Medicare Maryland Eligibility

Medicare card turning 65

Maryland Medicare eligibility is offered to those turning 65 or those who have a permanent disability after a two-year waiting period at any age. 

Most people are curious about their eligibility for Medicare in the state of Maryland. The most popular way to become eligible for Medicare is to turn 65. It is at this time that you will transition from your current insurance plan over into a Medicare type program.

What is Medicare?
Medicare is simply an insurance plan funded primarily by the government through taxes as well as lifetime contributions while you were employed. With original Medicare the government will cover 80% of approved procedures and medical expenses, while you are responsible for the remaining 20% as well as obtaining prescription drug coverage.

Medicare Maryland Eligibility



How do you qualify for Medicare?
Medicare was originally designed for people turning 65 or older but has since broadened its ability to cover people under the age of 65 as long as certain conditions are met.

One of these conditions is ALS, also known as Lou Gehrig’s disease. With ALS you can immediately apply and be enrolled into Medicare. With ALS you can immediately apply and be enrolled into Medicare. The other instant qualification is for those people that have end-stage renal disease, ESRD.

The last option if you are under 65 is if you have a permanent disability after a two-year wait. How this works is Medicare part A will be sent to you and activated immediately, and after 24 months you’ll be issued Medicare part B. You will need to start paying Medicare part B premiums once you qualify after the 24 month waiting period. However the majority of people must wait until they turn 65 in order to start utilizing Medicare coverage.

Is Medicare automatic?

When you turn 65 you will automatically be sent a Medicare card with hospital part A already activated. The second part of Medicare is activated depending on your current social security situation. If you are turning 65 and have already begun collecting Social Security benefits then you do not need to apply for Medicare part B, it will automatically be given to you.

what is medicare

When you turn 65 you will automatically be sent a Medicare card with hospital part A already activated. The second part of Medicare is activated depending on your current social security situation. If you are turning 65 and have already begun collecting Social Security benefits then you do not need to apply for Medicare part B, it will automatically be given to you.

If you have decided to delay Social Security benefits, then you will need to apply for Medicare part B to go active at the same time as Medicare part A. All this requires is a quick application online or by mail by utilizing this online application found here.

If you delay enrolling in Medicare part B and do not have any other credible coverage from a union or employer, then you may have to pay late enrollment penalty‘s and possibly have your enrollment delayed by several months. This is nothing you want to forget to do, so do it up to three months prior to your 65th birthday month.

Is original Medicare enough coverage for me?
Typically no.  Since there is unlimited spending caps inside the Medicare system, you could be financially straddled with a 20% share of cost for all medical procedures and tests. Imagine going into a hospital for several weeks and receiving well over $1 million worth of medical care without any additional Medicare coverage, you will eventually be sent medical bills that could reach up to $200,000.

This 20% exposure is exactly why you need to consider additional Medicare coverage either through a Medicare supplement plan or a Medicare advantage plan.

medicare hospital bill

Medicare only covers up to 20% of your costs. With no limits or spending caps, you could face financial troubles without additional coverage.

Do I use Medicare if I’m still working?

This depends on your employer if they will continue offering you coverage after you turn 65. Most employers don’t because it’s extremely expensive to insure a 65-year-old so they typically want you to jump onto Medicare immediately.

However if you’re lucky enough to have group insurance that will cover you passed 865 you do not need to enroll into Medicare part B. This will save you some money without having to pay Medicare part B premiums each month because you still have credible coverage elsewhere and will not be penalized for doing so. Just remember that you will have Medicare part A activated when you turn 65 but it will not affect your current group coverage.

senior working past 65

How do I get Medicare when I retire past age 65?

If you retire from your job sometime after 865 you will be eligible to apply for Medicare part B at any time. You have up to eight months after you lose health insurance coverage to apply for Medicare part B however do not wait this long as you will not be covered during this time period.

If you retire from your job sometime after age 65 you will be eligible to apply for Medicare part B at any time. You have up to eight months after you lose health insurance coverage to apply for Medicare part B however do not wait this long as you will not be covered during this time period.

Medicare part A will go effective on the first day of your 65th birth month and your Medicare part B will go effective when you finally request it to.  You will have two different dates printed on your Medicare card one for Medicare part a and one for Medicare part B.

Once Medicare part B is active, you have 63 days in which to enroll into a Medicare advantage plan or a Medicare prescription drug plan. If you are considering a Medicare supplement plan then your window of enrollment is six months from the start date of Medicare part B.

