Medicare is the state’s health insurance plan for eligible people 65 years of age or younger. Certain people under the age of 65 are also eligible for Medicare, including people with disabilities, permanent kidney failure, and people with amyotrophic lateral sclerosis (Lou Gehrig’s disease).
In general, you can apply as long as you meet the following conditions:
1. At least 65 years old; 2. US citizens or green card holders who have lived in the United States for more than five years; Points, you can only get four quarterly points per year. So in 2020, you only need to earn $5,640 to get four quarterly points. If you don’t have a job, you can rely on your spouse to meet the 40-point requirement. But you must also be at least 65 years old, There is also legal status to qualify.
WHAT ARE THE PARTS OF MEDICARE? WHAT COVERAGE IS COVERED?
Medicare (also known as the “red and blue card”) consists of 2 parts:
1. Medicare Part A (Part A )
2. Medicare Part B (Part B )
People who enjoy American medical insurance (Medicare) hold a card with blue on top and red on the bottom, commonly known as a “red-blue card”.
Medicare Part A and Medicare Part B are called traditional plans.
1. Medicare Part A (Part A):
Responsible for reimbursement of some hospitalization expenses, such as inpatient nursing services, nursing services, hospice services, and home health care services. “Part A” does not pay premiums, but has a deductible of $1,408 once per year for hospitalization. There is no charge for the first 60 days of hospitalization, $352 per day out of pocket for more than 60 days, and $704 per day out of pocket after 90 days.
2. Medicare Part B (Part B):
Responsible for reimbursement for necessary medical services such as outpatient clinics, specialists, preventive services, emergency services, etc. Part B pays a monthly premium of at least $144.60 (this is the norm in 2020, and will be adjusted each year), depending on taxable income. In addition to the premium, there will be a deductible of $198 per year. The so-called reimbursement of some medical services refers to the reimbursement of 80% of the expenses, and the remaining 20% must be paid by oneself. There is no upper limit. This may cause trouble for some people. The specific plan will be mentioned later in the article.
The benefits of the “Medicare Red and Blue Card” are :
- There are no network restrictions, covering the United States, and can be used in any hospital and clinic that accepts “red and blue cards” throughout the United States,
- No prior authorization required
- No referral is required to see a specialist.
With the medicare red and blue card, what else do I need?
The Red-Blue Card Legacy Plan does not include prescription drug coverage. In 2003, Congress passed a new law that added a program called Medicare Part D specifically for reimbursement of prescription drugs. The lowest price this year for 2020 is only $7.20 (SilverScript Smart Rx plan). Average monthly $13-$20. Prices have dropped by an average of 34% over the past three years. Higher premiums are required if special medications are required. Part D “Medicare Part D” also has an important point: delaying applying to the program will result in a lifetime delay in applying for penalties!
Need a Supplemental Plan (Medigap)?
Traditional plans (Medicare Part A and B) reimburse you 80% of the cost, and Part D reimburses you for the portion of your prescription drug. The 20% unreimbursed portion that remains uncapped will become a hidden worry that affects your high-quality retirement life. But don’t worry, you can buy a supplement plan! Supplemental Plan G (Medigap Plan G) reimburses the remaining 20%, reimburses the Part A deductible, and also covers medical emergencies while traveling abroad (80%). Supplementary plans are approximately $150-$180 per month in premium. The usage is the same as the red and blue cards: no network restrictions, covering the United States; no prior authorization is required, and no referral is required to see a specialist.
There is one important point: the government stipulates that as long as you apply for a “supplementary plan” within 6 months of the “red and blue card” being effective, the insurance company must grant you the lowest price and cannot deny you coverage. If this period is exceeded, the insurance company will investigate your health status and have the right to increase the price of your insurance or even deny coverage based on your health status. Therefore, please be sure to pay attention to the application period of the ” Supplementary Program” and try not to miss it!
What is the total cost now?
Part A – $0
Part B – $144.60/month
Part D – $15/month Supplemental Plan G (Medigap Plan G) – $180/month
Average cost: $144.60 + 15 + $180 = 339.60/month If economic conditions permit, it is recommended that you purchase both a “Supplemental Plan” and a “Part D Plan” so that you only need to pay about $339.60 per month, covering almost All medical expenses throughout the year. If your financial conditions do not allow it for the time being and feel that the monthly premium is too expensive, you can consider “Part C”, also known as “Preferential Plan”
Part C, Medicare advantage (AKA Part C)
Part C, the preferential plan, is provided by a licensed private medical insurance company. It covers all medical services that can be reimbursed in “Part A” and “Part B”, so it can be used in place of the red and blue cards. Unlike Supplemental Plans, many Part Cs do not require premium payments. Unfortunately, the network range is relatively small and you need to pay a registration fee every time you see a doctor. The discount plan even includes services not covered by traditional plans, such as other benefits and services such as dental, eye, and hearing aids, as well as gym memberships, transportation, and over-the-counter drug programs. In addition to network restrictions, Part C requires a share of medical expenses.
Customers who choose the Part C benefit plan have the option to add, change, cancel or switch their existing insurance plans between October 15 and December 7 each year. Such as switching from a traditional plan to a Part C discount plan, from a Part C to a traditional plan, from one Part C plan to another Part C plan, from a Part D prescription drug plan to another Part D plan, or you The first time you are eligible without purchasing, you can apply during this period, and the changes will take effect from January 1, 2021, next year. If you miss this period, you will need to wait until this period next year to make changes or apply again.
You can choose
To recap, old-age insurance has different plan options. With just a traditional plan that reimburses 80% plus a Part D prescription drug plan, your monthly premium will average $159.00. If you wanted to add a supplemental plan to cover the remaining 20%, your monthly premium would increase by approximately $180; the average is $339.00 per month. If you want the lowest price, you can opt for the Part C discount plan with no monthly fee, but this plan has network limitations and pre-approval. Whatever decision you make, you can contact our company. We can find a solution that suits you based on your situation.