With nearly 10,000 people turning age 65 each day, yes, each day, understanding Medicare and how it works has become an increasing larger topic of discussion. Here is a short breakdown of how Medicare works:
When a person turns 65 OR becomes permanently disabled, they become eligible for Part A – which covers hospital expenses and Part B - which covers medical or clinic type expenses. Part A is entitled at age 65 as long as you have put in 10 years of work. Part B is the portion a person has to pay for. A person is eligible at age 65, others will continue to work past 65 and can hold off taking Part B until they are ready to retire. Your part A and part B will collectively cover about 80% of your medical expenses, however, there is no out of pocket maximum. This means that if you have a $100,000 bill, you could be responsible for $20,000 if you only carried parts A and B.
In order to help reduce those costs, people may sign up for a Medicare Advantage Plan, a Supplement, or a Cost Plan. These are all designed to help cover the expenses that Medicare covers, but not does cover at a 100%. They typically also carry an out of pocket maximum to help give a person a cap on what they may have to pay out of pocket for medical expenses. Through our office, we carry the following type of Medicare products:
Blue Cross Blue Shield of North Dakota – they offer a tradition Supplement, with most people choosing their Plan F. On this type of plan, you pay a monthly premium that is gender and age based and they also do some underwriting taking medical history into consideration.
Medica – They offer Cost Plans, which are a little different than the traditional supplement plan or an advantage plan that most people are familiar with. Medica has 4 different tier levels ranging in price and coverage. Medica rates do not depend on gender, age, or medical history. You are only ineligible if you currently have end stage renal disease. Click below to see a brief overview of the current plans and prices.