Understanding Maryland’s New Medicare Supplement Birthday Rule

Turning 65 shouldn’t be stressful.

Having the right Medicare information will help ease your transition into a wildly different health insurance system. The Medicare system has it’s own set of rules and regulations. From enrollment periods and mandatory coverage rules, to acronyms that will drive you crazy, Medicare isn’t the easiest thing to understand.

Follow A Simple Gameplan For A Smooth Transition

Working with a broker like myself will make your life much easier. I do this for a living and have helped 1,000’s of seniors since 2011. If you follow a simple gameplan, you’ll be into a Medicare plan without any hassles, penalties or delayed coverage. Just keep these 4 steps in mind:

1 – Make Sure Medicare Is The Top Choice

Turning 65 typically means that Medicare insurance is your only choice. But for some seniors, staying with your employer’s plan may be more beneficial. First, make sure your employer or Union will allow you to stay on their plan past age 65. Secondly, make sure they won’t charge you more than $350 per month for their plan, if they do, it is simply not worth staying on their plan. Lastly, try to figure out if your monthly premiums will rise dramatically in the first few years. Some teacher’s unions only subsidize 65+ health insurance for the first two years, in year three, the monthly premium nearly triples, making Original Medicare a much better option.

If you or your spouse served in the Military, you may be entitled to Military insurance benefits either through the Veteran’s Health Care system (VA) or through Tricare For Life. You are allowed to have both VA Benefits and a Medicare insurance plan. These dual-benefits work together to offer the veteran additional network options, either with care provided by the VA or with care provided by a provider outside of the VA system. However, if you qualify for Tricare For Life (typically after 20 years of military service) then you do not need additional Medicare coverage. In fact, adding any Medicare plans on top of what Original Medicare offers will actually disrupt your Tricare benefits.

2 – Determine If You Need To Apply For Medicare Part B

Medicare is made up of two basic parts, Medicare Part A covers Hospital Benefits and Medicare Part B covers outpatient services. Here’s the issue, if you have not yet turned 65 and are already collecting Social Security benefits, then you don’t need to apply for Medicare A or B, the Social Security Administration (SSA) will automatically enroll you into both A & B.

If you have not yet turned 65 and are not taking your Social Security benefits yet, and you want to start Medicare when you turn 65, you will need to apply to be enrolled into Medicare Part B (the Social Security Administration will automatically send you Part A up to 90 days prior to your 65th birth month regardless of your status).

Turning 65 will automatically trigger you being enrolled into Medicare Part A. Your enrollment into Part B is determined by your current SSA benefits status. To enroll into Medicare Part B, you can sign up for Medicare online, or you can arrange an appointment by finding a local SSA office and meeting them in person, or you can download OMB No. 0938-1230 which is an APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE). You will need to drop this off at your local SSA office or mail it to them, which should be sent with a tracking number and some way to prove it was received. Enrollment takes at least 10 to 14 days and longer during busy times, so be sure you plan accordingly. You can apply for Medicare Part B enrollment up to 3 months prior to your 65th birth month.

3 – Don’t Miss Vital Medicare Deadlines

There are many deadlines that must be followed when entering Medicare. Here are some of the most important ones:

Part B 90 Day Rule – File for Medicare B up to 90 days prior to your 65 birth month and up to 90 days after. If you miss this 7 month window, your coverage will be delayed by as much as a full year, including financial penalties. If you have sufficient credible coverage from an employer, you may not need to apply for Part B.
Part D Mandatory Coverage – Obtain Medicare Part D (prescription drug plans) within 63 days of your Medicare Part B becoming effective. If you don’t have credible coverage or sign up for a PDP plan, then you will start incurring penalties and your coverage will be delayed.
Loss Of Employer Coverage – Prior to losing your employer’s coverage, you should apply for Medicare Part B. However, once Part B starts, you’ll only have 63 days to enroll into a Part D drug plan or Part C Advantage Plan and up to 6 months to enroll into a Medicare Supplement Medigap Plan. Do not miss these guaranteed enrollment periods so you don’t have to answer any health questions.

4 – Understand Your Optional Medicare Insurance Plans

As you know, Medicare by itself doesn’t cover 100%. Original Medicare only covers about 80% of the Medicare allowed billable rates. So if that procedure costs $1,000 and you don’t have any other insurance to help pay for it, you may be billed up to $200 for that procedure. And since there are no spending limits (called Max-Out-Of-Pocket), if you end up in the hospital, the costs could skyrocket past your financial means. This is why it’s important to understand what options are available to you when you turn 65.

