Central Texas Medicare Insurance

Central Texas Medicare Insurance

855-474-6253

Medicare Insurance

Quick Links:  Part A Covers – Part A Costs – Part A Enrollment – Part A Eligibility – Part A Premiums

Medicare Supplement Insurance also is known as “Medigap” fills in gaps Original Medicare and is offered by private companies.

Traditional Medicare plans pay for much, but not for all, and do not pay the costs for covered healthcare services and supplies. A Medicare Supplement Insurance (Medigap) policy/plan can help pay some remaining part of the healthcare costs, including:
  • Copayments
  • Coinsurance
  • Deductibles
Medicare Supplement Insurance consists of two parts. Medicare Part A – hospital insurance and Medicare Part B – medical insurance. Medicare Part A covers Medicare inpatient care that is care received while in a hospital, nursing facility, and, in particular, circumstances, at-home treatment. Most people became automatically eligible for Medicare Part A when they reach the age of 65. It is possible when they are already getting retirement benefits from social security or the railroad retirement board. A person also qualifies for Medicare Part A before 65 if he/she is a disabled person, last-stage at renal disease, or amyotrophic lateral sclerosis. To be eligible for Medicare Part A, you must be either a United States citizen or a legal permanent resident of the USA at least five straight years.

Medicare Part A covers:

  • Hospital care of inpatient
  • Conditioned home health services
  • Nursing facility care provided that custodial care isn’t the only care required
  • Hospice care
Medicare Part A beneficiaries receive full coverage for hospital expenses that are critical for your inpatient care, including semi-private room, nursing services, meals, medications included in your inpatient treatment, and other related services and supplies from the hospital. Part A also has critical inpatient care provided through:
  • Critical access hospitals
  • Acute care hospitals
  • Long-term care hospitals
  • Mental health care
  • Inpatient rehabilitation facilities
  • Participation in a clinical research study
Medicare Part A insurance does not cover the costs of a private room, your private-duty nursing, your care items expenses as shampoo, telephone, and television. It also does not cover the cost of blood. You do not pay for blood if the hospital gets it from a blood bank without any charges. But if the hospital purchase blood for you, you have to pay for the first three units that you will receive each.

Medicare Part A Costs

In Medicare Part A, you don’t pay a monthly premium for Hospital Insurance coverage if you and your spouse paid Medicare taxes while working.  You will get a premium-free Part A at the age of 65 if:
  • You are receiving retirement benefits from social security
  • You are receiving services from the railroad retirement board.
  • You or your partner/spouse had government employment covering Medicare.
If you’re under 65, you can also get premium-free Medicare Part A:
  • You are a disabled person and got social security or railroad retirement board
  • You have last stage Renal Disease
If you are not qualified for a premium-free Part A plan, you can buy it.
  • The approximate cost is $458 each month.
If you paid Medicare taxes for less than 30 quarters, the approximate premium is $458. If you pay Medicare taxes for 30-39 quarters, the approximate cost is $252. Part A hospital inpatient cost and co-insurance include $1,408 deductible for each benefit period. Co-insurance includes:
  • Days 1-60: $0 for each benefit period
  • Days 61-90: $352 per day of each benefit period
  • Days 91 and beyond: $704 per each “lifetime reserve day” after day 90 for each benefit period

Medicare Part A Enrollment

You will automatically get enrolled in Part A Medicare insurance if you turned 65 and receiving social security retirement benefits or railroad retirement board benefits. You will start receiving Medicare Part A benefits from the first day of the month you turned 65. If your birthday is on the first day of the month, your services will begin the month before you turn 65. The high time to get a Medicare plan is during your 6-month Medigap open enrollment period. You will get better prices and more policies.

Medicare Part A Eligibility

You are eligible for a Medicare supplement insurance Part A if:
  • You are age 65 or older and a U.S. citizen.
  • You are a legal resident of at least five years.
  • You are getting retirement benefits.
  • You are disabled and getting disability benefits.
  • You have the last-stage renal disease (ESRD).
  • You have amyotrophic lateral sclerosis.

Medicare Part A Premiums

Most Medicare part beneficiaries do not pay a premium if they worked at least ten years and paid Medicare taxes at that time. People who aren’t able to get premium-free Medicare Part A can also get themselves enroll in Part A and pay a premium. Four ways to pay your Premium:
  • Pay online via Medicare account.
You can pay by your credit card, and debit card into your Medicare account online
  • Pay directly from your Bank saving Account
You can also directly pay your premium from your savings account
  • Medicare Easy Pay
The third and free service that automatically deducts your premium payments from your savings or checking account each month is Medicare’s easy pay app on the 20th of the month.
  • Mail check to Medicare
Quick Links:  Part B Covers – Part B Costs – Part B Enrollment – Part B Eligibility – Part B Premiums

Medicare Part B consists of medical insurance that is part of Medicare and covers medical services and supplies. These are medically important in treating your health condition. Part B includes outpatient care, ambulance services, preventive services, and durable medical equipment. It also covers part-time home care and rehabilitative services, including physical therapy.

