How to Apply for Medicare in Wichita

Understanding Medicare eligibility and Medicare enrollment is a challenge for every single person who arrives at the Medicare age and that number is high. 10,000 people turn 65 every day and no one knows exactly what they need to decide on at that age. To make it easier, Adams Insurance Services is here to help with the basics on Medicare enrollment for Wichita residents.

In order to be eligible for Medicare, you must be 65 years old and be a U.S. citizen for at least five consecutive years. Meeting eligibility requirements allows you to qualify for Medicare Parts A and B which are automatically available and managed by the federal government. Sometimes there are special circumstances, like disabilities and health issues, where you can be eligible for Medicare earlier than 65. However, the 65 age group has the Initial Enrollment Period (IEP) for Medicare which covers the three months before, the month of, and three months after your 65^th birthday.

What Does Medicare Cover

You may have heard the term “original Medicare” which is your automatic enrollment in Medicare Parts A and B, offered as a federal health insurance program. Here is the 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 Wichita.

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

If you have paid into Social Security for at least 10 years, you will not pay premiums in Part A. However, if you have not contributed enough to Social Security or if you enrolled in Medicare Part A late, monthly premiums will be high. The other costs that come 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 (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

Medical history or pre-existing conditions do not affect Medicare enrollment in Part A. To sign up for Medicare Part A, enrollment is automatic with your Social Security payments. Otherwise you can sign up at your local Social Security office.

What is Medicare Part B

At the time of Medicare eligibility, you 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
• Ambulance
• 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, in 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, your monthly premium will be higher. Regardless, your monthly premiums are deducted automatically from your Social Security benefits if you receive Social Security. 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 entirely dependent on the situation, such as care outside the U.S. which is usually not covered. Another example is how much you could 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 vary but often occur. There is no maximum out-of-pocket for Medicare Part B.

To sign up for Medicare Part B, be sure to enroll is as soon as you eligible during your Initial Enrollment Period. You can also sign up during the 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. 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

Deductibles, coinsurance, premiums, prescription drug coverage, vision, hearing, dental, and more are often not covered by Medicare Parts A and B. Additional Medicare coverage plans offered by private Wichita Medicare providers are available 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 Wichita Medicare Insurance Providers

Here are the many Medicare providers in Wichita we work with to provide Medicare Part D plans, Medicare Advantage plans, and Medicare Supplemental plans.