How to Apply for Medicare in Kansas City
Medicare eligibility and Medicare enrollment is very confusing and complicated, so if you are feeling overwhelmed as you approach Medicare age know that you are not alone! 10,000 people turn 65 every day and many people are confused and not sure how to approach their Medicare decisions at that age. Adams Insurance Services is here to help answer questions on Medicare enrollment for Kansas City residents.
If you have been a U.S. citizen for at least five consecutive years and have are at least 65 years old, you are eligible for Medicare. Meeting these eligibility requirements allows you to qualify for both Medicare Parts A and B, which are automatically available and managed by the federal government. There may be some special circumstances, like disabilities and health issues, where you can be eligible for Medicare earlier than 65. However, the 65 year old age group has an Initial Enrollment Period (IEP) for Medicare. This IEP covers the three months before, the month of, and three months after your 65th birthday.
What Does Medicare Cover
“Original Medicare” may be a term you are familiar with. This usually refers to your automatic enrollment in Medicare Parts A and B, and is offered as a federal health insurance program. But there is a catch – Medicare Parts A and B do not cover all healthcare costs. Private insurance companies offer additional options to buy Medicare Supplemental Insurance, Medicare Part D, or Medicare Advantage which help cover additional healthcare costs in Kansas City.
What is Medicare Part A
Medicare Part A is provided by the federal government to cover:
- Inpatient hospital stays
- Skilled nursing services
- Hospice care
- Certain blood transfusions
- Impatient mental health
As long as you have paid into Social Security for at least 10 years, you will not pay premiums in Part A. However, if you have not met these minimum contributions, or if you enrolled in Medicare Part A after the IEP, monthly premiums will be high. The other costs associated with Part A include:
- 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. 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 effected by medical history or pre-existing conditions. To sign up for Medicare Part A, enrollment is automatic with your Social Security payments, or you can sign up at your local Social Security office.
What is Medicare Part B
At the time you reach Medicare eligibility, you also 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 has no cost, with Part B you will pay monthly premiums based on yearly income. If you wait to join Medicare Part B after your personal Initial Enrollment Period (IEP), your monthly premium will be higher. Regardless, if you receive Social Security, your monthly premiums are deducted automatically from your Social Security benefits. Some additional costs associated with Medicare Part B include:
- 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 are will vary between situations, such as care outside the U.S., which is usually not 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. The excess charges Part B will not cover will often occur, but vary wildly. Medicare Part B has no maximum on out-of-pocket expenses.
When you sign up for Medicare Part B, be sure to enroll as soon as you are eligible during your Initial Enrollment Period. There is also an 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 individual 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
A number of things are not covered by Medicare Parts A and B, such as deductibles, coinsurance, premiums, prescription drug coverage, vision, hearing, dental, and more. Private Kansas City Medicare providers can provide additional Medicare coverage plans to help cover these 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.
Kansas City 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.