Trusty.care

Your Medicare journey starts here

 

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I am almost 65 and still working.

You need to find out if your work will still cover you after you turn 65. 

You need to find out the time period you will need to apply after you stop working if your work will still cover you. 

You need to find out if you should put off every kind of Medicare until you stop working. 

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I am almost 65 and retired. 

If you are married, you need to first determine if your spouse will be able to cover you through their work. 

You need to decide what kind of coverage you want. There are two basic buckets of packages.

You need to figure out how you are going to get your medications covered. 

You need to figure out the types of services covered by Medicare.

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I have a different situation...

Although most people fall into the first two buckets, there are lots of reasons why things are not as simple as the first two situations. This is not exhaustive but these are some of the more common situations. 

  • Are you or were you in the military?
  • Were you on disability?
  • Were you in the Federal government?
  • Are you in prison? 
  • Do you live overseas?
  • Do you receive state assistance?
  • Are you not an American citizen?
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The two main options 

The two main ways to get coverage through Medicare are these two options. Each package works together to cover your healthcare needs. 

 

Original Medicare+

Original Medicare+ contains Medicare A, B, D and Medigap

Medicare Advantage

Medicare Advantage contains Medicare A, B, C, & D

Pros & Cons of Original vs. Advantage

Our simplest explanation for Medicare.

*Medicare is a group of things that work together. It is not one thing. 

 

1. Part A & Part B: Original Medicare

Who: Most people get both of these.

What is it: Part A is technically called "hospital insurance", but it covers a lot of things that aren't in a hospital and doesn't cover a lot of things that are in a hospital. It is usually free. Part B is technically called "medical insurance" (this is confusing, as it is also called "Supplementary Medical Insurance" but it doesn't cover a lot of things and isn't free (everyone pays a premium that is usually paid through Social Security). 

Most important thing: Medicare A & B (a.k.a. Original Medicare) only covers 80% of your healthcare costs. You really, really, really need to get more than just Medicare A & B or you will be...well let's just say, get more. 

2. Part C Advantage Medicare & Part D Medications

Who: Everyone should get one of these. 

What is it: Original Medicare only covers a portion of costs, so you need some additional coverage that comes through Medicare C or Medicare D. There are a lot of pros and cons you should consider when selecting between Medicare C or D.

Most important thing: You really should get one of these if you can afford it and if you can't, then you really need to get other types of assistance available to you. 

The building options 

2a. Part C -Medicare Advantage

Who: If you want something that feels similar to what you had before and if you want a plan with a cheaper premium.

What is it: Part C (a.k.a. Advantage or MAP) is one way to go about covering what the foundation doesn't cover. C is sort of like a regular insurance plan in that it functions similarly to the insurance you had with an employer. It is a one-stop-shop. 

Upsides: The upsides are that these plans are more comprehensive and the premiums are affordable.

Downsides: The main downside is that you have to go to doctors that are in their network and this can sometimes be limiting. 

The other downside is that deductibles and copays can quickly ratchet up costs. 

2b. Part D & Medigap

Who: If you are a snowbird or want a lot of flexibility in which doctor you can go to, then this is the better option (probably).

What is it: The other option is to go with Part D (a.k.a. prescription) and a Medigap plan. Now you can just get D if you want but we really don't recommend it. So here is how that works, you get D and it covers your medications. But as you remember you still have that 80% only coverage with the foundation. Medigap covers the gaps that A, B, and D have in terms of coverage.

Upsides: On the upside, 90% of doctors take this kind of Medicare package.

Downsides: On the downside it is a bit more complicated and requires some time figuring out which plan to get.  The premiums can cost more. 

2c. Other Add-Ons or situations

There are a number of other situations that make your situation unique. If you get TRICARE, RRB, COBRA, HSA, FEHBP, Medicaid, SSI, or SSDI then things may be different for you. 

Also if you are under 65 there are other factors to consider. 

 

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Ask us anything

Didn't get the answer you were looking for? Send us any questions you have and we will do our best to get you the answers you need. 

 
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New York, NY, 10003
United States

 
 
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