Medicare Supplements

Medicare is federally funded health insurance for people age 65 and older. Certain disabled persons under 65 can also qualify for Medicare. Medicare does not pay for all the medical expenses of covered individuals.

There are four parts to Medicare:

• Part A helps pay for inpatient care in a hospital or nursing facility following a hospital stay, some home health care and hospice care.
• Part B helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance. For individuals new to Medicare in 2011 the average Part B premium is $115 per month. This amount is higher for singles earning more than $85,000 or couples earning over $170,000.
• Part C, Medicare Advantage, plans are available in many areas. People who qualify for Medicare Parts A and B can choose to receive all of their health care services through an one of the approved providers under Part C.
• Part D, Prescription Drug Coverage, helps pay for medications prescribed by doctors. Starting this year, 2011, high income earners will pay a surcharge for this coverage.

Here are some tips for North Carolina residents turning 65:

1. If you have retired or are retiring from a government agency or private company, check to see if it pays for part or all of your Medicare supplemental coverage or drug plan.
2. Since Medicare does not pay for all medical expenses, most Medicare beneficiaries purchase a Medicare Supplement and a drug plan or a Medicare Advantage Plan with drug benefits from a private insurance company. With either choice you will continue to pay your monthly Part B premium. Contact Social Security at 800-772-1213 for more information.
3. Medicare Supplements do not cover prescription drugs. If you do not purchase a drug plan when you first become eligible, you may be charged a higher premium if you purchase one later. Low-income individuals may quality for financial assistance through government programs.
4. The best time to purchase a Medicare Supplement, drug plan, or Medicare Advantage plan is during the three months prior to your 65th birthday. By so doing you avoid the risk of a break in coverage, paying higher premiums (being “rated up”), or being declined due to your health.
5. Consider a Medicare Advantage Plan if you are healthy and want the lowest premiums. In addition to offering low premiums and drug benefits, they often include extras such as gym memberships and dental and vision benefits. However, these plans typically require co-payments, have hospital deductibles, and restrict you to certain doctor and hospital networks. These limitations are not typical with popular Medicare Supplement Plans like Plan F.
6. The government provides information to help you select the best plan for your situation, including the handbooks Medicare and You and Choosing a Medigap Policy, the Seniors’ Health Insurance Information Program (SHIIP, 800-443-9354), and the website www.medicare.gov (800-633-4227).
7. What appears to be your least expensive option today might change in the future. Medicare Supplements assign rates by three different formulas:
   • In Community-Rated plans, everyone in the same area, such as NC, pays the same, but rates can increase due to inflation and other factors.
   • In Entry Age plans, rates may go up due to inflation and other factors, but not your age.
   • In Attained-Age plans, premiums increase with age and inflation.

   Additionally, some insurance companies offer high discounts initially that gradually disappear and leave the beneficiary with higher than anticipated monthly payments.

8. Despite these resources, selecting the best plans from among the choices can be confusing. An independent licensed agent like myself who represents multiple insurance companies can help you sort out your best options from the dozens of plans and providers available. Since we are compensated by the companies we represent, you will not pay an extra fee or a higher premium for taking advantage of our services. Contact Paul Hanlon at (919) 924-6277 or paul@apexhealthinsurance.com for more information or to apply for a Medicare Suppliment plan.