing issues once symptoms present themselves. 

This is absolutely not the case. Individuals who schedule routine physicals and screenings can get an early diagnosis if they are developing a medical condition – increasing the likelihood of success for medical intervention and thus life expectancy.

Regularly scheduling tests creates a basis for physicians to compare results as time passes, which helps them get a more well-rounded perspective of your individual needs. 

Talk to your doctor to determine which regular screenings you should take based upon your age, family medical history, and more. While you’re at it, also talk to your doctor about what Medicare plans they accept. This will be important to know when you select a Medicare plan when you turn 65.

Consider Your Long-Term Health Coverage Needs

As you age, your medical coverage needs will change. For example, if you have risk factors for certain diseases, you might want to consider the need to treat those if they do, in fact, develop later in life. 

Being proactive starts by having the right conversations with your doctor to determine how to best plan for your future health so that you're covered – regardless of what life throws your way.

One important factor to take into account when considering your long-term health is having the right healthcare coverage. Choosing a plan simply based on their current health needs is one mistake many newly eligible Medicare beneficiaries make. Talking with your doctor as well as a Medicare advisor can help you prepare for the future.

Review Your Finances (Taxes, Retirement, Etc.)

While financial planning may feel overwhelming, it's important to have a handle on your finances in this stage of life.

Budgeting

Start by making sure you have a budget to grasp the full range of expenses you will have each month. 

Financial planners suggest that you need to replace 80% of your income once you retire. Likely, your Social Security benefits will not meet that benchmark. Social Security provides a standard of living comparable to the bottom quarter of earners in the United States. If your standard of living requires an income higher than $30,000 a year, you need to consider how you will supplement your benefits. 

Additionally, turning 65 also means you become eligible for Medicare, which impacts your finances in more ways than you may realize. For example, there are different Medicare plan options, including plans with $0 premiums but high out of pocket costs or vice versa. 

Choosing a plan that fits your budget needs in this stage of life is important. You may be eligible for Medicare costs savings programs or a Medicare Supplement plan that helps cover your out of pocket expenses, like copays, deductibles, and coinsurance. 

If you’re concerned about how Medicare will impact your finances, consider meeting with a Medicare advisor

Taxes and More

Beyond basic expenses, it’s also important to understand your taxes in this stage of life. 

For example, where you live can impact what taxes you pay in retirement. Some states offer better tax implications for seniors, such as Florida and New Hampshire – if you’re considering moving when you retire check out the best states for seniors to retire in.

Furthermore, your taxes can impact your Medicare costs. If your adjusted gross income (AGI) reported on your taxes is above a certain level, you may incur a surcharge on your Medicare Part B and Part D plan premiums. This surcharge, referred to as IRMAA, can significantly impact your health coverage costs. 

The surprising part?

IRMAA is based on your taxes from 2 years prior! For this reason, it’s important to understand how IRMAA works and what you might be able to do to avoid the costly surcharge.

Ultimately, it’s crucial that you have a full picture of your finances as you enter this new stage of life.

Get Ready For Medicare – Find A Medicare Advisor For This Next Stage Of Life

It is essential to enroll in Medicare benefits as soon as you become eligible during your Initial Enrollment Period (IEP). 

The IEP is the seven-month window around your 65th birthday (three months before and the three months after). If you miss your window, you could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual Enrollment Period.

If you have entered your Medicare eligibility window, schedule an appointment with a Medicare Advisor in your community who can help you in this transition. 

Not eligible yet, but turning 65 in the near future? Explore more of our Medicare Resources. We cover everything from Medicare Advantage to Part D Prescription Drug plans and more! Being familiar with the ins and outs of Medicare will help you make the best decision when you do become eligible.

  • This field is for validation purposes and should be left unchanged.

Receive helpful Medicare reminders, updates, 
and information conveniently in your inbox.


We are
Your
Neighborhood
Medicare Advisors

Speak to your advisor
Copyright © 2023 Plan Advisors, LLC · Privacy Policy · Website Design by The Marketing Squad
Plan Advisors Washington
crossmenu