What To Know Before You Turn 65

About to Turn 65?

Start Planning Now to Reduce Stress and Get the Best Rates

In order to receive the best rates and most options when it comes to health coverage, 65 is the magic number. The federal rules in place protect you by giving you the freedom and power to choose, but those choices can quickly become overwhelming. United Integrity Group, Inc. is here to help! Here’s what you should know in the years and months leading up to your 65th birthday.

THE INITIAL ELECTION PERIOD IS YOUR OPPORTUNITY TO GET COVERED

Medicare coverage has an “Initial Election Period” in which you can apply for coverage and cannot be denied for factors such as your age and health. This gives you a one-time opportunity to make the best health plan decision for your needs. The Initial Election Period starts three months before the month you turn 65 and ends three months after. To determine whether you are in your Initial Election Period and what your options for coverage are, get in touch with us today, and we will be happy to walk you through the process.

The months leading up to your 65th birthday is the best time to make decisions about your health care coverage to ensure you have the most options possible. This allows you to choose the health plan that will best fit your needs in the most cost-effective way.

DOES IT MAKE SENSE FOR ME TO SIGN UP FOR MEDICARE?

Is Medicare always the best option for everyone turning 65? It depends. How long do you or your spouse intend to keep working after your 65th birthday? Do you or your spouse have credible employer coverage? At times, employer coverage may be the best option as long as it conforms to Medicare rules and guidelines. Let us help you navigate these important decisions with a simple phone call.

What happens when it’s time to make the switch? We can guide you through making the best decision for your healthcare and your wallet. You may be able to still take advantage of the Initial Election Period to sign up for Medicare after your 65th birthday, as long as you meet certain conditions: you or your spouse needs to have maintained credible coverage with no gaps, and have been working the entire time since you turned 65 to be eligible to sign up for Medicare under the Initial Election Period. Our licensed representative can help you determine your eligibility and find the best health plan available to you, so call us today.

HOW DO I SIGN UP FOR MEDICARE?

A good first step is to contact one of our agents, who can help you through the Medicare process and will advocate to find you the best plan. When you’re ready to sign up for medicare, you can visit Medicare.gov to begin the application process. If you get stuck or have a question, our agents can meet with you to walk you through it, or provide assistance over the phone with screen share.

What is Medicare Supplement Insurance?

WHAT IS MEDICARE SUPPLEMENT INSURANCE?

Medicare Supplement insurance, also known as Medigap, offers plans meant to cover the costs Medicare does not.

Consequently, it covers a wide array of payments:

  • Deductibles
  • Copayments
  • Coinsurance
  • International care

Medicare Supplement plans are offered by private insurance companies, and the benefits of the standardized plans are always the same. The only differences that occur are in the required premiums, as rates differ from insurance company to insurance company. Some states may have additional regulations concerning coverage.

Prices vary by location, age, sex and possibly current health conditions except for those turning 65, going on Medicare Part B for the first time, losing credible coverage, or qualifying for Medicare disability.

HOW DOES IT WORK?

Medicare pays for most medically necessary expenses. The remaining 20% is sent to Medicare who then forwards to your Medicare Supplement insurance company.

Like other insurance plans, Medicare Supplement plan policyholders must pay a monthly premium to receive services. This premium is paid in addition to premiums for Medicare Part B. (Most individuals do not pay for Medicare Part A, as it has previously been paid in payroll taxes during their working career.)

WHO SHOULD CONSIDER A MEDICARE SUPPLEMENT PLAN

To be eligible for a Medicare Supplement plan, individuals must meet the following criteria:

  • An individual must be at least 65 years old, unless on Medicare Disability or has ESRD
  • The applicant must have Medicare Part A and Part B.

ADVANTAGES

Medicare Supplement plans offer several benefits.

LESS PAPERWORK

Your Medicare Supplement plan sets up an automatic crossover with Medicare, so you do not have to file any claim paperwork. Your doctor simply sends the entire bill to Medicare, and Medicare forwards the remaining portion to your Medicare Supplement insurance company.

FREEDOM TO CHOOSE HOSPITALS AND DOCTORS

Insured individuals can go to any facility that accepts Original Medicare. Instead of being forced to pick from a list an insurance company provides, you’ll have more flexibility to choose the hospitals and doctors of your choice.

TRAVEL

If you travel between states or internationally, Original Medicare may not cover you in the event you would need care away from home. However, Medicare Supplement plans do provide additional coverage. As a result, vacations or business trips can be enjoyed fully.

COST

Medicare Supplement plans provide peace of mind knowing that most of your expenses will be paid by Medicare and the insurance company.

