{"id":16212,"date":"2019-07-19T08:00:42","date_gmt":"2019-07-19T13:00:42","guid":{"rendered":"https:\/\/taxprocenter.proconnect.intuit.com\/?p=16212"},"modified":"2019-08-09T15:07:18","modified_gmt":"2019-08-09T20:07:18","slug":"medicare-101-coaching-your-clients-about-medicare-coverage","status":"publish","type":"post","link":"https:\/\/accountants.intuit.com\/taxprocenter\/tax-law-and-news\/medicare-101-coaching-your-clients-about-medicare-coverage\/","title":{"rendered":"Medicare 101: Coaching Your Clients About Medicare Coverage"},"content":{"rendered":"

Thousands of baby boomers turn 65 each day and become eligible to join the millions of Americans already enrolled in Medicare<\/a>. With more people working into their retirement years, you and your clients should know more about Medicare cost and benefits; it\u2019s never too soon to share this information with them.<\/p>\n

The Basics<\/b><\/p>\n

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease. There are four main parts to Medicare coverage (plus a supplemental plan), and these plans are offered by private insurance companies.<\/p>\n

    \n
  1. Medicare Part A (Hospital Insurance)<\/b>\u00a0covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care.<\/li>\n
  2. Medicare Part B (Medical Insurance)<\/b>\u00a0covers certain doctors\u2019 services, outpatient care, medical supplies and preventive services. You pay nothing for most preventive services if you get the services from a health care provider that accepts the assignment. In 2019, the standard Part B premium is $135.50 per month (or higher depending on your income). Original Medicare includes Parts A and B, and you\u2019re able to choose the doctors, hospitals and other providers that accept Medicare. In general, you\u2019ll pay a deductible or coinsurance for Part A and Part B services.<\/li>\n
  3. Medicare Part C (Medicare Advantage or MA)\u00a0<\/b>is an all-in-one alternative to original Medicare, and includes Part A, Part B and, typically, Part D. The coverage is provided by private insurance companies approved by Medicare, and you typically choose health care providers who participate in the plan\u2019s network. You typically pay a monthly premium for the MA Plan, in addition to the monthly premium for Part B. You\u2019ll also be responsible for a copayment and coinsurance for covered services, and these plans have a yearly limit for your out-of-pocket costs. Many MA plans also offer vision, hearing and dental coverage.<\/li>\n
  4. Medicare Part D (Prescription Drug Coverage)<\/b>\u00a0adds prescription drug coverage to original Medicare and some other Medicare plans. You usually pay a monthly premium, and these plans are run by private companies approved by Medicare.<\/li>\n<\/ol>\n

    Medicare Supplement Insurance (Medigap):<\/b>\u00a0If you choose to buy a Medicare Supplement Insurance policy, the plan may pay some of the deductibles and coinsurance for Parts A and B.<\/p>\n

    Enrollment<\/b><\/p>\n

    If you\u2019re already receiving Social Security benefits, you\u2019ll automatically be enrolled in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) when you turn 65 years old, but you can decline Part B coverage and sign up later. Since everyone has to pay a premium for Part B, you may delay this coverage if you\u2019re already covered by another plan.<\/p>\n

    If you\u2019re\u00a0not<\/i>\u00a0receiving Social Security benefits, you need to sign up for Medicare. Most people should enroll in Part A when they turn 65 years old, even if they are covered through their employer\u2019s insurance plan. If you paid Medicare taxes while you worked, you won\u2019t have to pay a premium for Part A.<\/p>\n

    Other Coverage<\/b><\/p>\n

    If you have Medicare and other insurance coverage, such as employer or union, military or veterans\u2019 benefits, each type of coverage is considered a payer. When you have more than one payer, you need to coordinate your benefits to determine which payer will pay first and which one will pay next.<\/p>\n

    The primary insurance company will pay up to the limits of the coverage; then, the secondary insurance company will pay (up to coverage limits) if there are costs not covered by the primary insurer. Remember to tell your doctor and health care providers that you\u2019re covered by multiple insurers to help them determine where to send the bills and to avoid delays.<\/p>\n

    Practical Tips<\/b><\/p>\n

    When you work into retirement years or have a spouse with employer coverage, it\u2019s important to stay on top of the rules because of the dollars at stake.<\/p>\n