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Medicare Does Not Have To Be Hard

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“I’ve been researching online for the last 2 weeks and I am more confused now than when I started.”

-Randal W. Houston, TX (actual customer quote)

We have clients who bring out entire bags of mail that they never even opened because the volume was so overwhelming and they didn’t understand what they were reading.

If you are new to Medicare, you might feel the same way. With all the parts and plans to Medicare and the endless commercials and mailings, it can be hard to get things straight in your mind. How does this work?

When Do You Get Medicare?

While most people start Medicare when they turn 65 years old, you can also gain access to Medicare before age 65 by virtue of a qualifying disability or by developing certain conditions such as ALS (Lou Gehrig’s Disease) or ESRD (End Stage Renal Disease). You could also be considered “new” if you delayed Medicare, continued working past age 65, and remained on your employer group health plan. Regardless of how you are approaching Medicare, as you are getting ready to take the “plunge” you may be wondering “now what”? You may have even heard that you could be fined or penalized by not signing up when you are eligible!

When it is time for Medicare, it can seem overwhelming and that is too bad because it shouldn’t be. Medicare is, by most accounts, a very popular government program. For many, it is the first time in a long time that they have affordable health coverage. The process of choosing your Medicare health plan should be exciting, not scary or confusing.

We make it Clear…We make it Easy

Who Can Get Medicare?

You must be a citizen or legal residents. A legal resident must have lived in the United States for at least 5 years in a row including the 5 years immediately preceding applying for Medicare. You must also be:

• Age 65 or older or…
• Younger than 65 with a qualifying disability for at least 24 months or…
• Any age and diagnosed with ALS or ESRD

What Are The Parts of Medicare?

There are 4 parts to Medicare: A, B, C, D

Part A
Helps pay for hospital stays, inpatient care, hospice, and skilled nursing.
For most people Medicare Part A is premium free by virtue of a life full of working and paying taxes. In fact, most beneficiaries do not have to pay premium for Part A. The work requirement is working 40 quarters (10 years) and pay payroll taxes. For those that did not work 40 quarters, there will be a premium. The premium charged will depend on how many quarters worked.

Hospital Stay:
• You pay a $1,600 deductible per benefit period (up to 60 days)
• Then $400 per day for days 61-90 of each benefit period
• Additionally, $800 per lifetime reserve day (maximum of 60 days)

Skilled Nursing Confinement:
•Medicare pays all eligible expenses for the first 20 days. You pay a copay of $200 per day days 21 – 100 of each benefit period. You are responsible for all costs each day after day 100 of the benefit period.

**There is NO out-of-pocket maximum limit.

Part B
Helps pay for Doctors and other outpatient care and services
Part B cost is based on your income. Most people pay the standard rate which is $164.90/mo (2023). This premium is deducted from your social security payment of you are receiving benefits. If you haven’t started taking your social security, you will be billed quarterly. For people who earn more, you might be charged an IRMAA (Income Related Monthly Adjusted Amount). Medicare calculates your IRMAA by looking at your Modified Adjusted Gross Income (MAGI) to determine your additional premium. Your MAGI is determined from your IRS tax return from two years prior. Currently about 5% of beneficiaries must pay more than the standard rate.

Deductible: You pay a one-time deductible of $226 per year for 2023. This is subject to change annually.

Other Costs: You must pay 20% of the Medicare-approved amounts for qualifying medical services, plus Excess Charges (if applicable).

**There is NO out-of-pocket maximum limit.

Parts A& B are commonly known as “Original Medicare”

Part C
Combines Part A and B of Medicare into one plan and is offered by private companies. These plans usually include prescription drug coverage.
Part C consists of Medicare Advantage plans. You must be enrolled in both Parts A and B to be eligible for Medicare Part C. You still must pay any premium associated with Parts A&B (including any IRMAA assessed). There could be an additional premium for a Medicare Advantage plan. Premiums for these plans will depend on the type of plan you choose and can range from $0 up to $200/mo or more.

Part D
Helps pay for prescription drugs.
Part D prescription drug plans are offered by private companies contracted by Medicare for this purpose. Part D can be acquired within a Medicare Advantage Prescription Drug Plan (MAPD) or as a stand-alone plan. Within a MAPD plan, the Part D plan may or may not have a monthly premium. As a stand alone plan, premiums can run as low as $7/mo for a basic plan and as high as $100/mo (or more) for plans with enhanced coverage (2023). Which type of plan you enroll in should be determined by a thorough analysis of your prescription drug needs and which type of coverage you desire. Like Part B, people who earn more could have an IRMAA added to the Part D plan premium.

