Making Sense of Medicare Costs

AAA Benefits Counselor Ark-Tex Area Agency on Aging/ArkTex Council of Governments

Getting Medicare is a major milestone. Here’s where you can get the information you need, no matter where you are in your Medicare journey.

Four important facts:

Some people get Medicare automatically, and some have to sign up. You may have to sign up if you’re 65 (or almost 65) and not getting Social Security.

1. There are certain times of the year when you can sign up or change how you get your coverage.

2. If you sign up for Medicare Part B when you’re first eligible, you can avoid a penalty.

3. You can choose how you get your Medicare coverage.

4. You may be able to get help with your Medicare and Prescription drug costs.

Medicare covers a wide range of medical services. But Medicare is not free nor does it does cover everything. Anyone with Medicare will pay for a portion of their expenses, but what is paid will depend on the type of coverage you are enrolled in.

■ Parts A and B, Original Medicare.

■ Part C, a private Medicare Advantage plan.

■ Part D, prescription drug plan. Costs of Medicare include: Premiums — This is the amount you pay each month for Part B, your Medicare Advantage plan, and Part D. Some people who do not have a work history may also have to pay a premium for Part A.

If you are still employed when you reach Medicare age and take advantage of employer insurance coverage, which is also referred to as creditable coverage, you may be able to delay Parts A and B without having to pay a penalty if you enroll later.

Deductibles — This is the amount you must spend before Medicare pays for your insurance benefit. For example, if you had a hospital stay covered under Part A in 2021, you would have to pay $1,484 before Medicare kicks in.

Copayments/Coinsurance — You may have to pay a portion of the costs of a covered drug or service. This is called a copayment or coinsurance. It is also sometimes called cost-sharing.

Get Help — The Certified Benefits Counselors at Ark-Tex Area Agency on Aging understand there are a lot of options to consider regarding Medicare. Free assistance is provided by the benefits counseling staff to Medicare beneficiaries of any age to help navigate the different choices and decisions that come with Medicare.

If you, or someone you know, is having trouble with the costs of Medicare, such as paying the monthly premiums or copayments, the benefits counselors can help you find out if you can get help paying those costs. They can also help with the application process.

Each person’s health situation is different, no plan or option is the same for everyone. Contact Angela Glass, Certified Benefits Counselor with the Ark-Tex Area Agency on Aging at 1-800-372-4464 for any questions you may have about Medicare. Ark-Tex Area Agency on Aging Serves Bowie, Cass, Delta, Franklin, Hopkins, Lamar, Morris, Red River, and Titus counties.