If you miss these enrollment windows you could potential he have to wait many months before the window of opportunity opens up again in the late fall or what we call open enrollment, OEP.

Medicare supplement plans in Maryland operate a little bit differently because you can apply for and be approved for a Medicare supplement plan at any time throughout the year even without an open enrollment.  if you wait until after your six month guaranteed issue enrollment., Your application will go through full underwriting and you will need to answer health questions in order to be approved for coverage.

maryland broker in maryland

As you can see there’s many options when considering obtaining Medicare coverage as a 65-year-old. If you would like more information or need help with enrolling please give me a call at area code 410-896-1212 or email to me directly at peterpalmiotto@gmail.com.

I am a licensed independent Medicare broker servicing the entire Maryland area.

Turning 65 Maryland Medicare Insurance Plan Options

medicare turning 65 in maryland

Turning 65 in Maryland entitles you to opt into Medicare insurance and most of the time it is beneficial to do so. However, Medicare can be extremely confusing and most information you find is outdated or very misleading at best.

There are several steps you need to take when considering joining a Medicare plan when you turn 65. Here are a few of the most important things to consider when turning 65 and looking to enroll into a Medicare plan.


Current Coverage From An Employer, Union, Spouse, Government Plan

You may not need to enroll into Medicare (or Medicare Part B) if you have coverage from your current employer, spouse, government or union plan that will allow you to continue coverage after you turn 65.

Most companies realize that your cost of insurance skyrockets after you turn 65, so they will not offer any continuation of coverage. However, there are plans out there and companies that will allow you to continue your coverage well past your 65th birthday and the cost of this coverage might be worth you staying where you are.

A general rule of thumb is the $300 mark. If you will spend more than $300 per month with your current employer, spouse, government, union plan, then you should consider entering the Medicare market and taking full advantage of the fact that will have much coverage and benefits for less money each month. Consult with the human resources department to determine what your costs will be if you stay put after you turn 65.

When I work with clients the average price to have full Medicare coverage is around $300 per month. This includes all major medical including doctor and hospital visits as well as worldwide emergency and urgent care visits. It also includes coverage for your prescription drugs. However there are cases in which your Medicare cost could be slightly higher due to the fact that you are a high income earner. You can reference the chart below to see if you would trigger any Medicare high income earner penalties inside of the Medicare system.

medicare high income earner part b penalties

Doctor And Specialist Preferences And Freedom Of Choice

There are many options when selecting a Medicare plan but first you really need to determine what type of selection and freedom you want.

Determining this prior to meeting with a broker is extremely helpful in deciding what type of plan you will actually enroll in.

Because Medicare is a completely separate system of healthcare there are many rules that do not apply to what you are normally used to, and there are many rules that you now need to understand and follow to get the most out of your Medicare insurance.

Determining if you like staying within a specific network of doctors or if you like the freedom to choose anyone at any time is a major factor in determining which type of plan you will ultimately purchase.

You should discuss this with your broker as they can give you multiple different options with either choice.

is my medicare doctor in network

Typically the general rule of thumb is if you enjoy a certain group of doctors within the same system, such as the University of Maryland or Johns Hopkins, then you may consider a Medicare advantage plan. If your doctors are spread out amongst various different doctor networks and you really like to choose your doctors in any doctor network at any time without a referral required, then you will probably enjoy a Maryland Medicare supplement plan. They both have their pros and cons and there is usually something for everybody.

Maryland offers many different Medicare insurance plans when turning 65 and using an experienced broker will help guide you to the best plan possible.

Prescription Drug Costs - Do You Really Need Coverage?

When you turn 65 Medicare insurance brings with it a whole different set of rules for both your medical coverage as well as your Medicare prescription drug coverage. These rules are universal regardless of which plan you select.

Providing your broker with a complete list of your current prescription medications is the best way to determine which plan will save you the most money for the remainder of the calendar year.

It’s quite shocking to see the price differences on the same medications from one plane to the next. Even when you compare Medicare advantage plans to standalone Medicare prescription drug plans, you will notice a significant price difference from one plane to the next.

These price discrepancies are further complicated by selecting various types of pharmacies from your local pharmacies to the big chain stores even to Costco Pharmacy or Sam’s Club. The price differences can be enough that they may sway your decision on which specific plan to select.

This complexity is exactly why you should work with a certified Medicare insurance broker that offers at least 10 different plans to ensure you are being offered the lowest priced plan with the most benefits as possible.

medicare prescription drug plans in maryland

Each year Medicare changes the coverage limits and the deductibles in regards to prescription drug coverage. Currently the drug coverage deductible is $435 (for 2020). This deductible will reset on the first of every year and typically goes up year after year. This is why you should always have your broker shop for your Medicare insurance prescription drug plans every October or November to determine if it is smart to switch plans for the ensuing year.

