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FAMILY BENEFIT SERVICES

Medicare

We have experienced licensed agents available to help you navigate through all of your healthcare options. We’re here year round to walk you through each step of the process.  

Choosing the Medicare Individual Health Insurance Plan that Works for You.

OUR MEDICARE PARTNERS

What am I eligible for when it comes to Medicare Health Insurance?

If you are a permanent U.S. resident over 65 or are under 65 with certain disabilities or illnesses, you may be eligible for the federally funded health insurance program known as Original Medicare.

If you receive Social Security disability benefits for 24 months, not only are you eligible- you will be enrolled in Original Medicare in the 25th month.

Many people are also automatically enrolled on their 65th birthday and can expect their Medicare cards 3 months beforehand.

We can assess your eligibility and help you apply @ no cost to you! Contact us today >>

Here’s how to tell if you’re eligible:

I’m under 64.

You may qualify for full Medicare benefits if you are 64 or under and:

You have received Social Security Disability benefits for 24 consecutive or nonconsecutive months.

You receive a disability pension from the Railroad Retirement Board.

You have Lou Gehrig’s disease.

You have End-Stage Renal Disease (ESRD).

Under 64? Start planning for the future with Family Benefit Services

I’m 64.

You may qualify to enroll in a Medicare plan during your Initial Election Period:

3 months before your 65th birthday on the month of your 65th birthday and the 3 months after your 65th birthday. 

Even if you don’t qualify for full benefits, you can still enroll in Original Medicare at a premium. 

Almost 65? Get ready for your Initial Enrollment Period with Family Benefit Services.

I’m over 65.

If you are 65 or older you may qualify for Medicare and can enroll during the General Election Period:

January 1 – March 31 for a July 1st effective date.

There is also a Special Enrollment Period where certain qualifications or circumstances allow you to enroll outside of Open Enrollment. 

Even if you don’t qualify for full benefits, you can still enroll in Original Medicare at a premium.

Get ready for your General Election Period with Family Benefit Services.

Medicare was first introduced in 1965 to help make healthcare more affordable and more accessible than ever before.

BUT, the application process can be daunting if you’re not entirely familiar with filing for federal benefits programs. So before you apply, let’s talk about the different parts that make up an individual insurance plan with Original Medicare.

There are two parts to Original Medicare: Part A (hospital insurance) and Part B (medical insurance)

Part A covers hospital insurance for inpatient stays as well as services from a skilled nursing facility, hospice center, and select home service companies. 

Most people don’t have to pay a monthly premium for Medicare Part A. This is because you’ve already paid into the system in the form of Medicare tax deductions on your paycheck. 

But Part A doesn’t cover everything. You must pay a deductible of $1,556 before Medicare Part A kicks in and starts paying for your care. After that, you can expect Medicare Part A to cover about 80% of inpatient care during that benefit period.

If you are 65 or older, you will be eligible for Medicare Part A if one of the following applies to you:

  • You are eligible for Social Security benefits
  • You are eligible for Railroad Retirement benefits
  • You or your spouse (living, deceased, or divorced) was employed somewhere where Medicare taxes were paid for 40 or more quarters.
 

If none of this applies to you, you can still receive Medicare Part A by paying a monthly premium, so long as you are a legal U.S. citizen or have lawfully lived in the U.S. for at least five years. You will automatically be eligible for Part B Medicare, which covers doctor services if you are eligible for Part A.

Medicare Part B, also called “medical insurance”, covers things like doctor’s visits, mental health services, some preventative care, and more.

Medicare Part B is an optional additional coverage that covers doctor’s services, outpatient care, medical supplies, and preventive healthcare services. Everyone pays a monthly premium for Part B, which usually costs around $170.10 for those new to Medicare as of 2021.

You will also have to make other cost-sharing payments for care, like a deductible, copays, and coinsurance. Similarly, you can expect Part B to pay up to 80% of covered care.

People who are still working or covered by their spouse’s health plan may want to delay their Part B enrollment. However, if you delay your enrollment and do not have creditable coverage, you may have to pay a higher monthly premium as a penalty for not signing up during your initial enrollment period.

What is NOT covered by Original Medicare?

  • Most prescription drugs
  • Long-term care
  • Routine dental care or dentures
  • Routine vision care
  • Routine hearing care or hearing aids
  • Routine foot care
  • Other alternative treatments.

Original Medicare does not cover everything, but at Family Benefit Services you can find extra coverage for the important things, like prescriptions and routine dental care. 

If you want to learn about these plans and extra coverage, we are here to help! Contact us today >>

Enrollment Periods for Medicare.

Initial Enrollment Period

The IEP is the time during which a person who is newly eligible for Medicare may make an initial enrollment request to enroll in Original Medicare, a Medicare Advantage (MA) plan or a Medicare Prescription Drug plan.

For most people, the IEP is the seven-month period that begins three months before you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

If you don’t enroll in Part B when you’re first eligible, you can enroll between January 1 and March 31 each year, during the General Election Period. However, you may have to pay a late enrollment penalty unless you qualify for a Special Enrollment Period (SEP).

If you delay enrolling in Part B because you have group health coverage based on current employment, you’re entitled to an SEP at any time during which you may enroll in Part B. You may also enroll in Part B during an eight-month SEP beginning the month after your employment ends or the group health coverage ends, whichever happens first, and will usually not have to pay a late enrollment penalty.

Get help with your Initial Enrollment Period @ No Cost To You! Contact us today >>

Annual Enrollment Period October 15 - December 7

The Annual Enrollment Period (AEP) is the time each year when you can choose which kind of Medicare coverage you want to enroll in effective January 1 of the following year.

For example, if you want to change Medicare Advantage (MA) plans because your needs have changed, or if you decide to change from a Medicare Advantage (MA) plan to Original Medicare with a Medicare Supplement insurance plan, you may do so during the AEP. Coverage takes effect on January 1 of the following year.

Not sure if you want to change your Medicare plan? Contact us today >>

If you’re not sure whether you qualify for a Special Enrollment Period (SEP) contact us today >>

Special Enrollment Period (SEP)

Certain circumstances may qualify you for a Special Enrollment Period (SEP) that allows you to enroll for Medicare outside of open enrollment. These circumstances include:

  • Moving to a new residence
  • You already have Medicaid
  • You are eligible for Extra Help with Medicare prescriptions
  • You have lost access to your employer’s health plan
  • You have a covered chronic health condition
  • You are not enrolled in a Five Star program and one is available in your coverage area

Unbiased Help @
No Cost to You.

Determining which Medicare Parts are right for you is an important decision you make before sending in your application.

Your choice of Medicare plan should be made with your long-term healthcare needs in mind. Our team has helped thousands choose a Medicare plan that was right for them. We can guide you through every step of the process.