Medicare
Cost of healthcare in retirement continue to be one of the top financial concerns for retirees, second to running out of money in retirement. If you are age 65 or older and have enrolled in Medicare, then you can expect about 50% of your healthcare to be covered through the Medicare program. At SMG, we specialize in helping you navigate through the Medicare puzzle.
What Is Medicare?
Medicare is health insurance for:
- People age 65 or older
- People under 65 with certain disabilities
- People of any age with End Stage Renal Disease (ESRD)
What you have to keep in mind, is that Medicare alone will not cover all your medical bills. This is the reason why most people who don’t have healthcare provided through an employer, will elect to choose some sort of supplement coverage in addition to Medicare.
Medicare Parts
Original Medicare
Hospital Insurance
Hospital Insurance for Inpatient Care, Nursing Care, and Services & Supplies.
Medical Insurance
For Doctor’s Services, Outpatient Care, and Preventive Services
Prescription Drug Coverage
PART D
Optional Prescription Drug Coverage A prescription drug option managed by private insurance companies under contract with Medicare to help cover the cost of prescription drugs. It may help lower your prescription drug costs and help protect against higher costs in the future.
*A Prescription Drug Plan is optional however if you do not choose one you may get pentalized.
Medicare Advantage
PART C
Advantage Plans are made up of Medicare Parts A & Part B, with additional benefits
Medicare Supplement Insurance
Works with Original Medicare Parts A and B
• Medicare Part A Coinsurance
• Medicare Part B Coinsurance
• Deductible Coverage Available
A Medicare supplement insurance policy, also known as a Medigap policy, helps pay your share (coinsurance, co-payments or deductibles) of the costs of Medicare-covered services. Some Medicare supplement policies cover certain costs not covered by Original Medicare Parts A and B.
Medicare Supplement insurance companies can sell you a standardized Medicare supplement policy identified by letters A through N. Each standardized Medicare supplement insurance policy must offer the same basic benefits, no matter which insurance company sells it. Cost and customer service are usually the only difference between Medicare supplement policies sold by different insurance companies.
Choose The Medicare Supplement Plan That's Right For You
| Medicare Pays | Medicare Supplement plans pay | Plan A | Plan B | Plan C | Plan D | Plan F | Plan G | Plan N | Plan K | Plan L | Plan M | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Part A: Inpatient Hospital Care |
||||||||||||
| First 60 days | All but $1600 | $1600 Part A deductible | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | 50% | |
| Coinsurance 61-90 | All but $400 a day | $400 a day | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Coinsurance 91-150 | All but $800 a day | $800 a day | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| After day 150 up to an additional 365 days in your lifetime | Nothing | 100% of eligible expenses | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Blood benefit | All but first 3 pints | First 3 pints | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ |
|
Skilled Nursing Facility Care |
||||||||||||
| First 20 days | 100% | Nothing | ||||||||||
| Coinsurance 21-100 days | All but $200 a day | Up to $200 a day | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ||
|
Part B: Physician Services and Supplies |
||||||||||||
| Yearly deductible | Nothing | $226 | ✓ | ✓ | ||||||||
| Coninsurance | Generally 80% | Generally 20% | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓*2 | 50% | 75% | ✓ |
| Blood benefit | All but first 3 pints | First 3 pints | ✓ | ✓ | ✓ | ✓ | ||||||
| Excess charges | Nothing | 100% of eligible expenses | ✓ | ✓ | ||||||||
|
Other Benefits |
||||||||||||
| Emergency Care outside the U.S. (Foreign travel) | Nothing | 80% of eligible expenses up to a lifetime maximum of $50,000 after a $250 yearly deductible | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Hospice benefits | All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care | Medicare copayment/coinsurance | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ |
- Some plans may not be available in your state
- Plan N pays the balance of the part B coinsurance except for up to a $20 copayment per office visit and up to a $50 copayment per emergency room visit.
- K plan has $6,220 out of pocket Limit
- L Plan has $3,110 out of pocket Limit
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