Because the drug prices can be so different from one plane to the next and from one pharmacy to the next, do not rush into selecting a Medicare plan without fully discussing your prescription drug requirements with your Medicare insurance broker first.

And just remember that even though you may not be currently taking any medications, you are obligated to purchase and carry Medicare prescription drug insurance (Part D). There are some penalties if you fail to obtain coverage within 63 days of turning 65 or within 63 days of your Medicare part B Becoming active.

Some people may not be required to have Medicare prescription drug coverage due to what we call “ credible coverage“ from an existing employer, union, government plan or veterans administration benefits. 

Those that receive state assistance from Maryland’s Medicaid program (HealthChoice) are required to obtain coverage, however, the monthly premiums are typically covered 100% by the state. Those on Medicaid typically receive lower prescription drug prices at set rates regardless of how expensive your medications actually are. There are no late enrollment penalty’s for people that are Medicaid qualified.

Medicare prescription drug plans can be complicated and have a lot of different rules surrounding them. This is why it’s critical that you work with an experienced Medicare insurance broker that offers a variety of different Maryland insurance plans.

medicare lifestyle - determine your plan

Lifestyle, Budgets And Medical Requirements

The last thing we look at typically is one’s lifestyle, their budget and of course their medical requirements.

While most plans cover every major medical procedure you can comprehend, there are plans designed specifically to address certain elements such as COPD, ESRD, or those confined to a nursing home. These are typically Maryland Medicare Advantage Part C Plans.

Saving money is always the goal of most of my clients, so working within your budget is important. I typically tell my clients that they should budget about $300 per month to cover their basic Medicare insurance plans.

Is $300 can be broken down relatively easily in the following manner;

  • $145 per month for Medicare part B premiums, this is paid directly to CMS and normally withdrawn directly from your Social Security benefits. If you are not collecting Social Security, then CMS will bill you on a quarterly basis for these monthly recurring premiums.  Medicare part B premiums could be higher if you are a high income earner please see the chart here. Medicare part B premiums could be as low as zero dollars depending on your income and if you qualify for Medicaid.
  • $20 per month for a Medicare prescription drug plan in the state of Maryland. This of course can vary greatly depending on what type of medications you take and which plan may ultimately be the least expensive. You do not need to pay this premium if you have credible coverage elsewhere, are on Medicaid, or if you join a Medicare advantage plan that has Medicare prescription drug coverage built into it.
  • $150 per month is typically the monthy rate for a non-smoker in Maryland for Medicare supplement plan G. There are many other plans available but plan G is typically the most popular plan if you are born after January 1, 1955.  

You can eliminate bullet points number two and three if you enroll into a Medicare Advantage Plan. The monthly premium for Medicare advantage plans in Maryland start at $0 dollars per month and can range upwards of $150 per month depending on the county and the type of coverage you desire.

If you are in great health and have the financial means to support a $6000 deductible, which you would only pay if you used a lot of medical services throughout the year, then there is one plan that will actually pay you approximately $3500 per year to be in their plan. It is a MSA Medicare savings account design for those looking to invest their money through Medicare savings account and are infrequent users of medical services.

As you can see your lifestyle, budget and medical requirements will really determine your overall price structure for your Medicare Plan in the state of Maryland. Use a Broker for best results.

researching maryland medicare insurance plans

Turning 65 allows you to access Medicare, but don’t get confused by all the miss information found online and on TV ads. Be sure you work with a local, knowledgeable licensed broker that works independently and is not associated with any one particular insurance carrier.

Avoid sales people that call you without you giving them permission first. They could be from a different state without the intricate knowledge of Maryland insurance plans, or they could be calling from out of country with a very limited set of certifications or permissions to sell you insurance.

There are tons of options in Maryland for your Medicare insurance options, working with a knowledgeable broker will help you find the best plan to fit your needs in the most efficient way possible.

If you’d like a free consultation or quote over the phone or in person please contact me directly at peterpalmiotto@gmail.com or call me direct at 410-896-1212.

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maryland medicare options

Johns Hopkins Medicare Advantage

maryland Johns Hopkins Medicare Advantage

Johns Hopkins Medicare Advantage Plans Makes Medicare Easy

Medicare Advantage Part C plans are a fantastic alternative to Original Medicare for people in Maryland, and offer so much more.

