There are 4 Parts to Medicare:
Part A = Hospital Insurance (Inpatient) Is typically premium free, taxes paid during your working years pays for Part A.
Part B = Medical Insurance (Outpatient) Is not premium free. The standard monthly premium for those enrolling in 2020 is $144.60. Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago to determine your Part B rate.
(Medicare Parts A & B are referred to as ORIGINAL MEDICARE) Original Medicare does not cover preventative dental or routine vision. Click the link at the top right of this page to look at dental and vision plans.
Part C = Medicare Advantage Plans (offered by private insurance companies approved by Medicare)
Part D = Prescription Drug coverage (offered by private insurance companies approved by Medicare)
Once enrolled into Medicare A & B you then have to choose from one of the two options available:
The alternative to Original Medicare is a Medicare Advantage plan (Part C). Part C plans include all Part A, Part B and most times Part D prescription drug coverage, all in one plan. Part C plans have networks. There are 53 Medicare Advantage plans available in Berks County in 2020. Part C plans have monthly premiums from as low as $0 all the way up to $301.00. Each plan assigns a copay for each medicare service with no 2 plans being the same. Some plans will include extra benefits that are not covered by Original Medicare such as; preventative & comprehensive dental, routine vision with an allowance toward glasses and/or frames, a hearing aid allowance, free transportation to medical appointments, a monthly stipend to use for over the counter items and gym memberships, to name a few.
Keep Original Medicare (your red, white and blue card) and purchase a Medicare Supplement plan. There are no networks with Medicare Supplement plans. There are 11 Plans to choose from. Each one has a different level of coverage. The Plans available are: Plan A, B, C, D, F (High deductible F) G, K, L, M & N. Each Plan of the same letter has the same benefit regardless of the company you purchase it from but the price definitely will vary.
Plan C & F are only available to eligible Applicants with a 65th birthday prior to 1/1/20 or with a Medicare Part A effective date prior to 1/1/20.
Part D Prescription Drug coverage:
When you keep Original Medicare you'll need to enroll in a separate Part D Prescription Drug plan. There are 31 Drug plans available in Berks County in 2020. Medicare says enrolling into Part D is optional. But if you don't enroll when you're first eligible or went longer than 63 days without creditable drug coverage. You'll have to pay this penalty for as long as you're enrolled in Part D prescription drug coverage.
Make sure your prescriptions are on the Part C or Part D plan's formulary before enrolling!
Make sure your doctors and specialist are in the Part C plan's network before enrolling!
If you are not on an employer plan and are not collecting Social Security, call Social Security within 3 months of turning 65 to schedule an appointment. You can also enroll online at SSA.GOV
Reading's SS office phone number: 1-866-274-5960
If you are collecting Social Security you will automatically receive your Medicare card within 3 months of turning 65. If receiving Social Security Disability payments, you'll automatically receive your Medicare card after the 24th monthly payment.
You can delay enrolling into Part B of Medicare without penalty if:
1. You have employer coverage due to active employment, either yours or your spouse's.
2. The employer where you have the coverage has more than 20 employees.
If you're already enrolled in Medicare you'll have a Special Enrollment Period when you're ready to retire. You'll have 63 days after your employer coverage ends or employment ends, whichever is later, to enroll in a Medicare Advantage Plan, Prescription Drug Plan or a Medicare Supplement Plan.
These are just a few scenarios.
Your insurance needs are specific to you. Whether it's a Medicare Supplement plan, a Prescription Drug plan or a Medicare Advantage Plan you want, I'll shop the market and select the plan that's best suited for you.
I received my Pennsylvania Insurance license in April 2006 and began my insurance career selling Life insurance and Annuities. During this time I worked with companies such as Monumental Life Insurance and American General Life Insurance. I was introduced to Medicare in 2013 and have been helping clients in this market ever since. I have helped hundreds of people maneuver through the Medicare maze.