How to Apply for Medicare in Coffeyville
If you don’t know where to begin with Medicare eligibility and Medicare enrollment, you are not the only one! 10,000 people turn 65 every day and this is a challenge for everybody as they reach Medicare age. Many people are confused and don’t know where to look for help to understand the Medicare system and how it will, or won’t, cover their healthcare needs. To make it easier, Adams Insurance Services understands how overwhelming this time is, and is here to help Coffeyville residents with the basics on Medicare enrollment.
Once you reach 65 years of age and have been a U.S. citizen for at least five consecutive years, you are eligible for Medicare. Meeting eligibility requirements means you are qualified for Medicare Parts A and B, which are automatically available and managed by the federal government. Your Initial Enrollment Period (IEP) covers the three months before, the month of, and the three months after your 65th birthday. There are occasionally special circumstances, like a disability or specific health issues, where you can be eligible for Medicare earlier than 65.
What Does Medicare Cover
Original Medicare is a federal health insurance program, which includes automatic enrollment in Medicare Parts A and B. It should be noted that Original Medicare is not an all-inclusive healthcare plan – Medicare Parts A and B do not cover all healthcare costs. You may need to purchase additional coverage through a private insurance company, such as Medicare Supplemental Insurance, Medicare Part D, or Medicare Advantage which help cover additional healthcare costs in Coffeyville.
What is Medicare Part A
Medicare Part A is provided by the federal government to pay for:
- Inpatient hospital stays
- Skilled nursing services
- Hospice care
- Certain blood transfusions
- Impatient mental health
Part A does not have premiums, as long as you have paid into Social Security for at least 10 years. However, if you have not contributed enough to Social Security or if you enrolled in Medicare Part A outside of your Initial Enrollment Period, monthly premiums will be high. The are other costs that are associated with Part A, such as:
- You pay a deductible before Part A starts paying costs for each hospital stay.
- If you stay in a hospital for longer than 60 days, you will pay a daily copay (instead of what?). The copay rises after 90 days in a hospital.
- If you stay in a skilled nursing facility for longer than 20 days, you pay a copay.
- There is a copay for outpatient prescription drugs received in hospice care.
- You pay coinsurance for inpatient respite care for hospice patients.
Multiple hospital stays under Part A coverage could create multiple deductibles. Other coverage limits for Medicare Part A include:
- Hospital care outside of the U.S. (usually)
- Doctor services in the hospital
- Personal in-hospital costs (ie: custodial care)
- Prescription drug costs
- Additional Medicare benefits, such as hearing, dental, and vision
Medicare enrollment in Part A is not dependent on your medical history, or pre-existing conditions. To sign up for Medicare Part A you can contact your local Social Security office, but enrollment is automatic with your Social Security payments.
What is Medicare Part B
When it is determined that you have Medicare eligibility, you will receive Medicare Part B automatically, with the Social Security payments caveat. Medicare Part B covers:
- Necessary doctor visits and services
- Outpatient hospital visits, mental health, physical therapy, occupational therapy, speech-language therapy
- Laboratory services
- Durable medical equipment including wheelchairs, oxygen tanks, etc.
- Some preventive care, diagnostic screenings, and skilled nursing
- Dental, vision, and hearing only in certain limited situations
Unlike Part A, which does not have a fee for the basic coverage, Part B requires monthly premiums, which are based on yearly income. If you do not join Medicare Part B after your personal Initial Enrollment Period, during the yearly open enrollment period, this monthly premium will be even higher. Monthly premiums are automatically deducted from your Social Security benefits, if you receive Social Security. There can be some additional costs associated with Medicare Part B, such as:
- A deductible paid for the year before Medicare Part B starts paying a share of your costs.
- A copay for outpatient hospital visits.
- Coinsurance after a deductible is paid. Part B covers 80% of the Medicare-approved coinsurance and you pay 20%, generally speaking.
There are coverage limits that vary and depend on the situation. Such as, care outside the U.S. is not typically covered. Another example is how much you pay out-of-pocket for occupational therapy could change or not be covered, depending on when you get a screening. Encountering these excess charges could be an often occurrence and there is no maximum out-of-pocket expense for Medicare Part B.
To sign up for Medicare Part B, be sure to enroll is as soon as you are eligible during your Initial Enrollment Period. There is also an annual Open Enrollment Period that spans October to December annually, but there could be a penalty if you do not enroll at the time of Medicare eligibility during your Initial Enrollment Period. Like Part A, coverage for Part B cannot be denied because of medical history or pre-existing conditions.
Other Medicare Coverage Options from Private Companies
There are a number of expenses that are not usually covered by Medicare Parts A and B. Deductibles, coinsurance, premiums, prescription drug coverage, vision, hearing, dental, and more are a few of these expenses. You do have the option of purchasing an additional Medicare coverage plan, which are offered by private Coffeyville Medicare providers, to help cover the costs. There are two main additional Medicare plans:
- Option 1: Medicare Supplemental Insurance which covers some or all of the costs that are not covered by Parts A& B and/or Medicare Part D which covers prescription drug costs.
- Option 2: Medicare Advantage, also known as Medicare Part C, which combines Parts A & B to provide additional benefits. Most Part C plans cover prescription drug costs.
Adams Insurance Services, LLC provides these Medicare plans through the many Medicare providers we work with. Our personalized service and face-to-face consultations ensure we will find the perfect plan that meets your needs.
Our Coffeyville Medicare Providers
Here are the many Medicare providers we work with to provide Medicare Part D plans, Medicare Advantage plans, and Medicare Supplemental plans.
Get A Quote for Medicare Plans
Please use the form below to submit information and receive a personalized Medicare health insurance quote! You can also give us a call at 816-265-0859 to speak with Jeffrey Adams or Paula Wehba.
A sales agent may mail, call, or email as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans, or Medicare Supplement Insurance.