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Quality Medicare Plans and Exceptional Service in St. Louis and the Metro East
M Erney & Associates, a trusted name in healthcare coverage in St. Louis and the Metro East specializes in providing comprehensive Medicare and Supplement plans to meet the unique needs of our valued clients. As you approach or surpass the age of 65, the significance of having the right Medicare plan cannot be overstated. It’s not merely insurance; it’s your gateway to the peace of mind that comes with added coverage and benefits, ensuring your health and well-being are well taken care of.
Our team of seasoned experts at M Erney & Associates understands the intricacies of Medicare plans and is dedicated to guiding you through the maze of options available to you. We invite you to reach out to us so we can help you discover the perfect Medicare plan tailored to your individual requirements. Your health matters, and we’re here to help you make the right choices that provide you with the best benefits and superior coverage.
Medicare Enrollment
If you’re new to the world of Medicare enrollment, it’s important to understand the key periods and options available to you. Your Initial Enrollment Period (IEP) spans three months before and three months after your 65th birthday month. During this time, you have the flexibility to enroll in Part A, Part B, or both. Additionally, you can explore the option of enrolling in a Medicare Advantage Plan (Part C) or a prescription drug plan (Part D).
Another critical time-frame to be aware of is the Annual Enrollment Period (AEP), which occurs every year from October 15th to December 7th. This window allows you to make changes to your Medicare coverage. You can add, drop, or switch your Medicare plan during the AEP, giving you the opportunity to align your coverage with your evolving healthcare needs.
There is also a Special Election Period (SEP) designed to accommodate special circumstances. If you experience a qualifying event, such as a diagnosis of a chronic health condition, a change in your residence, eligibility for Extra Help, or the transition from employer coverage to Medicare, you may be eligible to make changes to your Medicare Advantage plan during the SEP. This ensures that your healthcare coverage remains aligned with your specific situation and requirements.
Understanding Your Medicare options
To make an informed decision that aligns with your healthcare needs, let’s delve into an overview of the available Medicare options and what each one entails. The initial step is enrolling in Original Medicare, a program administered by the federal government. This comprehensive coverage consists of two primary parts: Part A and Part B.
Part A primarily contributes to hospital-related expenses and inpatient care. Depending on your Medicare tax history, the premium for Part A varies. If you’ve paid Medicare taxes for fewer than 30 quarters, the standard premium stands at $499. For those who contributed between 30 and 39 quarters, the standard premium is $274. If you’ve diligently paid Medicare taxes for 40 quarters or more, there’s no premium requirement. Under this plan, hospital expenses are covered at 80%, ensuring a substantial level of support.
On the other hand, Part B is focused on covering doctor visits and outpatient care. The standard premium for the year 2023 is set at $164.90, though your specific amount may be influenced by your 2021 yearly income and tax returns. Part B provides coverage for medical expenses at the rate of 80%. It’s important to note that both these plans offer distinct advantages tailored to ensure your comprehensive healthcare coverage.
Frequently Asked Questions
If your Medicare card was lost, stolen, or destroyed, you can request a replacement online at Medicare.gov. You can print an official copy of your card from your online Medicare account or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) to order a replacement card to be sent in the mail.
If you already get Social Security benefits, you do not need to sign up for Medicare. We will automatically enroll you in Original Medicare (Part A and Part B) when you become eligible. We will mail you the information a few months before you become eligible.
Because you must pay a premium for Part B coverage, you can turn it down. However, if you decide to sign up for Part B later, your coverage can be delayed and you may have to pay a late enrollment penalty for as long as you have Part B coverage.
Residents of Puerto Rico or foreign countries will NOT automatically receive Part B. They must elect this benefit. If you don’t get Social Security benefits and are not ready to apply for them yet, you should sign up for Medicare three months before your 65th birthday. The easiest way to apply for Medicare is by using our online application or you can make an appointment by calling us at 1-800-772-1213 (TTY 1-800-325-0778), 8:00 a.m. – 7:00 p.m., Monday through Friday.