GUARANTEED RENEWABLE

Your Medicare Supplement plan cannot be canceled for any reason unless you do not pay premiums on time. Regardless of health or newly diagnosed conditions, your policy is guaranteed renewable.

PEACE OF MIND

If you’re retired or have low income, you have the freedom to choose your own hospitals and doctors without referrals and with limited out of pocket expenses.

Call today to speak with a licensed representative to find a plan to fit your financial goals and needs.

Medicare Supplement vs. Medicare Advantage

WHICH IS THE BETTER OPTION?

Are you trying to choose between a Medicare Supplement plan and Medicare Advantage plan? Here’s a side-by-side comparison so you can make the right choice when it comes to your insurance plan.

Around 44 million people, or 15 percent of the population of the United States, rely on Medicare. This government-run program, which has been operating since 1966, provides medical coverage for those 65 and older, in addition to individuals with disabilities.

The program helps seniors (and those on disability) pay for their medical needs. As the population ages, their need for healthcare increases. Without full-time jobs that provide full coverage, they need a program they can rely on.

While Medicare is a fantastic program, it doesn’t cover everything. Medicare Supplement plans and Medicare Advantage plans both exist to help you ensure that you have all accrued medical expenses paid.

There are pros and cons to Medicare Supplement plans and Medicare Advantage plans. The main difference between health plans include the associated costs, freedom to choose doctors and hospitals, specialist referrals versus no referrals, copays and deductibles. Contact us to answer your questions and determine which coverage is right for you, your health, and your lifestyle.

You have options, and they can be confusing. It is important to know which the best option for you is. Read on for more information.

WHAT DOES A MEDICARE SUPPLEMENT PLAN COVER?

The out-of-pocket costs of a Medicare Supplement plan are typically lower in the long run because they offer more flexibility, more stability, and more coverage than most other plans.

A Medicare Supplement plan has no networks – that means that you can continue to see your own doctors and use your own hospitals of choice. A medical provider can not turn you away based on your Medicare Supplement insurer as long as they accept Original Medicare. Medicare Supplement plans offer low to no copays and low to no deductibles, thus you don’t have to come up with a large sum of money if you were to become sick or injured. Medicare Supplement plans give you the freedom to choose between 30 different drug plans (depending on your state), which makes it more likely that you can get the particular prescriptions you need at a price you can afford. Call today to find out which drug plan will save you the most money based on your current medications.

You have the ability to sign up for a Medicare Supplement plan 6 months before you turn 65 and 6 months after. You cannot be denied due to health or age. To discuss your options, call today to find the ideal plan for you.

WHAT DOES A MEDICARE ADVANTAGE PLAN COVER?

Many people don’t realize that a Medicare Advantage plan is not Original Medicare–by choosing a Medicare Advantage plan, you are opting out of Original Medicare and purchasing a private plan. The main draw for a Medicare Advantage plan is that it may save you some money in the short term because they typically offer lower monthly premiums than a Medicare Supplement plan, but they tend to cost more in the long run due to many more out-of-pocket costs. Our licensed representatives can help you determine what those costs might be and which plans are most appropriate for you.

A Medicare Advantage plan has networks, which means you may only see doctors that are covered under their plan, and you may have to find new doctors and hospitals when you sign up. Medicare Advantage plans also typically carry copays and deductibles that must be paid for out-of-pocket. Medicare Advantage plans often offer drug coverage but may not cover the particular medications that you take. The costs for a Medicare Advantage plan can go up as high as $6,700 maximum out-of-pocket but could be higher if you get treatment or services outside of your network. It’s important to call to determine what type of drug coverage will suit you best.

It’s important to know if you choose a Medicare Advantage plan and become sick, you may not easily switch to a Medicare Supplement or Medigap plan. At this point, you will have forfeited your Initial Election Period and must now go through the medical underwriting process. During medical underwriting, your age, health history and pre-existing conditions will be taken into consideration for your eligibility. Your illness or injury will now be considered a pre-existing condition, and your new carrier may deny coverage.

Under a Medicare Advantage plan, your copays, in-network doctors, and drug coverage can change from year to year, so it’s important to review the terms of your plan often. Medicare Advantage plans are typically catered to those with lower income, even though they can have higher costs in the long run.

WHICH PLAN SHOULD I CHOOSE?

Deciding whether to go with a Medicare Supplement plan or Medicare Advantage plan isn’t something you should do on your own. As experts in the industry, our licensed agents are able to help educate and assist in making the best decision for your specific needs.

Contact us for more information and assistance in finding the right insurance plan during your golden years.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.