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Original Medicare is a federal government program that is your foundation. In addition there are three types of Medicare products available to you from private insurance companies.
Medigap—also known as Medicare Supplements
Part C: Medicare Advantage Plans
Part D: Prescription Drug Plans
Although marketed by private insurance, all three products are tightly regulated by government agencies.
It's a great start: Original Medicare is a great start but most people purchase additional coverage as there is significant financial exposure with Original Medicare alone. The good news is that the vast majority of doctors and hospital accept Medicare.
Part A is inpatient hospital coverage, skilled nursing home, and home health care. There is no cost for people who paid Medicare payroll taxes for the required 40 quarters.
If you are hospitalized in 2022, you will pay a deductible of $1556 per hospital stay. After 2 months (60 days) in the hospital, you pay a copay of $389 per day, and after 3 months (90 days) you pay a copay of $778 per day.
After 5 months, you pay the ENTIRE cost.
Part B is outpatient medical coverage for doctor visits, lab and X-rays, outpatient surgery, therapy, durable medical equipment, and more. There is a premium to pay for Part B of Medicare.
If you have outpatient medical expenses in 2022, you will first pay a deductible of $233 for the year. After that, Medicare pays 80% and you pay 20% of “Medicare approved” amounts. In addition, you would be responsible for up to 15% of the doctor’s charges above what Medicare approves, unless the doctor accepts “Medicare assignment.”
There is no limit to how much you would be responsible to pay if you only had Medicare by itself. That is why most people sign up for a Medigap plan or a Medicare Advantage.
If you are already drawing Social Security benefits, it’s done for you! You will automatically receive your red, white & blue Medicare card in the mail about 3 months before your birthday month.
However, if you are not in the Social Security system yet, you will need to actively enroll yourself. You can enroll for Medicare in Colorado and surrounding states online, by phone, or in person at your local Social Security office.
If you worked past 65 and are just now enrolling for Original Medicare, there is some additional paperwork required that takes away the online enrollment option. You will need to have your employer submit proof that you had group insurance since turning 65 in order to avoid late enrollment penalties.
Here is a detailed discussion of how to apply for Medicare.
NEW Medicare Card
If you are drawing Social Security because of a disability, you should receive your Medicare card about 3 months before your 25th month of disability benefits.
We can help you find a Medigap policy during your one-time 6-month open enrollment period, which starts with the month in which your Colorado Medicare begins.
If you miss this deadline, all is not lost. We can still get you enrolled into a Medicare Advantage Plan each year from October 15th through December 7th.
Call us today at (970) 224-5500 or toll free at (800) 553-1444 for a free, no-obligation Colorado (and surrounding states) Medicare consultation!