Medicare
Health insurance for individuals 65 and older or under 65 with a disability.
Who: Medicare Beneficiaries currently enrolled in Plan C, F or High F
What: Special Enrollment period to change plans without underwriting
Plan F >>> Plan G
Plan High F >>> Plan High G
Plan C >>> Plan D (not offered in Colorado)
When: January 1, 2021 – June 30, 2021
Contact us for more information
How Do I Get My Medicare Card?
Already receiving Social Security?
Your card should be sent automatically about 3 months prior to 65th birthday.
Not receiving Social Security?
3-6 months before turning 65, you must register for Medicare at ssa.gov.
Original Medicare
When transitioning from an individual or employer health plan where all benefits are covered under a single plan, it can be surprising to learn that Medicare separates hospitalization, doctor visits, and prescriptions into different parts. Learning the Medicare “alphabet” will help you understand your new benefits.
Original Medicare is includes Part A and Part B
Part A
Hospital Insurance
Helps Cover
* Inpatient Hospitalization
* Skilled Nursing
* Home Healthcare
* Hospice
2021 Costs
Premium: $0 – if “entitled” – beneficiary has paid
Medicare Payroll Taxes for 40 Quarters
Part A Deductible – $1484/year (days 1-60)
Part A Hospital Costs – Day 61-90 – $371/day
Part B
Medical Insurance
Helps Cover
* Preventative Services
* Doctor Visits
* Inpatient/Outpatient Doctor Services
* Ambulance
* Lab, Radiology, Durable Medical Equipment
2021 Costs
Premium: $148.50/month*
Higher Earners Pay More – IRMAA Adjustment*
Part B Deductible – $203/year
Part B Cost Share – 20% of approved Expenses
I Have My Medicare Card and will be turning 65 soon. Now what?
Aside from the onslaught of phone calls and mailings attempting to inform (and enroll you) in a Medicare plan, it is exciting for many to start Medicare and have lower premiums. The cost sharing of Original Medicare can leave beneficiaries exposed financially. Enrolling in either a Medicare Supplement Plan (MediGap) or Medicare Advantage Plan can fill in the gaps left in Original Medicare. What are the differences?
Medicare Supplement – MediGap Plans
- Plans provided by private insurance companies
that fill in the “gaps” left by original Medicare. - Known as the “prepay” option. Each has a
monthly premium, and the plan coordinates with
Original Medicare to cover medical costs. - Available Plans – A, B, C*, D, F*, G, K, L, N
- Plans C & F not available to Medicare
Benefiicaries who become eligible
after 1/1/2020 - Enrollment in Part A & Part B is required
- Prescription coverage is not included
- Once set, keep plan for life with paid premiums.
Advantage Plans – Part C
- Pay as you go – Copays when services are received
- All in one Alternative to Original Medicare.
Combines Part A, Part B & often Prescription Drugs
Sold by Private Insurance Companies
- Premiums are low – $0 – $60/month
- Traditionally Network driven HMO Plans
PPO Plans Now Available in Colorado
- Enrollment in Part A & Part B is required
- Extra Benefits are Often Included – Dental, Vision, Hearing
- Annual Out of Pocket Maximums – $3700 – $6800/year
- Option to change plans annually
Stand Alone – Prescription Drug Plans – Part D
Part D or Stand Alone Prescription Drug Plans help cover the costs of prescription drugs.
Colorado offers many stand-alone prescription drug plans. Things to consider when selecting a plan:
- Premium
- Formulary
- Medication Tier Level
- Preferred Pharmacy Network
Using your medication list and open dialogue, we sort plans, costs, and formulary to determine a plan that will best meet your current needs. Once the plan is set for the new year, no additional changes can be made.
** Every Medicare Beneficiary is required to enroll in prescription drug coverage. Failing to enroll when first eligible will result in a penalty when you do enroll. **
Medicare Open Enrollment
AEP – Annual Enrollment Period – October 15th – December 7th.
This is the time every year that Medicare Beneficiaries can select and enroll in a new Medicare Advantage Plan or PDP – Stand Alone Prescription Drug Plan. Year over year, your health needs change, formularies change, prices change – this is your opportunity to enroll in a plan that will best meet your needs as we enter a new year. Of course, best laid plans cannot predict the future.
Carriers We Work With
Helpful Resources
