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Medicare Made Easy

A simple guide to understanding Medicare and your available options

Senior couple

What is Medicare?

Medicare is a federal health insurance program for people...

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  1. Ages 65 and older​

  2. Under age 65 with certain disabilities

  3. Any age with end-stage renal disease or kidney failure

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Original Medicare provides a menu of benefits, but it isn't a complete package and although deductibles, coinsurance and copays are competitive, there are no limits to the amount of money you can spend out of pocket, which could leave you responsible for paying thousands in out of pocket costs.

The Big Question?

You may be wondering "Do I need to enroll in Medicare?" and for most people turning 65, the answer is yes

However, it still depends on your exact situation. Before we proceed with simplifying your understanding of Medicare, it's important that we determine when you need to take action.

 

Click the button to be redirected to Medicare's eligibility tool, where you can answer a few short questions and estimate your deadline to enroll into Medicare without any future re-occurring penalties. 

 

Once completed, write your results down - you'll specifically want your Initial Enrollment Period dates.

Sailboat

Medicare Part A

helps cover costs associated with inpatient hospitalization, skilled nursing, hospice and blood services.

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There is no yearly limit on annual out of pocket costs.

 

For most people, Part A premiums start at $0/mo

For the year 2024

Hospital

A

Inpatient Hospitalization

You Pay

Part A Inpatient Deductible

Days 1 - 60

$1,676

Part A Inpatient Deductible

Days 61 - 90

$419

Daily Inpatient Copay

Days 91 - 150

$838

Inpatient Coinsurance

Days 151+

100%

Nurse

A

Skilled Nursing, Hospice & Blood

You Pay

Skilled Nursing Confinement

Days 1 - 20

$0

Daily Skilled Nursing Copay

Days 21 - 100

$209.50

Skilled Nursing Coinsurance

Days 101+

100%

Hospice Care

Certified Terminal

Respite Care

0%

5%

Daily Skilled Nursing Copay

Pints 1 - 3

Pints 3+

100%

0%

Medicare Part B

helps cover costs associated with physician services, outpatient care, blood, tests and supplies.

​

Part B also has no yearly limit on annual out of pocket costs.

 

For most people, Part B premiums start at $174.70/mo

For the year 2024

Doctor

B

Physician, Outpatient Care & Labs

You Pay

Part B Deductible

Annual (2024)

$226

Medical Expenses

Coinsurance

20%

Outpatient Hospital Services

Minimum Coinsurance

Additional Hospital Costs

20%

100%

Excess Doctor Charges

Max 15% of Approved Amount

100%

Medical Expenses

Coinsurance

0%

Hospital bed

B

Home Healthcare & Blood

You Pay

Home Healthcare

Costs For Care

Durable Medical Equipment

0%

20%

Blood

Pints 1 - 3

Pints 3+

100%

20%

Covering the Gaps of Original Medicare

There are 2 main ways to cover the gaps with Original Medicare. Both options have their advantages, depending on what you personally find valuable. Luckily, both options are easy to understand, so relax and take a deep breath, this is going to be easier than you think.

Medicare Supplement

Also known as Medigap
Important questions to consider...

Do I have freedom to choose my providers/hospitals?

Do I need referrals to see a specialist?

Can my plan benefits change?

Is coverage guaranteed renewable if premiums are paid?

Does it include prescription drug coverage?

Medicare Advantage

Also known as Part C
Medicare Supplement
Medicare Advantage

Yes

No

No

No

Yes, if HMO

Yes

Yes

No

Purchase Seperately

Usually, Yes

Now hang on, let's not get ahead of ourselves...

Medigap plans generally charge more in monthly premiums than the alternative, Medicare Advantage.

It's important to shop both options carefully and make sure you stay with a price that you can comfortably afford.

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Additionally, Medicare Supplement and Medicare Advantage plans vary by insurance company. Premiums, deductibles and out of pocket costs can vary by plan, and in some cases if you make the wrong decision now and want to change in the future, you may be subject to health underwriting, meaning not everyone will be accepted.

 

It's important to make the right decision today to help avoid these risks in the future. 
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Request a quote

- and work with an expert -

We are not connected with, endorsed by, or sponsored by the U.S. Government, federal Medicare program, Social Security Administration, or the Department of Health and Human Services. Policies and benefits may vary by state and have some limitations and exclusions. Some states require these plans be available to persons under age 65 eligible for Medicare due to disability or End Stage Renal disease (ESRD). You may be contacted by an Agent. A licensed Agent will provide additional information upon request.

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