Maryland Medicare Options is Licensed and Certified to sell Johns Hopkins Medicare Advantage Plans. Enrolling is quick and easy. Give us a call (410) 896-1212.

Offered throughout most of Maryland, a Johns Hopkins Medicare Advantage plan provides you with comprehensive Medicare coverage including Medicare Part D drug coverage. This includes Doctors, Specialists, Hospitals, Emergency services, Mental Health and a variety of tests, labs and x-rays. Along with comprehensive medical coverage, these plans offer additional benefits* such as:

  • $0 Deductibles
  • Primary Care Doctor Co-payments as low as $5 per visit
  • Upto $300 every two years for Vision benefits
  • Comprehensive Prescription Drug coverage
  • Free Gym Membership through Silver & Fit
  • Free Preventative Health Screenings
  • Free Annual Routine Hearing Exam
  • $15 Teeth Cleaning 1x Per Year
  • Free Home-Delivered Meals after Inpatient hospital visits

*Benefits vary by county. Contact us for full benefits.

johns hopkins senior insurance plans

Johns Hopkins Medicare Advantage Plan Options:

  1. Advantage MD (HMO)
  2. Advantage MD (PPO)
  3. Advantage MD Plus (PPO)
  4. Advantage MD Premier (PPO)

They offer a well-balanced selection of plans designed to cover all your health needs and some fantastic extras like a free gym membership. Plans vary by county, so you'll need to call us to see which plans are available in your area.

Unlike Original Medicare, these Advantage Part C plans combine Medical insurance and Prescription Drug insurance all in one. Additionally, there are no Medicare Part B deductibles or drug plans to sign up for.

johns hopkins medicare advantage plan card

Free Preventative Service Screenings

Once enrolled, you'll be issued a membership card. For typical visits, show your card at participating providers and pay your co-payment for regular doctor visits. For those looking for preventative services and screenings, your Johns Hopkins Medicare Advantage plan covers the following preventative services for free:

  • Abdominal aortic aneurysm screening
  • Annual routine physical exam
  • Annual wellness visit
  • Barium enemas
  • Bone mass measurement
  • Breast cancer screening (mammogram)
  • Cardiovascular disease risk reduction visit (therapy for cardiovascular disease)
  • Cardiovascular disease testing
  • Cervical and vaginal cancer screening 
  • Colorectal cancer screenings
  • Depression screening
  • Diabetes screenings
  • Diabetes self-management training, diabetic services, and supplies
  • Digital rectal exams
  • EKG following a Welcome Visit
  • Health and wellness education programs 
  • HIV screening
  • Immunizations
  • Medical nutrition therapy services
  • Medicare diabetes prevention program (MDPP)
  • Obesity screening and therapy to promote sustained weight loss
  • Prostate cancer screening exams
  • Screening and counseling to reduce alcohol misuse
  • Screening for lung cancer with low dose computed tomography (LDCT)
  • Screening for Sexually transmitted infections (STIs) and counseling to prevent STIs
  • Smoking and tobacco use cessation (Counseling to stop smoking or tobacco use)
  • Vision care

In order to receive these services for free, please discuss scheduling them with your Primary Care Physician and they will direct you to a networked facility.

talk to your medicare doctor

When Can I Enroll Into The Johns Hopkins Medicare Advantage Plan?

There are specific times to enroll into a Medicare Advantage plan. The most popular time is during the fall, or what is called the Annual Enrollment Period (AEP). This occurs from October 15th through December 7th. During this period, you can add, drop or change an Advantage Plan. Any changes made during this period will not go into effect until January 1st of the next year.

maryland annual enrollment period for Medicare

Another popular time to add these plans is around the time you turn 65. Starting three months before your 65th birth month, a one-time enrollment period starts which lasts seven months, this is called your Initial Coverage Election Period or ICEP. During this time you can enroll into any plan you want, Advantage Plans, Supplement Plans and Medicare Drug Plans. There are a few additional rules, and you may qualify even if you're under 65 years of age. It's best to contact me at (410) 896-1212 to discuss your situation.

Other time periods to enroll into a Medicare Advantage Plan are called Special Election Periods or SEPs. These include situations like losing employer coverage, moving from one county or state to the next, qualifying for Medicaid, or moving into assisted living or a nursing home. There are many situations that trigger an SEP throughout the year, and you probably don't have to wait for Open Enrollment to take advantage of these windows. 

To see if you qualify for a Special Election Period, please contact me to discuss your Medicare options.

medicare advantage insurance plans in annapolis

Johns Hopkins Medicare Advantage Plans are just one of many choices you have when selecting a Medicare plan. From HMOs to PPOs, they offer the flexibility and freedom for your lifestyle and medical requirements.

