Medicare Dates and Deadlines

as you may know, Medicare has multiple dates and deadlines on an annual basis. I monitor these changes and advise my clients when appropriate. As your advisor, I will always have the latest information you need to make an informed decision.

October 15 to December 7 Each Year

Open enrollment. This allows you to switch your Medicare Advantage Plans and Prescription Drug plans with oput penalty, underwriting, or loss of coverage. Changes made during this period will become effective January 1.

 

January 1 to February 15

Dis enrollment period. This allows those who enrolled in a Medicare advantage plan to leave that plan to return to Original Medicare and enroll in a drug plan without penalty. You may also apply for a Medicare Supplement at that time.

 

January 1 to March 31 Each Year

Part B enrollment. This is if you missed the initial enrollment period for obtaining your Part B. This is the only time you can sign up for Part B without a Special electi9on Period. Changes go into effect July 1 of the same year.

 

Choose Your Agent Wisely

The person who take your Medicare insurance application becomes your new agent. Don’t trust this to just anyone.

Medicare Information Request Form

Making Medicare Easy

Are you are turning 65 in a few months and have a thousand questions about Medicare?

Or maybe you turned 65 a few years back but continued working and are now thinking of retiring and going on Medicare.

I can help. I know there is a ton of literature that you have been sent through the mail and advice you have gotten from your friends. I know it can be confusing listening, and reading and trying to figure out what is what.

I can help.

I have been helping people just like yourself for almost a decade navigate Medicare. I have been helping people with all their insurance needs for almost two decades. Take my quiz to make Medicare EASY.

Free Services

All of my services are 100% free to you. You will never pay a broker fee or pay more for your coverage with me. All rates are fixed by the insurance companies and my compensation comes from the carriers.

Discover What Your Needs Are

In order to find the right plan, I need to get to know you first. I will ask a few questions about your medical needs, medications you are taking and doctors you are seeing, and if you have a hospital preference, budget lifestyle etc. Take my quiz to make Medicare EASY

Explain What Medicare is

Next I will take a few minutes to clarify what Medicare is so you can better understand your options. I will clear up any misinformation and answer ALL of your questions.

Research and Present All Your Options

Based on your answers to my questions, I will come up with the best plan choices for your situation, taking into considerations all of your needs.  I will explain all the features and benefits of your choices. You are the final decision maker.

Questions after Enrollment or During the Year

As your agent, I am here to help you 365 days a year. I am just a phone call away. Don’t get caught without a great agent. You never know when you will need an advocate.

Your agent is your advocate.

Take the Medicare Made EASY Quiz

Medicare Information Request Form

How can I replace my Medicare card?

If your Medicare card is lost, stolen or damaged, you can ask Social Security for a new one.

  • Your Medicare card will arrive in the mail in about 30 days.
  • Social Security will mail your card to the address they have on file for you.
  • If you need proof that you have Medicare sooner than 30 days, you can request a letter from Social Security. The letter will arrive in the mail in about 10 days.
  • If you need proof immediately for your doctor or for a prescription, visit your local Social Security office.

10 things to know about your new Medicare card

 

  1. Your new card will automatically come to you. You don’t need to do anything as long as your address is up to date. If you need to update your address, visit your mySocial Security account.
  2. Your new card will have a new Medicare Number that’s unique to you, instead of your Social Security Number. This will help to protect your identity.
  3. Your Medicare coverage and benefits will stay the same.
  4. Mailing takes time. Your card may arrive at a different time than your friend’s or neighbor’s.
  5. Your new card is paper, which is easier for many providers to use and copy.
  6. Once you get your new Medicare card, destroy your old Medicare card and start using your new card right away.
  7. If you’re in a Medicare Advantage Plan (like an HMO or PPO), your Medicare Advantage Plan ID card is your main card for Medicare—you should still keep and use it whenever you need care. However, you also may be asked to show your new Medicare card, so you should carry this card too.
  8. Doctors, other health care providers and facilities know it’s coming and will ask for your new Medicare card when you need care, so carry it with you.
  9. Only give your new Medicare Number to doctors, pharmacists, other health care providers, your insurers, or people you trust to work with Medicare on your behalf.
  10. If you forget your new card, you, your doctor or other health care provider may be able to look up your Medicare Number online.

Watch out for scams

Medicare will never call you uninvited and ask you to give us personal or private information to get your new Medicare Number and card. Scam artists may try to get personal information (like your current Medicare Number) by contacting you about your new card. If someone asks you for your information, for money, or threatens to cancel your health benefits if you don’t share your personal information, hang up and call us at 1-800-MEDICARE (1-800-633-4227).  Learn more about the limited situations in which Medicare can call you.

