Medicare Made Easy
A simple guide to understanding Medicare and your available options
What is Medicare?
Medicare is a federal health insurance program for people...
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Ages 65 and older​
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Under age 65 with certain disabilities
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Any age with end-stage renal disease or kidney failure
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Original Medicare provides a menu of benefits, but it isn't a complete package and although deductibles, coinsurance and copays are competitive, there are no limits to the amount of money you can spend out of pocket, which could leave you responsible for paying thousands in out of pocket costs.
The Big Question?
You may be wondering "Do I need to enroll in Medicare?" and for most people turning 65, the answer is yes.
However, it still depends on your exact situation. Before we proceed with simplifying your understanding of Medicare, it's important that we determine when you need to take action.
Click the button to be redirected to Medicare's eligibility tool, where you can answer a few short questions and estimate your deadline to enroll into Medicare without any future re-occurring penalties.
Once completed, write your results down - you'll specifically want your Initial Enrollment Period dates.
Medicare Part A
helps cover costs associated with inpatient hospitalization, skilled nursing, hospice and blood services.
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There is no yearly limit on annual out of pocket costs.
For most people, Part A premiums start at $0/mo
A
Inpatient Hospitalization
You Pay
Part A Inpatient Deductible
Days 1 - 60
$1,632
Daily Inpatient Copay
Days 61 - 90
$408
Daily Inpatient Copay
Days 91 - 150
$816
Daily Inpatient Coinsurance
Days 151+
100%
A
Skilled Nursing, Hospice & Blood
You Pay
Skilled Nursing Confinement
Days 1 - 20
$0
Daily Skilled Nursing Copay
Days 21 - 100
$204
Skilled Nursing Coinsurance
Days 101+
100%
Hospice Care
Certified Terminal
Respite Care
0%
5%
Blood
Pints 1 - 3
Pints 3+
100%
0%
Medicare Part B
B
Physician, Outpatient Care & Labs
You Pay
Part B Deductible
Annual (2022)
$240
Medical Expenses
Coinsurance
20%
Outpatient Hospital Services
Minimum Coinsurance
Additional Hospital Costs
20%
100%
Excess Doctor Charges
Max 15% of Approved Amount
100%
Medical Expenses
Coinsurance
0%
B
Home Healthcare & Blood
You Pay
Home Healthcare
Costs For Care
Durable Medical Equipment
0%
20%
Blood
Pints 1 - 3
Pints 3+
100%
20%
helps cover costs associated with physician services, outpatient care, blood, tests and supplies.
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Part B also has no yearly limit on annual out of pocket costs.
For most people, Part B premiums start at $164.90/mo for 2023.
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Starting Jan, 2024
Part B premiums start at $174.70/mo
Covering the Gaps of Original Medicare
There are 2 main ways to cover the gaps with Original Medicare. Both options have their advantages, depending on what you personally find valuable. Luckily, both options are easy to understand, so relax and take a deep breath, this is going to be easier than you think.
Medicare Supplement
Also known as Medigap
Important questions to consider...
Do I have freedom to choose my providers/hospitals?
Do I need referrals to see a specialist?
Can my plan benefits change?
Is coverage guaranteed renewable if premiums are paid?
Does it include prescription drug coverage?
Medicare Advantage
Also known as Part C
Medicare Supplement
Medicare Advantage
Yes
No
No
No
Yes, if HMO
Yes
Yes
No
Purchase Seperately
Usually, Yes
Now hang on, let's not get ahead of ourselves...
Medigap plans generally charge more in monthly premiums than the alternative, Medicare Advantage.
It's important to shop both options carefully and make sure you stay with a price that you can comfortably afford.
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Additionally, Medicare Supplement and Medicare Advantage plans vary by insurance company. Premiums, deductibles and out of pocket costs can vary by plan, and in some cases if you make the wrong decision now and want to change in the future, you may be subject to health underwriting, meaning not everyone will be accepted.
It's important to make the right decision today to help avoid these risks in the future.
Part D
Prescrition Drug Coverage
Medicare drug coverage helps pay for out of pocket prescription drug costs. Even if you don't take prescription drugs now, you should consider getting a stand alone part D plan or a Medicare Advantage plan that includes it.
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If you decide not to get Part D when you're first eligible, and you don't have other credible prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you'll likely pay an ongoing late enrollment penalty. when you finally join a plan.
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Generally, you'll pay this penalty for as long as you have Medicare drug coverage.
Avoid Late Enrollment Penalties
If you do not enroll into Original Medicare when you are first eligible, you may face re-occurring penalties, which in some cases must be paid for as long as you live.
A
Part A Penalty
10% penalty based on your Part A premium. You will have to pay the penalty for twice the number of years you weren't signed up.
Doesn't apply to premium-free Part A.
B
Part B Penalty
10% penalty for each 12 month period that you weren't signed up, multiplied by your Part B premium.
Penalty is paid monthly for life.
D
Part D Penalty
1% penalty multiplied by the "national base premium", times the number of months you didn't have Part D or creditable coverage.
Penalty is paid monthly for life.
My employer has less than 20 employees, do I need Medicare?
Answer: If you have a group health plan and your employer has more than 20 employees, you still need to enroll in Part A, but you can wait to enroll into Parts B & D until you stop working or lose health insurance, whichever comes first.
You may also face re-occurring late enrollment penalties, which in some cases may be lifetime.
CMS Required Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.