Once Medicare Parts A and B kick in, whether you have one or both, your coverage sits in two broad categories: hospitalization, and medical equipment and supplies. What is noticeably absent from those is prescription drug costs. Medicare Part D is an essential part of your complete healthcare package, however it is an optional plan that you have to enroll in. Thankfully, for those seeking to add Medicare Part D, eligibility is simple.
Medicare recipients often find that Medicare's original plans do not offer all of the coverage they want or need. With Medicare Advantage plans, Medicare beneficiaries are offered the choice to get their Medicare through private companies which include additional benefits. Parts A and B of your standard Medicare plan cover hospital care and then medical, respectively, but it is possible that for you, your medical needs require a bit more coverage than that.
You may find that when you're enrolled in Medicare that you need additional assistance with the cost of healthcare. You cannot afford premiums or expanded packages that would allow you access to the treatments needed. With a limited income/assets you may be eligible for Medicaid on top of Medicare, which makes you dual-eligible. If you are in this situation there are two routes you can take.
- Enroll in Medicare, a Medicaid HMO (administered through NJ FamilyCare), and a separate plan for prescriptions.
- Enroll in a Dual Eligible Special needs plan which combines your Medicare, Medicaid, and Prescription Drug coverage into one plan.
As you prepare to enroll in Medicare for the first time, it's easy to find yourself with a lot of questions, especially if you're navigating the many options alone. Where do you even begin? What is the Medicare eligibility age? In New Jersey there’s over 1,000 combinations of ways that you can get your Medicare coverage. Read on to learn all you need to know as you begin this journey.
Medicare is government health insurance, and the majority of recipients are of the program age in by turning 65, but those are not the only people that qualify. In New Jersey and nationwide, persons under 65 can enroll in Medicare under specific circumstances, and it's important to know the specifics. It could be that you or someone you love can enroll in the program, allowing them to better manage their healthcare, and they do not have to wait until their golden years to do it. More to the point, if they qualify, then they shouldn't have to wait that long.
Senior Gold is state assistance program that helps with the soaring cost of prescription medication. The New Jersey state-funded program helps create a different, more manageable co-payment structure for those that are eligible and in need.
The Division of Aging Services part of New Jersey's Department of Human Services offers the NJSave application. Once filled out and returned, NJSave can help low-income Medicare recipients access several programs that can help them save money on premiums, deductibles, and other major expenses tied to their healthcare.
Medicare is a complex system. There are multiple rules and enrollment periods and if you make a Medicare mistake the penalties can last the rest of your life. Additionally, having a gap in your coverage can be financially catastrophic if you have a serious health event during that timeframe.
Below are a number of situations which can cause you to make a mistake with your Medicare. Agents at New Jersey Medicare Brokers can help answer your questions so that a Medicare mistake doesn’t happen to you.
A Medicare insurance agent can help you by addressing any concerns and ensuring you fully understand your policy. However, that is not where an agent or broker's job ends when assisting you.
In New Jersey and other states, those with Medicare and a high income find themselves having to pay higher costs. It's possible that you are seeing higher premiums than you anticipated on your Medicare Part B and your prescription coverage under Medicare Part D.
There are a multitude of potential Medicare plans and options, each customized based on affordability, healthcare needs, and risk tolerance. Medicare supplement or Medigap plans are one of the most popular options and fill in the gaps that Medicare doesn’t cover.
What if you sign up for one Medigap plan but realize it's not the perfect fit you needed? That could happen for multiple reasons: needing more or fewer benefits, or wanting to find a cheaper policy. The good news is that changing Medigap plans in New Jersey or any other state is easier than you think. Ensure that you receive an acceptance letter to the new supplemental plan before canceling your current coverage.
You might already have some questions about how policies and premiums are going to change for Medicare in 2020. On October 1st the 2020 Medicare Advantage and Prescription Drug plan details will be released but the financial structure the plans follow was recently announced.
- The maximum deductible for drug plans is going from $415 to $435.
- Threshold to enter the coverage gap (donut hole) is changing from $3,820 to $4,020
- Threshold to get out of the coverage gap and into catastrophic coverage is being significantly increased from $5,100 to $6,350.
- The average drug plan premium is projected to decline.
It’s very important to get a physical from your doctor every year to make sure your health hasn’t changed. When scheduling your Medicare physical exam it is important to ask for a “Wellness Exam” and NOT a physical. This is because Medicare does not pay for a Physical Exam, but does pay for a “Wellness Exam” annually. A physical exam is more comprehensive than a Wellness exam because it includes bloodwork a check of your vital organs, whereas a Wellness Exam does not.
What Can a Medicare Broker Do for You?
A Medicare broker provides unbiased, informed advice on your options and decisions when you need help with Medicare. The brokers we work with are contracted with multiple carriers and will listen to your situation before giving you an explanation of the options available to you. They will help you can put compare the benefits:
- Advice on policies across multiple carriers;
- Determining whether your current policy is still the best one for you, both in terms of coverage and how much it costs you; and
- Options for changing your plan and when to do it.
What is Republicans Medicare Plan? With all candidates across both aisles almost always preparing for elections, everyone wants to know their ideas about Medicare, especially when it could have a major impact on the care you can afford and receive.