Last updated on: November 10, 2022
Many people in the United States struggle when it comes to health insurance. It’s expensive, and it can be quite confusing. Fortunately, Medicare is an excellent option for people who are about to turn 65 years old or for people who are under the age of 65 but are eligible for Medicare due to a disability. Planning for Medicare before you become eligible is crucial so you don’t miss out on essential enrollment periods and end up having to pay more than you would’ve if you had signed up on time. This article aims to inform you of some of the important information you should know before you become eligible and sign up for Medicare.
Medicare Isn’t Free in Kentucky
Many people are under the impression that Medicare is free. Most likely, they’re confusing Medicaid with Medicare. It’s important to know that for most people, Medicare is not free! When you know this before you become eligible for Medicare, you can plan appropriately. However, if you are struggling financially and aren’t able to afford Medicare, it’s possible that you could qualify to receive help with your Medicare costs.
If you live in Kentucky and you qualify for both Medicaid and Medicare, you are considered dual-eligible. If you are enrolled in both Medicaid and Medicare, Medicare will act as your primary insurance. Medicaid will act as your secondary and supplemental insurance. This will help you cover some of the costs that Medicare doesn’t pay for. When you’re enrolled in both, you are often automatically enrolled in a Medicaid Savings Program. Most of the savings programs will help cover the costs of some or all of the Medicare Part B premium. Additionally, the savings programs will lower the price of a Medicare Part D prescription drug plan.
In Kentucky, The More You Make, The More You Pay
You might not be aware that Medicare Part B and Part D monthly premiums are based on the amount of money you make. For individuals who make less than $88,000 per year, the monthly Part B premium is $148.50 as of 2021. The most you could end up paying for Part B is $504.90 per month. For Medicare Part D, individuals who earn less than $88,000 pay $0 for Part D. If you make between $88,000 and $111,000, the cost of Part D is $12.30 per month. The most you could end up paying for Part D is $77.10 per month.
Medicare Doesn’t Cover 100 percent of costs
When you’re enrolled in Original Medicare and Medicare Part D, you still have to pay a portion of the bill if you live in Kentucky. Most Medicare Part D plans have a yearly deductible that you have to meet before they start paying for any o your prescription drug costs. Once you meet the deductible, you’ll have to pay a copay for your prescription drugs. The price of the medication depends on what tier it is in. For example, generic drugs are in a different tier than brand-name drugs and will cost you less.
Medicare Parts A and B also don’t pay for 100 percent of your healthcare services. In Kentucky, they pay 80 percent of covered services after you meet the deductible. For example, if you receive a bill for $10,000 after you’ve paid your deductible, Medicare will pay for $8,000, and you will be responsible for $2,000.
Medicare Supplements
Medicare Supplements are something everyone should know about before signing up for Medicare! As we previously explained, Medicare does not cover 100 percent of your costs. There’s also no maximum out-of-pocket costs with Medicare, meaning your healthcare costs each year can essentially be unlimited. Depending on which Supplement you choose to purchase, Medicare Supplements will pay for all of part of the twenty percent that Original Medicare doesn’t cover. Additionally, many Medicare Supplement Plans also pay for the Part A hospital deductible, emergency services when you’re outside of the United States, and much more.
Medicare Doesn’t Cover Prescription Drugs Unless You Sign Up For Part D
In order to get coverage for prescription medications that you take outside of the hospital, you must sign up for a separate Medicare Part D prescription drug plan. If you don’t, you will be responsible for paying for your prescriptions out of your own pocket, which can add up quickly.
Kentucky Enrollment Periods & Late Fees
One of the most important things you need to know about Medicare is that there are specific enrollment periods you must follow. If you don’t sign up on time, you will end up paying a late fee, possibly forever. Additionally, you could end up without coverage for many months. If you fail to enroll in a Medicare Supplement Plan on time, it’s possible that you might never be able to enroll in one. When you fail to sign up during the enrollment window, you have to go through medical underwriting. This means the insurance companies can ask you questions about your pre-existing and current health conditions and either deny you or significantly increase your monthly premium on that basis. When you sign up on time, they are not allowed to turn you down or increase your premium.
- Original Medicare Enrollment - Eligibility window is 3 months before the month you turn 65, the month you turn 65, and 3 months after you turn 65
- Medicare Supplement enrollment - The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. You generally will get better prices and more choices among policies. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the first month you have Medicare Part B (Medical Insurance) and you're 65 or older
- Part D enrollment –In order to be eligible for Medicare Part D, you must be enrolled in Medicare Parts A and B. Your initial enrollment window for Part D is the same as your seven-month window for Part A and/or Part B.
Enroll Medicare Kentucky Can Help!
Our goal at Enroll Medicare is to make sure you have as much information about Medicare as possible. We want to make it easy for you to choose the best plan for the best rate. Additionally, we want to ensure that you never miss an enrollment period because missed enrollment means less coverage and higher monthly payments. If you have any questions about your eligibility, when you can enroll, what plan is best for you, or any other Medicare-related questions, our licensed agents in Kentucky are here to help.
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