By Alison Nelson, Employee Benefits Account Manager
“I’m turning 65 and need to learn more about Medicare. What do I do?” This is a common and very valid question that I’m often asked. Medicare is daunting, and with 75% of Medicare beneficiaries worrying about affording costs beyond premiums, you’re going to want to understand all of your options.
I want to start by noting that I am not a Medicare expert. However, before you scroll away, I can provide some tools and resources that could be helpful in your Medicare journey.
A great first resource is medicare.gov. I know, I know. The government’s Medicare website for info on Medicare… revolutionary! But it truly is a great and underutilized site that breaks down the ins and outs of Medicare. In summary, there are four main plans with additional coverage available:
- Medicare Part A: Hospital Coverage
- This is often free and is automatic if/once enrolled in social security.
- Medicare Part B: Provider Coverage
- $170.10/month (or higher depending on income).
- We see most people waive Part B as long as they are enrolled in a qualified employer-sponsored health plan.
- Part B has no out-of-pocket maximum, so you would be responsible for 20% of expenses with no cap – this can add-up quickly. If employer coverage is terminated, we often recommend enrolling in a Medigap or Medicare Supplemental policy. This puts a “stopgap” or out-of-pocket limit to expenses. If this coverage is obtained following the loss or termination of qualified coverage, you can likely forego underwriting. If Medigap is waived at initial eligibility and obtained later, underwriting is likely – meaning if there are pre-existing conditions, you could be denied coverage.
- Medicare Part C: Medicare Advantage
- Part C is offered by Medicare-approved private companies that must follow rules set by Medicare. Medicare Advantage Plans include Part A and B coverage, and many include Part D drug coverage as well. However, it’s important to note that Part C is not available in Alaska.
- Medicare Part D: Prescription Coverage
- The costs vary by plan
- Medigap or Medicare Supplemental Coverage
- You are able to obtain supplemental coverage if enrolled in Part A & B.
- RISQ Consulting has a dedicated individual who is appointed by Medicare and is able to assist with Premera Medicare Supplemental Plans. There are no fees for her service.
- An additional popular Medicare Supplemental plan is with United Health Care through AARP.
Another resource, and one of the most comprehensive and digestible guides, is the Medicare & You 2023 Guide.
However, my number one recommendation is to reach out to the amazing folks at the Alaska Medicare Information Office! This is a free service for Alaskans by certified Medicare professionals. These pros are able to provide personalized recommendations and can walk you through the complexities of Medicare.
Becoming Medicare eligible can seem overwhelming, but with the right tools and resources, you’ll be able to navigate it like a pro. And, as always, if you have any questions or need to be pointed in the right direction, RISQ Consulting can help.