Medicare Part B covers:

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Part B Medicare services cover the following:

  • Clinical research
  • Limited outpatient prescription drugs
  • Mental health
  • Inpatient
  • Outpatient
  • Partial hospitalization
  • Ambulance services
  • Durable medical equipment (DME)

Part B Medicare insurance coverage is based on the following factors:

  • Your state laws
  • Federal laws
  • National coverage decisions
  • Local coverage decisions made by companies

Medicare Part B Costs

U.S. citizens can automatically get Medicare Part B insurance, and others need to sign up for Part B Medicare supplement. Every person who gets enrolled in Part B Medicare pays a premium each month. It also automatically deducted from their benefit payment each month if they get benefits from the following:

  • Social security
  • Railroad retirement board
  • Personnel management office

And If you are not getting these benefits, you pay through a bill every month.

People usually pay a standard premium amount. If your gross income is above a certain amount, you also pay an income-related monthly amount. Medicare also uses a modified adjusted gross income reported for Part B MadIcare on their tax return from 2 years ago. This tax return information is the most recent tax return provided to social security administration by the IRS.

A standard Part B Medicare premium amount in 2024 is $174.70.

Medicare Part B Enrollment

If you’re receiving retirement benefits before the age of 65 or qualify Medicare insurance because of a disability at an early age you will automatically be enrolled in Medicare Part A and Part B as soon as you become eligible.
If you do not enroll during your initial enrollment period and also not qualify in the special enrollment period. In that case, you have the option to sign up during the annual enrollment period, which starts from 1st January to 31st March of each year and coverage starting from 1st July.
If you’re not automatically enrolled, you can also apply directly for Medicare supplement Insurance part B via the Social Security website either in person or by calling at 1-800-772-1213 on working days.
Remember, when you reach the age of 65 and have Medicare Part B, your six-month Medicare open enrollment period begins its time to purchase a Medicare Part B Supplemental plan. You’ll get a guaranteed-issue right to buy any Medicare plan without paying a higher premium or medical underwriting once you get enrolled in Medicare Part B, not to miss this initial guaranteed-issue enrollment period for Medigap supplement insurance.

Medicare Part B Eligibility

Anyone eligible for Medicare Part A is qualified for Medicare Part B by enrolling and paying a standard monthly premium. And if you are not able for Medicare Part A, you can also qualify for Medicare Part B by meeting the following criteria:

  • You reached ta the age of 65 years or older.
  • You are a U.S. citizen.
  • You are a permanent resident residing in the U.S. for at last five continuous years.

You may also qualify for automatic Medicare Part B enrollment if you are a disabled person. Or if you are under 65 years of age and getting social security benefits, you will automatically get enrolled in Medicare Part B after 24 months of disability benefits. You will also get Medicare Part B insurance enrollment before 65 if you experience last-stage renal disease or amyotrophic lateral sclerosis.

Medicare Part B Premiums

Your Medicare Part B premiums can change from year to year, and cost can vary based on your situation. For many people, it is deducted automatically from their social security benefits.

The monthly Part B premium is $174.70 in 2024.

But if your income exceeds a certain amount, your premium may also increase than the standard premium, as there are different premiums for different income levels in Medicare part B.

If you don’t get social security or rail board benefits, you’ll get a bill to pay your premiums:

  • Part B for medical insurance
  • Part A for hospital insurance

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. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. Medicare Supplement Insurance Plans A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits. Medicare Part D Prescriptions Plans Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, or you don’t get Extra Help, you’ll likely pay a late enrollment penalty. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

Free Medicare Cheatsheet Here

A Proud Bridlewood Insurance Affiliate
Nanny for the elderly reading

CENTEX MAKES MEDICARE EASY
CALL 855-474-6253
SEND CENTEX A MESSAGE

Medicare News

Centex Senior Care is an independent licensed insurance agency and is not affiliated with or endorsed by the government or the federal Medicare program. Insurance-related solicitation. We do not offer every plan available in your area. Currently we represent 1-10 organizations which offer 1-100 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

© Copyright 2023, Centex Senior Services Privacy Policy

Call (254) 987-6004