 

Medicare 101

 

Medicare has 3 parts.

Part A – Hospital Coverage

Part B- Doctors and services

Part D- Drug coverage

 

Premium-free Part A

You usually don’t pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working.  This is sometimes called “premium-free Part A.”

Most people get premium-free Part A.

You can get premium-free Part A at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You’re eligible to get Social Security or Railroad benefits but haven’t filed for them yet.
  • You or your spouse had Medicare-covered government employment.

If you’re under 65, you can get premium-free Part A if:

  • You got Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

Part A premiums

If you buy Part A, you’ll pay up to $422 each month in 2018. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $422. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $232.

In most cases, if you choose to buy Part A, you must also:

Contact Social Security for more information about the Part A premium.

Some people automatically get Medicare Part A (Hospital Insurance). Learn how and when you can sign up for Part A.

Some people automatically get Medicare Part B (Medical Insurance), and some people need to sign up for Part B. Learn how and when you can sign up for Part B.

If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty.

Part A costs if you have Original Medicare

Note

All Medicare Advantage Plans must cover these services. If you’re in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those in Original Medicare. Review the “Evidence of Coverage” from your plan.

  • Home health care
  • Hospice care
    • $0 for hospice care.
    • You may need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it’s covered under Part D.
    • You may need to pay 5% of the Medicare-approved amount for inpatient respite care.
    • Medicare doesn’t cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
  • Hospital inpatient stay
    • $1,340 deductible for each benefit period.
    • Days 1–60: $0 coinsurance for each benefit period.
    • Days 61–90: $335 coinsurance per day of each benefit period.
    • Days 91 and beyond: $670 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime).
    • Beyond lifetime reserve days: all costs.

How much does Part B cost?

Part B premiums

You pay a premium each month for Part B. If you get Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill.

Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS).

2018

The standard Part B premium amount in 2018 will be $134 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount ($130 on average). You’ll pay the standard premium amount (or higher) if:

  • You enroll in Part B for the first time in 2018.
  • You don’t get Social Security benefits.
  • You’re directly billed for your Part B premiums (meaning they aren’t taken out of your Social Security benefits).
  • You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134.)
  • Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. If so, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

If you’re in 1 of these 5 groups, here’s what you’ll pay:

If your yearly income in 2016 (for what you pay in 2018) was You pay each month (in 2018)
File individual tax return File joint tax return File married & separate tax return
$85,000 or less $170,000 or less $85,000 or less $134
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $187.50
above $107,000 up to $133,500 above $214,000 up to $267,000 Not applicable $267.90
above $133,500 up to $160,000 above $267,000 up to $320,000 Not applicable $348.30
above $160,000 above $320,000 above $85,000 $428.60

 

Part B deductible & coinsurance

You pay $183 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for these:

  • Most doctor services (including most doctor services while you’re a hospital inpatient)
  • Outpatient therapy
  • Durable medical equipment

Find out what Part B covers.

Find out what you pay for Part B covered services.

Costs for Part D Medicare drug coverage

You’ll make these payments throughout the year in a Medicare drug plan:

Your actual drug plan costs will vary depending on:

  • The drugs you use
  • The plan you choose
  • Whether you go to a pharmacy in your plan’s network
  • Whether the drugs you use are on your plan’s formulary
  • Whether you get Extra Help paying your Medicare Part D costs

Look for specific Medicare drug plan costs, and then call the plans you’re interested in to get more details.

If you have limited income and resources, your state may help you pay for Part A and/or Part B. You may also qualify for Extra H

Medicare Information Request Form

About Me

Hello, my name is Michelle de Guzman

I have been in the insurance industry since 1999. Following a successful career in the financial services industry, in 2009, I redirected my focus to helping seniors throughout California and Florida make smart decisions about their Medicare options. I now specialize in educating and advising seniors through maze of Medicare Supplements and Advantage plans.

My hands on approach to servicing my clients has made me a Premier Agent in Orange County CA. But my greatest achievement is when a client refers their friend or family member.  My motto is “Always treat each client the way I would want my parents and grandparents to be treated.”

Following college at CSULB with a Mathematics major, I married a fellow CSULB Alum and together we are raising two amazing boys. I have been married to  my husband since 1994 and together we love to travel and explore America with our friends and family.

Request an appointment with Michelle de Guzman