Turning 65 triggers several “additional” options for Medicare insurance such as Supplemental Gap Plans, Medicare Advantage Part C plans and Prescription Drug Plans (PDP). All of these have their pros and cons.

While I won’t go into great detail in this article about your Medicare gap insurance options, I will say that it’s best to call me for a free Medicare consultation. These plans offer something for everyone, and can be pretty robust in their benefits.

I can explain in simple terms what all your options are so you understand the scope of offerings. I’m licensed and authorized to sell all the different types of plans in Maryland and the surrounding states. I can be contacted directly at (410) 896-1212.

Hospital Indemnity Insurance

Hospital Indemnity Insurance: A Safety Net for Maryland's Seniors

Name: marylandmedicareoptions
Brand: marylandmedicareoptions
Rating: 5.0 (94 reviews)

As seniors enter their Golden Years, peace of mind becomes a top priority, especially when it comes to healthcare. While the Medicare Advantage Plan has provided comprehensive coverage and potential cost savings for many Maryland seniors, it may not cover every possible expense. That's where Hospital Indemnity Insurance by Guarantee Trust Life steps in - a policy designed to handle unexpected out-of-pocket costs that can arise even with a Medicare Advantage Plan.

What is a Hospital Indemnity Insurance Plan?

Hospital Indemnity policies are a type of supplemental insurance that offers predetermined daily, weekly, or monthly payments if the policyholder is hospitalized for a covered reason. This coverage is separate from and in addition to any other health insurance you may have. Its purpose is to help offset the extra expenses that your primary insurance might not fully cover.

Example of how this is helpful. Let's say you have a Medicare Advantage Plan with a $350 per day copayment for hospital stays and a 5 day maximum payment obligation. If you stay five days in the hospital, you will pay $1,750 (5 x $350). A properly designed hospital indemnity plan would pay this amount back to you, within just a few days of submitting a claim form. This benefit can be obtained for less than $1 per day.

Contact Peter Palmiotto to enroll: (410) 896-1212 or peterpalmiotto@gmail.com

Key Features of Guarantee Trust Life's Hospital Indemnity Insurance:

Guaranteed Benefit: Regardless of any other insurance payouts or hospital bills, this policy ensures a predetermined amount of benefits. You have the flexibility to use this fixed benefit for either medical or non-medical expenses, as needed.
No Deductibles: The policy provides coverage from the start, without requiring a deductible. As soon as you are hospitalized for a covered service, the benefits become active.
Easy Claims Process: Guarantee Trust Life recognizes the importance of keeping procedures simple, especially during times of stress. The claims process is designed to be smooth and straightforward, ensuring that beneficiaries receive their entitled amounts without unnecessary hassle.
Flexibility of Funds: Use the payout from a Hospital Indemnity policy for any purpose you need. Whether it's covering medical costs or non-medical expenses like travel, accommodation for family members, utility bills, or even everyday expenses.

Benefits of Investing in a Hospital Indemnity Plan:

Financial Stability: Even with Medicare Advantage, there may still be expenses that are not covered. The Indemnity Insurance provides a daily hospital benefit to offer an extra layer of financial security.
Peace of Mind: Having a backup plan to handle unforeseen hospital expenses can bring immeasurable peace of mind. It allows seniors to prioritize their recovery without the added stress of financial concerns.
Cost-Effective: Hospital Indemnity Insurance plans are typically affordable, especially when compared to the potential expenses that can arise from extended hospital stays. The most popular level of coverage starts at less than $1 per day.
Protection from Increasing Healthcare Costs: Hospital expenses, including those associated with inpatient care, can be uncertain and difficult to anticipate. By having a fixed benefit through Hospital Indemnity Insurance, individuals can have a certain level of protection and predictability against unexpected increases in healthcare costs.
Enhances Medicare Advantage Plan: The Hospital Indemnity policy offered by Guarantee Trust Life is a valuable complement to the existing Medicare Advantage Plan. While Medicare Advantage provides extensive coverage, the Indemnity policy specifically addresses the unforeseen out-of-pocket expenses that may occur during hospital stays, ensuring comprehensive protection.

Conclusion:

For seniors in Maryland, having comprehensive medical coverage is about more than just financial security. It's about enjoying their golden years without unnecessary concerns. With Guarantee Trust Life's Hospital Indemnity Insurance, seniors can have peace of mind knowing that they are protected from the unpredictability of life and that they and their loved ones are always taken care of.

Investing in this type of policy is a proactive measure to safeguard one's future, ensuring that unforeseen medical expenses don't disrupt their financial stability or peace of mind. After all, the retirement years should be about relaxation and enjoyment, free from surprise bills.

