Medicare Insurance

Rex Poe Insurance can help you understand what Medicare is and navigate enrollment into a Medicare Insurance plan.

Your Medicare coverage choices

Are you new to Medicare? Before you choose your coverage, learn about the different parts of Medicare and steps to get you started with Medicare.

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get your Medicare coverage—Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people need to get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:

Step 1: Decide if you want Original Medicare or a Medicare Advantage Plan (like an HMO or PPO)

You can choose Original Medicare. What’s Original Medicare?

Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage? Medicare How do you choose your providers? You have your choice of doctors, hospitals, and other providers that accept Medicare.

How much does it cost

  • In 2021, the standard Part B premium amount is $148.50 (or higher depending on your income).
  • Generally, you pay a deductible and coinsurance for your Part A and Part B services. If you choose to buy a Medicare Supplement Insurance (Medigap) policy (see Step 3), your Medigap policy may pay some of these costs.

You can choose a Medicare Advantage (MA) Plan.

Here are some things to know:

What’s Medicare Advantage? Sometimes called “Part C” – includes both Part A (Hospital Insurance) and Part B (Medical Insurance). Who provides coverage?Private insurance companies approved by Medicare. How do you choose your providers?You may need to use health care providers who participate in the plan’s network. How much does it cost?

  • In 2021, the standard Part B premium amount is $148.50 (or higher depending on your income).
  • You usually pay a monthly premium for your MA Plan (in addition to your monthly Part B premium).
  • You may pay a copayment or coinsurance for covered services. Many MA plans offer vision, hearing, and dental coverage. Costs, extra coverage, and rules vary by plan.
  • Plans have a yearly limit on your out-of-pocket costs. Once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year.
  • Your out-of-pocket costs may be lower in an MA plan. This option may be more cost effective for you.

Step 2: Decide if you want prescription drug coverage (Part D)

You chose Original Medicare in Step 1. If you want prescription drug coverage, you must choose and join a Medicare Prescription Drug Plan. You usually pay a monthly premium. These plans are run by private companies approved by Medicare

You chose a Medicare Advantage (MA) Plan in Step 1. If you want prescription drug coverage, and it’s offered by your MA plan, in most cases you must get it through your plan

Step 3: Decide if you want supplemental coverage

You chose Original Medicare in Step 1.   You may want to get coverage to help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. You can choose to buy a Medigap policy from a private company.

You chose a Medicare Advantage (MA) Plan in Step 1.   You can’t buy or use separate supplemental coverage—but some plans have lower out-of-pocket costs than Original Medicare.

Other options

To learn more about Medicare plans contact Merry at REX-POE Insurance by phone at 440-729-2900 or email her at merry@rexpoeinsursance.com. You may also visit https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices.

2021 Costs at a glance

Part A premium Most people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A“). If you buy Part A, you’ll pay up to $471 each month in 2021. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $471. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259.
Part A hospital inpatient deductible and coinsurance You pay:

  • $1,484 deductible for each benefit period
  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $371 coinsurance per day of each benefit period
  • Days 91 and beyond: $742 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs
Part B premium The standard Part B premium amount is $148.50 (or higher depending on your income).
Part B deductible and coinsurance $203. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (dme)
Part C premium The Part C monthly premium varies by plan. Compare costs for specific Part C plans.
Part D premium The Part D monthly premium varies by plan (higher-income consumers may pay more). Compare costs for specific Part D plans.

Visit: www.medicare.gov for Medicare costs at a glance and further information.


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