Turning 65 soon? You can still be a member of Assurance Healthcare & Counseling Center while you’re on Medicare. In fact, membership with Assurance can work perfectly with Medicare, so long as you craft your plan knowing that you’d like to maintain membership here.
Membership at Assurance guarantees excellent access to a primary care physician, can help avoid some of the more costly items of healthcare, and we can help coordinate anything that may need to happen outside of our clinic – so long as you choose the right plan. Here are a couple issues to be aware of when signing up for Medicare…
Our biggest tip…
If you are convinced that purchasing a supplement to Medicare is best for you (see our recommendations below), DO NOT purchase an HMO or Medicare Advantage plan. These plans lock you into using specific providers, and if we (Assurance providers) want or need to refer you to a specialist outside of our clinic, these supplements will not allow us to refer you. You would then be required to see another primary care physician in order to refer you to a specialist.
Option 1) Assurance Membership, plus Medicare Part A + Part B (+ Part D if you feel better about adding it).
This plan is for those that are in fairly good health, are financially stable, and looking for the best care at the most reasonable price. The only thing this plan leaves out is the ‘supplement.’ You will mostly be responsible for 20% of ‘medicare-allowable charges’ (the key is medicare-allowable), which in most cases is quite affordable.
For example… A knee surgery typically costs around $15,000, but Medicare only allows $6,000. This means that Medicare will pay 80% of the $6,000, which is $4,800, and you will be responsible for only $1,200 (the equivalent to about 8-12 monthly supplement payments). The difference between the $6,000 of Medicare-allowed and the original $15,000 simply goes away (it’s basically a contracted price between that facility and Medicare). You are not billed for the difference, and neither is Medicare. You are only billed the $1,200 and that’s it.
This plan cost will depend on your income. Currently, the starting cost is $134 for plan B, and anywhere from $16-64 for part D. Part A has already been paid through your wages, so long as you worked for a certain period of your lifetime.
Option 2) Purchase Assurance Membership, plus Medicare Part A + Part B + a non-HMO Supplement (and Part D if not included in Supplement).
This plan is for those who don’t mind spending extra monthly (generally $130-200 more than Option #1) in order to ensure that no surprises will come later with one-time payment for surgeries, hospital stays, etc.
Do not purchase an HMO Supplement plan! If you wish to continue using an Assurance Membership, it is much easier if you purchase a PPO plan, as we can still refer you to specialists and coordinate your care as your primary care physician with a PPO plan, but not with an HMO plan.
The plans that we’ve heard work best are Plan F (which is going away beginning in 2020), and Plan G. These are both considered “Medigap” plans – and no matter what company you purchase these plans from, they are required to have the exact same features. So a higher price shouldn’t necessarily mean ‘better’ coverage.
Stay tuned for recommendations on exactly where to purchase these supplemental plans if you’re interested. We’ll hopefully have a recommendation soon!
If you’d like to schedule a meeting and hear more information about Medicare in general, feel free to call our office to schedule an appointment or reach us through our contact page.
Frequently Asked Questions…
I currently have a plan with my employer… should I stay with them?
As with most things, it depends. Your Human Resources contact should know more about whether it makes sense to continue on your employer’s plan or to sign up directly with Medicare. If you’re unsure who to speak with, ask to speak with their insurance broker or agent.
I currently have Health Sharing / Medical Cost Sharing plan – should I sign up for Medicare or continue with them?
In nearly all cases, you’re better off signing up for Medicare now (your premium will continue to increase the longer you wait after age 65 to sign up with Medicare – which they call a ‘penalty’) and considering one of the above options. Some medical cost sharing plans won’t work after age 64, and other health sharing ministries turn into an expensive supplemental plan.
For example; with Liberty HealthShare, they have an option that looks a lot like a supplement, but the price increases after you turn 65. We would recommend dropping Liberty HealthShare and signing up for Medicare alone using one of the above options. If you really believe in what Liberty or your Health Sharing Ministry is doing, we recommend donating to them to help others.
What if I wait to sign up for Medicare after I turn 65?
Medicare calls it a penalty, but it looks more like an increased premium – for every 12 months you wait after age 65 to join Medicare, you’re charged an extra percentage. You’ll get the best rate if you sign up for Medicare starting at age 65 – and the time to sign up is during the 6 month period surrounding your 65th birthday (3 months before to 3 months after).
Why would I purchase Part D if I get cheap medications through Assurance?
This is a very, very good question, and many people choose to not purchase Part D. Part D is often so inexpensive, that if there happens to be a medication that we’re not able to supply to you at a cheaper rate than Medicare, you’re able to get that through part D. Signing up for part D years after you turn 65 also results in a ‘penalty’ (we call it an increased premium), so it’s often easiest to just get that when you turn 65 when it’s most affordable.
But, if you would rather not pay that monthly premium, we do all we can to get you inexpensive medications!