What is Medicare?

So what is Medicare? What will Medicare cost in 2020? On this page, you’ll get answers to these and other common medicare questions. However, your situation maybe unique so it’s best to speak directly with a Medicare expert. You’re welcome to call us at 1-855-368-4717.

Medicare is a national health insurance program in the United States that started in 1966 by the Social Security Administration (SSA). It is primarily for Americans age 65 or older. However, it is also for younger people with SSA disability status and terminal diseases.

Medicare is a national U.S. health insurance program for Americans 65 or older.

medicare.gov

How to enroll into Medicare?

How you enroll in Medicare will depend on whether you are drawing social security income or you have deferred it. If you are drawing social security income, then you will automatically be enrolled in Medicare Part A and Part B. You will receive your Medicare card by mail approximately 3 months prior to your 65th birthday. So if you are already receiving social security benefits, you don’t have to do anything. However, if you are not drawing social security income, then you will need to register for Medicare Part B. There are three ways you can do this:

  1. Go online at www.ssa.gov
  2. Call 1-800-772-1213
  3. Visit your local social security office and register in person

If I’m working, do I have to start Medicare?

No, you don’t have to start Medicare as long as you or your spouse is still working and you have health insurance through your or your spouse’s employer. So if you’re working and have health insurance, you can defer Medicare Part B and you will not be penalized. However, if or when you lose that coverage, you will have 60 days prior coverage ending and 63 days after coverage ends to enroll in Medicare Part B.

When does my Medicare coverage start?

Medicare coverage starts the first day of month you turn 65. For example, if your birthday is 10/10/1948, your Medicare will start 10/01/2013. If your birthday is on the first of the month, your Medicare will start a month prior to your birth month on the first day. For instance, if your birthday is 10/01/1948, then your Medicare will start 09/01/2013. This is how Medicare calculates your coverage start date.

What is my Medicare Claim Number?

Your Medicare Claim Number is the number that Medicare uses to file your claims. Your Medicare Claim Number used to be your social security with a letter after it. Between April 2018 and April 2019 the Centers for Medicare & Medicaid Services (CMS is governmental agency that administers Medicare) mailed new Medicare cards. Your social security number on Medicare cards were replaced with a new Medicare Number to prevent identify theft and taxpayer fraud.

medicare claim number
New Medicare Card

Each new Medicare Number is unique to each beneficiary, is 11 characters in length, and composed of numbers and uppercase letters excluding letters (S, L, O, I, B, Z) which could be interpreted as numbers. Medicare will no longer accept social security number after December 31, 2019. The date on your Medicare card is the date your health insurance coverage starts. For example, if your 65th birthday is in the middle of the month, October 15, your coverage will start on October 1.

Is Medicare free?

Medicare is free (no premium) for most people with Medicare Part A. However, most people with Medicare Part B have a premium. Part B premium is typically based on your income from the prior two years. In other words, if the current year is 2020, then Medicare Part B is based on your income from 2018.

What will Medicare Cost in 2020?

Medicare cost in 2020 will increase. The monthly premium for Medicare Part B will cost more. The deductible for Medicare Part A will cost more for hospital and skill nursing facility care. Similarly, annual deductible for Medicare Part B will also cost more. According to the CMS Fast Sheet, the increase in Part B premiums and deductible is largely due to rising spending on physician-administered drugs. These higher costs have a ripple effect and result in higher Part B premiums and deductible. For specific Medicare cost increases in 2020 continue reading.

The increase in Part B premiums and deductible is largely due to rising spending on physician-administered drugs.

Center for Medicare & Medicaid Service (CMS) Fact Sheet November 8, 2019

What will Medicare Part B premium cost in 2020?

Medicare Part B premiums 2020

The standard monthly Medicare premium for Part B will be $144.60 for 2020. This is up $9.10 from 2019.

 How do I pay for Medicare?

Medicare premiums for Part B are typically deducted from your Social Security Income (SSI) check. However, if you are not drawing SSI, Medicare will mail you a quarterly bill (every 3 months).

What is Medicare Part A?

Find out what Medicare Part A covers and costs.

MedicareBob™’s cliff notes:

In general, Medicare Part A covers hospital care, skilled nursing facility care, nursing home care, hospice, and home healthcare. Like all health insurance Medicare Part A does not pay for healthcare service in full. Medicare Part A charges you the following:

What will Medicare Part A cost in 2020

  • Hospital – When you go to the hospital, Medicare Part A will require you to pay the first $1,408 in 2020, an increase of $44 from $1364 in 2019, before Medicare will pay for any of your hospital bills. For stays longer than 60 days, you will have a copay $352 per day that you will have to pay in 2020. Furthermore, hospital stays longer than 90 days will cost you $704 per day in 2020.
  • Skilled nursing facility care – Medicare Part A will only pay for the first 20 days. From 21 days to 100 days you will have a copay of $176 per day in 2020. After 100 days all costs are coverage by Medicare Part A.
  • Hospice and home health services – if you meet Medicare’s requirements, then Medicare will provide these services at no cost to you.

What is Medicare Part B?

MedicareBob™’s definition: Medicare Part B covers your medical and Doctor’s bills. For example, doctor visits, outpatient procedures, durable medical equipment, lab work, and more!

What will Medicare Part B deductible cost in 2020?

The annual deductible for Part B will rise to $198 in 2020, which is $13 more than $185 deductible in 2019. You only pay this deductible once per year. Then Medicare Part B will pay 80% of your medical and doctor bills. Consequently, you will have to pay the remaining 20% (called coinsurance).

What is a deductible?

A Deductible is an amount of money that you are require to pay before your insurance plan will pay anything towards your bills.

Deductibles Examples

  • Medicare Part A will have $1,408 deductible when you go to the hospital in 2020. This means that you have to pay the first $1,408 before Medicare Part A will step in and pay anything.
  • Medicare Part B has an annual deductible of $198 in 2020. This means that you have to pay the first $198 of your medical and doctor bills before Medicare will step in and pay anything.

What is a Copay?

A copay is a pre-negotiated amount (fixed dollar amount) between a service provider or facility and an insurance plan. For example, Medicare Part A will charge you a $352 copay per day starting day 61 in the hospital in 2020.

What is Coinsurance?

Coinsurance is a percentage that you are required to pay. Instead of being a fixed dollar amount, it is a fixed percentage. For instance, Medicare Part B requires you to pay 20% coinsurance. Therefore, Medicare Part B pays 80% of your Doctor and Medical bills and you are required to pay the other 20%.  

Is physical therapy covered by Medicare?

Yes and no… Yes, Medicare Part B does cover physical therapy. However, there are some limitations. The physical therapy has to be ruled as “medically necessary.” Even then, there are limits called “therapy caps” or “therapy cap limits.”

What is not covered by Medicare Part A and Medicare Part B?

The following is not covered by Medicare Part A and Medicare Part B: Long-term care, Routine dental or eye care, dentures, cosmetic surgery, acupuncture, hearing aids/ exams, routine foot care.

Which plan is right for me?

Watch this video to learn the difference between Medicare Advantage plan Vs. Medicare Supplement plan. Discover which plan maybe a better fit for you.

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