Key Medicare Information 2024

Medicare vs. Medicaid- Both Government sponsored health insurance

Medicare’s beneficiaries are primarily age 65 and older or meet other exceptions. Beneficiaries have paid into the Medicare system through payroll taxes over their working life.
Medicaid’s beneficiaries are low to moderate income individuals. This program is dependent on income.

Premiums:

Deductibles:

Part A- Hospital Deductible: $1,632 (2024) for each benefit period
- A Benefit period starts the day you are admitted as an inpatient in a hospital or Skilled Nursing Facility (SNF) and ends when you have not received inpatient hospital care or skilled care in SNF for 60 days in a row.
- If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins.
Part B- $240 (2024) per year
Part D- Depends on chosen plan

Coinsurances:

Part A:
- Days 1-60: $0 coinsurance after you pay your Part A Deductible
- Days 61-90: $408 Per day
- Days 91 and beyond:
  - $816 for each lifetime reserve day (up to 60 over your lifetime)
  - All costs after you use your lifetime reserve days
Part B: 20 % of the Medicare-approved amount after you pay your deductible
Part D: Depends on chosen Plan
- Depending on costs of prescriptions taken, you may be subjected to the Coverage gap pricing, also known as the donut hole

What’s covered? A few examples:

Part A:
- Inpatient hospital care
- Inpatient skilled nursing care, after qualifying event(s)
Part B:
- Medically necessary doctors’ services
- Medically necessary Durable Medical Equipment (DME)
- Many preventative services
Part D:
- Prescribed medication on a list of covered drugs (Formulary)

Options:

Original Medicare, you can add a supplemental plan and Part D
Medicare Advantage (Part C)- some include or you can add on extra coverage such as vision or dental

When to sign up:

If you are collecting Social Security, you’ll automatically be enrolled when you turn 65
If not, you’ll need to enroll yourself during your Initial Enrollment Period or Special Enrollment Period (SEP).
- Initial enrollment period- the 7 month period that begins 3 months before and ends 3 months after the month you turn 65
- Special enrollment period- a period of time that exempts/excuses you from late enrollment penalties because you were covered under a group health plan based on current employment.
  - This is an 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first.

Important things to know:

You can no longer contribute to an HSA once you sign up for Medicare.
- Could have up to a 6-month look-back, where you are not able to contribute if you sign up after you turn 65.
You could have higher premiums based on “Income Related Monthly Adjustment Amount” (IRMAA), calculated annually using your tax return information from 2 years prior
If you miss the enrollment period, you could be subjected to a late enrollment penalty, which could be in place for the entire time you have Medicare.

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