How Do I Enroll?

If you are receiving Social Security or Railroad Retirement Board benefits, enrollment in Medicare is automatic when you become eligible. You will get your card in the mail.

If, however, you are not receiving benefits, you will have to enroll yourself when you become eligible. You can enroll online, call or visit the local Social Security office.

I Need Help Enrolling in Medicare – Click Here

Real Clients. Real Help.

Linda L.– Magnolia, Texas

“Just wanted to let everyone know how great you were I needed to change my Medicare health insurance and he went the extra mile for me I would highly recommend him.”

Mark H.– Houston, Texas

“Justin is genuinely committed to doing the right thing. He’s honest and has proposed what makes sense for me and my business partner. ”

B.F.– Houston, Texas

“Justin cares for his clients. He took the time to find out my needs & concerns. As a result found exactly what I wanted. I would recommend him to anyone.”

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    What Our Awesome Clients Have To Say

    • “After receiving hundreds of phone calls, emails, and pamphlets through the postal mail regarding Medicare, I sought out Justin White, who had sent a simple but sincere letter to my attention amidst all the confusing insurance information. The best couple of hours ever spent, as he took the time and patience to explain all the options and listen to what I truly wanted and needed. With his assistance, I was able to choose the best Medicare Plan for me which provided peace of mind and confidence as I move into my age 65 new chapter of life! His guidance and continued attention is truly appreciated, and I highly recommend contacting Justin to save on your personal frustration when it comes to insurance needs.”
      - Barbara M. in Spring, Texas
    • “Kyle, You have assisted & advised me regarding my insurance needs for the last six years. You handle all the paperwork. You show me where to sign. Every year, I scan through the Medicare booklet. I put stick it notes at questions. Kyle always has the answers. Kyle Trahan, he’s the man. He’s my Medicare Advantage insurance man.”
      - Jean A. in Houston, Texas
    • “Just wanted to let everyone know how great you were I needed to change my Medicare health insurance and he went the extra mile for me I would highly recommend him.”
      - Linda L. in Magnolia, Texas
    • “As an older person, we are bombarded with so much information through mail, phone calls and television regarding insurance plans and Medicare. Kyle Trahan is respected and well sought out by many of us. He is very knowledgeable on the medical plans and he answers the Medicare questions in a way that we can understand them. Kyle puts us at ease and he is very patient with us. We feel free to ask any question. He also does one on one meetings. He helps us make our medical decisions in a timely manner. If any of us were paying Kyle Trahan for the good information he provides freely- he would be worth every penny. Thank you again for all you do.”
      - Glendia A. in Houston, Texas
    • “Justin is genuinely committed to doing the right thing. He’s honest and has proposed what makes sense for me and my business partner.”
      - Mark H. in Houston, Texas
    • “Medicare can use a lot of representatives as caring and knowledgeable as Kyle. We look forward to his visits at Brazos Senior Villas.”
      - Marcos O. in Katy, Texas
    • “At Brazos Senior Villas, we look forward to Kyle’s regular visits. he is a real helpful guy, not only for healthcare info but help with computer and cell phone questions and various problems. He takes time to listen! We love him!”
      - Aline B. in Katy, Texas
    • “Justin cares for his clients. He took the time to find out my needs & concerns. As a result found exactly what I wanted. I would recommend him to anyone.”
      - B.F. in Houston, Texas
    • “Kyle Trahan has the knowledge and professionalism that is invaluable in choosing a plan for health insurance. He has helped a great many people in the senior community where I live. We trust his ability to help us get the best possible coverage. Thanks Kyle for being there for me and all the others in our community.”
      - Betty H. in Katy, Texas
    • “Wanted to thank you for all you did for me! I got my meds transferred over to CVS and got my shots taken care of. It cost me $47.00! Yay!! I owe you big! I will tell everyone about you. God Bless you and your company. Thank you again!”
      - Liz S. in Katy, Texas

    about us

    At Senior Health Services, we believe in making this process easy and even fun! We simplify the Medicare process for you, explain how it all works and then help you find the type of plan that fits your needs the best.

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    Senior Health Services is not affiliated with the Federal Medicare program, Social Security, or any other governmental agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all of your options.

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