Mind the Gap

Once you turn 65, it’s easy to feel like you’re made in the shade.

Part A is premium-free if you’ve paid into Medicare for ten years.

Part B is reasonable, with a monthly premium of only $174.70.

Even Part D, prescription insurance, is affordable.  Some plans start at only $10 a month!

If your adult life has been fraught with the very real struggle of trying to find affordable healthcare, Medicare can feel like a blessed relief.  And it is!

But…

There are gaps in Medicare!

Part A has a hefty deductible of $1,632.00 for hospital visits (meaning, you would have to pay this amount out-of-pocket before Medicare coverage starts).

Part B only covers 80% of doctor bills and procedures.  You are on the hook for paying the leftover 20% every time you go to the doctor or have a procedure like a MRI.  Costs can really rack up here!

To protect your pocket-book and retirement savings, we highly recommend that all our clients on Original Medicare enroll in a Medigap policy, like a Plan G:

Plan G covers the following:

  • Part A co-insurance and hospital costs
  • Part B co-insurance and co-payments
  • Blood (first three pints)
  • Part A Hospice care coinsurance
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible ($226 in 2024)
  • Foreign travel emergency (up to plan limits)

A Plan G GREATLY helps mitigate your out-of-pocket exposure.  We want you to use your retirement savings to enjoy retirement, not pay medical bills.

But here’s the kicker: once you enroll in Medicare Part B, the clock starts ticking.

You only have a six-month window of time to enroll in a Medigap policy with no underwriting.

That means that you can enroll in any Medigap policy regardless of pre-existing health conditions.

After that six-month window of time has passed (also known as your guaranteed-issue period), you ARE subject to underwriting and may be turned down from enrolling in the Medigap policy of your choice or have to pay a higher premium.

Just to reiterate: once you enroll in Medicare Part B, your six-month guaranteed-issue period begins.  After this, you are NOT guaranteed a Medigap policy.

We are here to walk you through ALL the confusing dates and periods of Medicare.  If talking through your options and questions would help, I’m always available for a chat.  Click this link to schedule a phone call on my online calendar: https://martinassociates.as.me/schedule.php?calendarID=2839926

Posted in Medicare.

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