turning 65

Skilled St. Louis Senior Insurance Specialists Explain What You Need to Know About Medicare When You Turn 65

A milestone birthday brings changes to your insurance status

Do you have 65 candles on your birthday cake? Then Senior Health Solutions, LLC has important information for you about Medicare and other insurance. Once you hit 65, your insurance status changes. We can explain how Medicare works and what is does and does not cover. As each individual comes from different circumstances, we provide a “Turning 65 Simplified” no-cost assessment of your situation and from that can help you pick coverage that meets your current and future needs.

Advising you when to apply for Medicare

Medicare is a government-based insurance program for individuals age 65 or older or on disability. The cost of Medicare depends on your income (based on your federal tax return). Generally there is a standard monthly premium for Part B. The enrollment period begins three months before you turn 65 and runs through the third month after you turn 65 – a total of seven months. If you miss your initial enrollment period, you can sign up between January and March.
Medicare has various options for people age 65 and older

Once you understand the various parts of Medicare, it is easier to make decisions regarding what your needs are. Medicare has four parts:

  • Medicare part A

    This portion covers hospital costs for in-patient stays, skilled nursing care, hospice and certain medical care. To learn more about the assortment of options please contact us.

  • Medicare part B

    More traditional insurance, Medicare part B covers doctor visits, medical supplies, outpatient treatments and some preventative care. You can opt out of part B and forego the payments.

  • Medicare part C

    Sometimes called Medicare Advantage Plans, or MA plans, these are optional Medicare-approved insurance programs offered by private companies. These programs cover all services of original Medicare but may include Part D Drug coverage and additional benefits.

  • Medicare part D

    This part covers pharmaceuticals through private insurance carriers.
    Since every Part D is different, we work with you and Medicare directly to find the plan that saves you the most money on your prescriptions.

In addition to Medicare, some people purchase Medicare gap insurance, or otherwise known as a Medicare supplement.

Medigap insurance covers certain costs that are not included in part A or B. It is important to note that you cannot have both Medicare part C at the same time as Medicare supplement insurance. You cannot use Medicare supplement insurance to pay for Medicare Advantage plans’ copays.
Understanding Medicare’s premiums in Missouri

Medicare costs vary. If you or your spouse paid for Medicare taxes while you were working you could qualify for premium-free part A. You may also qualify for premium-free part A if you receive Social Security or qualify for Social Security.

Certain former government employees with Medicare coverage also qualify for premium-free part A. If you have been on Social Security – Disability for more than 24 months, you may get premium-free part A. End-stage-renal-failure patients also qualify for it.

Those who do not qualify for premium-free part A pay a standard monthly cost. In most cases if you purchase part A, you also purchase part B for a monthly fee. Part B costs depend on your income.

Costs of Medicare parts C and D vary from policy to policy. Senior Health Solutions outlines the costs of benefits for each plan that suits your needs.

Can I choose my own doctor?

If you choose to use Medicare Advantage insurance, check if your doctor is in network. Medicare Supplement may not have network restrictions, but has monthly premiums that you need to consider.

For more information about Medicare and its supplements, contact our skilled professionals for a no-obligation assessment
Our team advises seniors and their families
About insurance options every day. We know that you have questions and concerns and take the time to explain the various plans so you can make an informed decision. Contact us today at (636) 244-4415 or online to get started.
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Important Information
How to enroll into Medicare
We can help you find a Medicare plan in your area to fit your needs. Once you decide on a plan we can walk you through the Medicare enrollment process.
How much is the cost?
These are the basic costs for people with Medicare. If you want specific cost information (like whether you've met your deductible, how much you'll pay for an item or service you got, or the status of a claim)
Do my doctors accept these plans?
Use this helpful link on the Medicare and Medicaid Services (CMS) website to find and choose Physicians and Other Healthcare Professionals enrolled in the Medicare program, as required by the Affordable Care Act (ACA) of 2010.
What to do if you don't want a part D
If you want to drop your Medicare Prescription Drug Plan (Part D) and you don't want to join a new plan, you can do so during the Open Enrollment Period, between October 15–December 7 each year. The change goes into effect January 1 of the following year.
Keeping your work benefits
Employer or union health coverage refers to health coverage from your, your spouse's, or other family member's current or former employer or union.
Medicare - Advantage Plans
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.
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