Enrolling in Mandatory Medicare Plans at 65 Years Old

Many baby boomers in the U.S. are struggling to live under the Coronavirus pandemic with their health issues. Low immunity and lack of exercise bring more attention to their twilight period, and we wonder about medical options available to us after retirement. It is mandatory that we must have Medicare from the age of 65, and thus we need to be aware of what medicare is really caring about and how to choose what we need.

As you know, Medicare A is for hospital insurance and B is for medical insurance offered by the federal government. C is a Medicare Advantage offered by the approved-private companies. Part D is for drug coverage.

Part A, if you worked over the 40 quarters (10 years of work) before you enroll in your Medicare, then you are free of charge of your premium otherwise you have to pay according to how many quarters you have worked before you enroll in your Medicare. According to Medicare.gov,

most people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A“). If you buy Part A, you’ll pay up to $471 each month in 2021. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $471. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259.

If you are hospitalized then, you have to pay the deductible

  • $1,484 deductible for each benefit period
  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $371 coinsurance per day of each benefit period
  • Days 91 and beyond: $742 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs

Part B, the premium amount is $148.50 (or higher depending on your income).

Of course, you have to pay deductible and coinsurance too. It is $203. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (dme)

Part C is a Medicare Advantage plan and the premium will depend on where you live.

Part C, Advantage Plan includes all your Part A and Part B benefits and it is provided by Medicare-approved private companies. Use doctors and hospitals in the plan’s network (for non-emergency or non-urgent care). Most plans include drug coverage. Many plans include extra benefits, like vision, hearing, dental, and more. The yearly limit on your out-of-pocket costs. You have to shop around between health insurances provide Medicare Advantage Plan.

Part D is your drug coverage and its premium varies depends on how much the income that you reported on your IRS tax return.

in 2021

If your filing status and yearly income in 2019 was
File individual tax return File joint tax return File married & separate tax return You pay each month (in 2021)
$88,000 or less $176,000 or less $88,000 or less your plan premium
above $88,000 up to $111,000 above $176,000 up to $222,000 not applicable $12.30 + your plan premium
above $111,000 up to $138,000 above $222,000 up to $276,000 not applicable $31.80 + your plan premium
above $138,000 up to $165,000 above $276,000 up to $330,000 not applicable $51.20 + your plan premium
above $165,000 and less than $500,000 above $330,000 and less than $750,000 above $88,000 and less than $412,000 $70.70 + your plan premium
$500,000 or above $750,000 and above $412,000 and above $77.10 + your plan premium
  • Late enrollment penalty: 

You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

  • A Medicare Prescription Drug Plan (Part D)
  • A Medicare Advantage Plan (Part C) (like an HMO or PPO) or another Medicare health plan that offers Medicare prescription drug coverage
  • Creditable prescription drug coverage

In general, you’ll have to pay this penalty for as long as you have a Medicare drug plan. The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage. Learn more about the Part D late enrollment penalty.

  • Deductibles, copayments, & coinsurance: The amount you pay for Part D deductibles, copayments, and/or coinsurance varies by plan. Look for specific Medicare drug plan costs, and then call the plans you’re interested in to get more details.

3 months before your 65 birthday, after 3 months of your birthday, you must enroll in your Medicare to prevent penalty. Thus before your birthday, you have to enroll in Part A and Part B plus Part D or  Medicare Advantage Plan(C)with Part D. If you are more affordable to pay for your healthcare insurance, then you can add Part G for the coverage of your gap(out of pocket money) as well. 

In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty until you have Part B and could have a gap in your health coverage.

In conclusion, If you choose the original Medicare Plan(Part A and Part B) and Part D, you still need your vision, hearing, and dental insurances. However, the total monthly premium of the Original Medicare Plan (Part A, Part B, Part D)will be around $155.80-$234.00.

If you choose the Medicare Advantage Plan, you will be covered as all in one : (Part A, Part B, Part D, Part G, Vision, Hearing, Dental) but you have to go to the hospital or your doctor offices that it is in the system across in the U.S. The monthly premium will be around $148-$297.50.

코리일보/COREEDAILY

Coree ILBO copyright © 2013-2021. All rights reserved.

This material may not be published, broadcast, rewritten or redistributed in whole or part with out the express written permission.

Leave a Reply

Your email address will not be published.

Confirm that you are not a bot - select a man with raised hand: