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Managing the Medicare Maze can be Maddening

By February 27, 2020October 4th, 2021Fogle Blog, Medicare

Most Medicare beneficiaries are 65 or older. Others are eligible to enroll in Medicare if they have a certain illness or situation, including being on disability for 24 months. There are two main sections of Medicare: Part A covers inpatient needs, skilled nursing/rehab facilities and hospice; Part B covers doctor office visits, medical equipment, preventive services and outpatient care. Part A and Part B form what is referred to as “original Medicare. “Part C” Medicare Advantage and a Medicare Supplement are two options that help cover holes original Medicare does not cover. Fogle Insurance would help clients obtain or learn about those coverage options. “Part C Medicare Advantage plans are contracted with Medicare and provide all Part A and B benefits,” explained Fogle’s Laura Finan. “A Medicare Supplement plan would work alongside ‘original Medicare’ and supplement the coverage already provided by Part A and B. Medicare Part D covers prescription drugs. Most Medicare Advantage plans will include coverage for medications in addition to medical benefits. Medicare Supplement plans do not cover prescriptions. “If you have a Supplement, you would need to enroll in a stand-alone prescription plan,” Finan advised.

Premiums on the rise

Just like in past years, Part B premiums are increasing. Premiums are charged to most all Medicare beneficiaries and can increase based on your taxable income. The monthly premium in 2020 is $144.60, about $9 more than 2019. The new premiums are determined by the beneficiary’s 2018 income. “There is an appeals process available to those who think their income represented is not their current income,” Finan explained. “This comes into play when people get a severance package that causes a one-time, large influx in taxable income.” Medicare Supplement Plan G enrollees will see an increase in Part B deductibles, which apply to outpatient/doctor visits, to $198, which is a hike of $13. “This is a one-time annual deductible members need to pay if their plan does not already cover the Part B deductible,” Finan said. The transition from employer-chosen coverage to Medicare options can be difficult for some people to navigate, especially those who have been working for decades for companies that made their medical insurance choices for them. When transitioning to Medicare, there are many decisions to make. “Sometimes, as good as the power of choice sounds, it is a pretty daunting process,” Finan noted. “I work to break down each person’s needs and try to find a plan that not only covers what they need, but also fits their budget.” People 65 and older who still work full time and have medical coverage may be able to delay Part B enrollment, but should confirm that their employer plan is compliant so they avoid any issues with coverage and penalties in the future. If you do not sign up for Part B of Medicare when you are first eligible to do so, your premiums can go up 10 percent for each 12-month period without that coverage, and the penalty applies indefinitely. Although Part D of Medicare is voluntary, Medicare does penalize a beneficiary who has more than a 63-day gap in prescription drug coverage by charging an additional 1 percent of the national average for every month they went without coverage.

“Denver Citizen – 2020-02-21.” The Denver Citizen – Lake Norman Media Group, 21 Feb. 2020,