Learn more about additional plans I offer at: https://marylandmedicareoptions.com/extras/

The Benefits of A Medicare Advantage Plan

Medicare Advantage Plans in Maryland

Seniors often find the healthcare system overwhelming, particularly when it comes to choosing the right insurance. In Maryland, navigating Medicare options can be daunting. However, there is a solution that stands out for its extensive coverage and potential cost savings: the Medicare Advantage Plan.

What is a Medicare Advantage Plan?

Medicare Advantage Plans, also referred to as Part C, provide a comprehensive alternative to Original Medicare. These plans are offered by private companies that have been approved by Medicare and include coverage for both Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). In addition, many Medicare Advantage Plans also cover prescription drugs (Part D). These are called Medicare Advantage Prescription Drug plans, or MAPD.

Benefits of a Medicare Advantage Plan In Maryland:

In addition to the services provided by Original Medicare, many Medicare Advantage Plans offer additional benefits such as vision, hearing, dental care and transportation. Some plans even include gym memberships and money each quarter for Over-The-Counter items. This allows seniors to access a wider range of services without needing to buy extra coverage not offered by Supplement Plans.
Affordability: Medicare Advantage Plans can often provide cost savings compared to Original Medicare. While there may be premiums associated with these plans, many offer lower out-of-pocket costs. In fact, some plans even have a $0 premium, depending on your county and state. Additionally, Medicare Advantage Plans include an out-of-pocket maximum limit, ensuring that there is a cap on the amount you would spend in a given year.
Prescription Drug Coverage: The majority of Medicare Advantage Plans already include Part D coverage, which means seniors don't need to get a separate drug plan. This streamlined approach makes it easier for them to handle their medications and overall healthcare. While costs remain about the same as a separate Rx plan, the convenience of having a "bundled" insurance product is helpful.
Integrated and Coordinated Care: Certain Medicare Advantage Plans, like Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), prioritize integrated care. These plans establish networks of doctors and healthcare providers who collaborate closely to offer coordinated care. This approach enhances the overall quality of healthcare and improves health outcomes for patients.
Additional Services and Programs: In an increasingly competitive market, insurance providers are offering extra services to their customers. These include telehealth visits, nurse hotlines, and even transportation assistance for medical appointments. These additional services can be incredibly valuable for seniors, especially those who have difficulty with mobility or live in more rural parts of Maryland.
Options and Freedom: In Maryland, seniors have a range of Medicare Advantage Plans to choose from. Each plan comes with its own advantages, costs, and network of providers. This allows seniors the flexibility to select a plan that suits their specific needs and financial situation. They can carefully evaluate the doctors, specialists, and hospitals included in each plan and make an informed decision based on what best aligns with their preferences.
Convenient and Simplified Healthcare: With an all-in-one plan, managing your medical needs becomes easier. You can handle appointments, understand benefits, and deal with paperwork more effortlessly. Plus, you'll have a single ID card that covers all services, including doctor visits and pharmacy pickups.

Things to Consider:

Network Restrictions: Some healthcare plans, such as HMO or PPO, may impose limits on the healthcare providers you can visit. Going outside of the plan's network might result in higher costs for you. Typically your copayments will be up to 50% of the Medicare allowed billing rate. Plans and benefits vary by county and by plan.
Different insurance plans have varying costs. When comparing plans, it's important to look beyond just the monthly premium and consider factors such as deductibles, copayments, and coinsurance. The Max-Out-Of-Pocket (MOOP) is the financial limit that anyone on a Medicare Advantage Plan in Maryland would be required to pay. Think of this as a "worst case scenario." These "MOOPs" change each year and vary by plan.
To enroll in a Medicare Advantage Plan, you need to have Original Medicare (Parts A and B) and reside within the plan's service area.
Enrollment Limitations: Part C plans are controlled by CMS, which requires the member to adhere to enrollment and disenrollment rules like Annual Enrollment Period (10/15 to 12/7) and the Medicare Advantage Open Enrollment period which runs 01/01 to 03/31 each year. There are additional chances to make a change, like moving, or being Medicaid eligible, that can help facilitate a change mid-year.

Conclusion:

A Medicare Advantage Plan can provide seniors in Maryland with comprehensive coverage, cost savings, and additional benefits beyond what Original Medicare offers. However, it's important to carefully consider personal needs, budget constraints, and healthcare priorities when making a decision about insurance options.

Maryland seniors can make an informed decision about their healthcare by understanding the benefits and potential drawbacks. This ensures they have the necessary support as they enter their golden years. Learn more about these plans offered by Maryland Medicare Options.