What will you be billed for a hospital stay with Medicare coverage?

Just like many things with Medicare the answer depends on a number of factors.  Medicare Part A is hospital insurance and you’d think that Medicare Part A would be the coverage you would use for a hospital visit, however, whether you are actually admitted to the hospital or “under observation” at the hospital will determine if Medicare Part A will pay or if your bill will be covered under Medicare Part B. 

Understanding Medicare and IRMAA - Income Related Monthly Adjustment Amount

Income Related Monthly Adjustment Amount (IRMAA) is a mouthful but understanding the thresholds and additional premium costs for Medicare Part B and Part D is important for retirement planning.  The amount you pay for Medicare in New Jersey is dependent on your income from two years ago.  In 2021 your Medicare premium and IRMAA charges are based on your 2019 tax return.  If your income was below $88,000 filing single or $176,000 filing jointly then you will pay the standard Medicare premium amounts.  However, if you have a higher income then you will be charged an IRMAA on top of the $148.50 monthly premium for Part B plus an additional charge to your prescription drug plan.  The additional amount you are charged is based on which income bracket you fall within. 

Does Medicare Cover Gym Membership?

You may be surprised to know that Medicare gym memberships or fitness packages may be included in your health insurance coverage.  This benefit is included on many Medicare supplement (Medigap) and Medicare Advantage (Part C) plans in New Jersey.   Original Medicare, Parts A and B, and Prescription drug plans (Part D) do not include any sort of gym or fitness benefits.

Are you insured when traveling with Medicare?

After a long year of being in quarantine, we all are ready to go on a long-awaited vacation.  However, you may be wondering if you will be covered if you have an unexpected medical event while outside of New Jersey.  Whether you are escaping to the Rocky Mountains or a sunny, tropical beach outside the United States, your travel destination will determine how you are covered while traveling with Medicare health insurance.  Additionally, the type of coverage you have on top of Original Medicare, a Medicare Supplement or Medicare Advantage plan, will dictate how you are covered during your time outside of New Jersey.

Medicare and Dental

You likely know that Medicare benefits help cover routine wellness visits and screenings along with continuing care for preexisting conditions, but what about dental benefits? Does your existing Medicare coverage qualify you for dental, and if so, how do you ensure you receive Medicare dental along with your traditional healthcare plan?

What to Know when you Qualify for Medicare due to Disability in New Jersey

In New Jersey, when you are eligible for Medicare due to disability, you are limited in what Medicare Supplement options are available to you.  Medicare Supplement plans have a monthly fee and pay secondary to your Medicare Parts A and B coverage which comes from the government.  New Jersey residents under age 65 and eligible for Medicare due to disability only have one Medicare Supplement option available to them.  Medicare Supplement Plan D will pay for all doctor and hospital bills not paid for by Medicare Parts A and B except for a $203 deductible and Part B Excess charges.  

What to Know About Medicare and COBRA 

Health insurance is overwhelming, especially when you're faced with picking a plan that covers your providers, medications, and medical needs. Additionally, you would like to keep your finances intact and not make a mistake.

If you are eligible for both Medicare and COBRA in New Jersey, it is very important to fully understand your options so you are not penalized or accidentally have a gap in health insurance.  In order to make an informed decision you'll need to know what each program is and which plan fits your needs and eligibility status.

What to Know About Visiting a New Jersey Social Security / Medicare Office

The New Jersey Medicare Brokers office is looking forward to meeting people in person again soon.  We can help guide you through the process of applying for Medicare, Extra help, or answer your Medicare questions.  Our agents are well versed in the Medicare enrollment process and will contact your local Social Security office with you to help guide you through the process.  

Options for New Jersey Prescription Help

Paying out-of-pocket for prescriptions, particularly when you have an ongoing illness that necessitates monthly medications, can become a hardship when you have budgetary constraints, or you're going through a period of low or no employment. 

How Important is the Medicare Star Rating?

The Medicare Star Rating is put into place to help you determine which plans are most highly rated as a whole in terms of coverage and costs, among other factors. Since there are numerous plans to pick from in New Jersey, the Medicare Star Rating can help you whittle down your choices easily.

Medicare Assignment

Researching Medicare plans and premiums can be overwhelming, and you may come across terms you're not quite sure of. Understanding Medicare assignment will help you determine what your costs will be and which doctors you will be able to see.  Knowing all of your options is important when choosing a Medicare plan in New Jersey.

Medicare Assignment in New Jersey 

Medicare assignment is when your doctor accepts a determined price for Medicare approved medical services, checkups, procedures, and screenings. Doctors that accept Medicare Assignment  agree to the Medicare payment— the payment is "assigned" and non-negotiable. You won't get any surprise bills for this service and will receive statements from Medicare saying how much they paid.

Why Should You Engage with a Medicare Broker?

With there being over one thousand potential combinations of ways you can take your Medicare in New Jersey, there is a lot to go over all at once—and by yourself. You might worry you're not making the right decision or choosing too hastily. This is where a Medicare broker can step in and help—at no cost to you.

President Biden’s Medicare Plan

With each new president, changes are made to the healthcare system. President Biden is no exception. Read on to learn about the plans President Biden has for Medicare and what President Biden hopes to achieve regarding Medicare during his tenure in the White House.  Many of his goals would have to pass through Congress which makes them becoming a reality more difficult.

A Guide to Medicare HMO and PPO Options

When you're looking for the right plan for your Medicare coverage in New Jersey you may see phrases like Medicare HMO or PPO. There are significant differences between these two types of plans and understanding them can help you choose the best coverage for your healthcare needs in the most affordable way possible.

Medicare Part D Senior Savings Model: An Overview

Medicare recipients who take insulin to control their diabetes know the cost for this life saving medication in previous years has become outrageous.  A vial of insulin can cost patients as much as $250, and some people require multiple insulins per month. The average person simply can not afford these prices without aid. 

This year, in response to the rising price of insulin, the Centers for Medicare & Medicaid Services (CMS) introduced the Part D Senior Savings Model. This program reduces the out of pocket cost for a 30 day supply of insulin to $35!