You can voluntarily terminate your Medicare Part B (Medical Insurance). However, you may need to have a personal interview with us to review the risks of dropping coverage and for assistance with your request. To find out more about how to terminate Medicare Part B or to schedule a personal interview, contact us at 1-800-772-1213 (TTY: 1-800-325-0778) or visit your nearest Social Security office. If you send us a request to terminate your Part B and then change your mind, you must send a request to cancel the request of termination before the date that Part B ends.
Medicare Part B premiums vary based on beneficiary’s income and can change each year. For current rates visit the Medicare Cost site. Each year, Social Security sends a letter to people collecting Social Security benefits (and those who pay higher premiums because of their income) stating each person’s exact Part B premium. You can get details at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).
If you have Medicare Part A, but you did not enroll in Medicare Part B during your Initial Enrollment Period (IEP), you may sign up during the General Enrollment Period (GEP), or you may qualify for a Special Enrollment Period (SEP). The annual GEP runs from January 1 to March 31, with coverage starting the month after you enroll. You may have to pay a late enrollment penalty for not signing up when you were first eligible. Those with group health plan coverage through an employer or spouse may qualify for an SEP.
In most cases, if you don’t sign up for Medicare when you’re first eligible, you may have to pay a higher monthly premium.
More information on Medicare late enrollment penalties:
Part A Late Enrollment Penalty (Medicare.gov)
Part B Late Enrollment Penalty (Medicare.gov)
Part D Late Enrollment Penalty (Medicare.gov)
You may have health insurance coverage under a group health plan based on your or your spouse’s current employment. In this case, you may not need to apply for Medicare Part B at age 65. You may qualify for a Special Enrollment Period and be able to delay signing up for Medicare Part B without a late enrollment penalty. Coverage based on current employment does not include COBRA (Consolidated Omnibus Budget Reconciliation Act), Retiree health coverage VA (Veterans Affairs) health coverage, or Individual health coverage (such as through the Health Insurance Marketplace). Find out how your coverage works with Medicare at Medicare.gov or contact your employer or union benefits administrator.
States must help pay some of the Medicare costs for beneficiaries who have limited income and resources. Under these programs, states help pay for Medicare Part A and Part B premiums, deductibles and copayments. Some of these programs also pay additional Medicare expenses for elderly and disabled people. To find out if you are eligible for state help, contact your local medical assistance office. A representative can tell you the specific requirements and help you apply. For more information see (Medicare.gov).
Some people with higher income may pay a larger percentage of their monthly Medicare Part B and prescription drug costs based on their income. We call the additional amount the income-related monthly adjustment amount. Visit Medicare Premiums: Rules For Higher-Income Beneficiaries to see if the adjustment amount applies to you.
Medicare is a health insurance program for people age 65 or older. Some younger people are eligible for Medicare including people with disabilities, permanent kidney failure and amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS). Medicare helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
Original Medicare included:
Part A—Hospital insurance helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay), and some home health care and hospice care.
Part B—Medical insurance helps pay for doctors’ services and many other medical services and supplies that the hospital insurance does not cover.
Other parts of Medicare are:
Part C—Medicare Advantage plans are offered by private companies and approved by Medicare. These plans generally help you pay the medical costs not covered by Original Medicare.
Part D—Prescription drug coverage helps pay for prescribed medications.
TRICARE is the health care program serving military service members, retirees, their families and survivors worldwide.
More Information: TRICARE and Recent Changes In The Law
Signing up for Medicare Part B may provide you with additional service and location options.
If you don’t sign up for Part B when you are first eligible, you may have to wait to sign up, which will delay your coverage, and you may also have to pay a late enrollment penalty for as long as you have Medicare Part B.
Visit Medicare.gov for more information.
Meet Mike Erney
My name is Mike Erney. I am a local Independent Insurance Broker licensed in Illinois and Missouri. I specialize in the senior healthcare market and have helped hundreds of individuals with their Medicare plan options and decisions.
I am contracted with most carriers that have plans available in your area. My mission is to help anyone newly eligible for Medicare or those wanting to review their current plan to insure they are receiving the best benefits available for their specific situation and needs.
Let me help you make Medicare easy…Call today!