If you'd like more information about the plan choices in your area, please contact Maryland Medicare Options for your free Medicare consultation by phone or in person. 

What To Do With Medicare When Turning 65

maryland medicare plans when turning 65

Turning 65 shouldn’t be stressful.

Having the right Medicare information will help ease your transition into a wildly different health insurance system. The Medicare system has it’s own set of rules and regulations. From enrollment periods and mandatory coverage rules, to acronyms that will drive you crazy, Medicare isn’t the easiest thing to understand.

Follow A Simple Gameplan For A Smooth Transition

Working with a broker like myself will make your life much easier. I do this for a living and have helped 1,000’s of seniors since 2011. If you follow a simple gameplan, you’ll be into a Medicare plan without any hassles, penalties or delayed coverage. Just keep these 4 steps in mind:

1 – Make Sure Medicare Is The Top Choice 

Turning 65 typically means that Medicare insurance is your only choice. But for some seniors, staying with your employer’s plan may be more beneficial. First, make sure your employer or Union will allow you to stay on their plan past age 65. Secondly, make sure they won’t charge you more than $200 per month for their plan, if they do, it is simply not worth staying on their plan. Lastly, try to figure out if your monthly premiums will rise dramatically in the first few years. Some teacher’s unions only subsidize 65+ health insurance for the first two years, in year three, the monthly premium nearly triples, making Original Medicare a much better option.

If you or your spouse served in the Military, you may be entitled to Military insurance benefits either through the Veteran’s Health Care system (VA) or through Tricare For Life. You are allowed to have both VA Benefits and a Medicare insurance plan. These dual-benefits work together to offer the veteran additional network options, either with care provided by the VA or with care provided by a provider outside of the VA system. However, if you qualify for Tricare For Life (typically after 20 years of military service) then you do not need additional Medicare coverage.  In fact, adding any Medicare plans on top of what Original Medicare offers will actually disrupt your Tricare benefits.

tricare for life vs medicare

2 – Determine If You Need To Apply For Medicare Part B

Medicare is made up of two basic parts, Medicare Part A covers Hospital Benefits and Medicare Part B covers outpatient services. Here’s the issue, if you have not yet turned 65 and are already collecting Social Security benefits, then you don’t need to apply for Medicare A or B, the Social Security Administration (SSA) will automatically enroll you into both A & B. 

If you have not yet turned 65 and are not taking your Social Security benefits yet, and you want to start Medicare when you turn 65, you will need to apply to be enrolled into Medicare Part B (the Social Security Administration will automatically send you Part A up to 90 days prior to your 65th birth month regardless of your status).  

Turning 65 will automatically trigger you being enrolled into Medicare Part A. Your enrollment into Part B is determined by your current SSA benefits status.  To enroll into Medicare Part B, you can sign up for Medicare online, or you can arrange an appointment by finding a local SSA office and meeting them in person, or you can download OMB No. 0938-1230 which is an APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE).  You will need to drop this off at your local SSA office or mail it to them, which should be sent with a tracking number and some way to prove it was received.  Enrollment takes at least 10 to 14 days and longer during busy times, so be sure you plan accordingly. You can apply for Medicare Part B enrollment up to 3 months prior to your 65th birth month. 

social security administration to apply for Medicare part b

3 – Don’t Miss Vital Medicare Deadlines

There are many deadlines that must be followed when entering Medicare. Here are some of the most important ones:

  • Part B 90 Day Rule – File for Medicare B up to 90 days prior to your 65 birth month and up to 90 days after. If you miss this 7 month window, your coverage will be delayed by as much as a full year, including financial penalties. If you have sufficient credible coverage from an employer, you may not need to apply for Part B.
  • Part D Mandatory Coverage – Obtain Medicare Part D (prescription drug plans) within 63 days of your Medicare Part B becoming effective. If you don’t have credible coverage or sign up for a PDP plan, then you will start incurring penalties and your coverage will be delayed.
  • Loss Of Employer Coverage – Prior to losing your employer’s coverage, you should apply for Medicare Part B. However, once Part B starts, you’ll only have 63 days to enroll into a Part D drug plan or Part C Advantage Plan and up to 6 months to enroll into a Medicare Supplement Medigap Plan. Do not miss these guaranteed enrollment periods so you don’t have to answer any health questions.

maryland medicare deadlines

 

4 – Understand Your Optional Medicare Insurance Plans

As you know, Medicare by itself doesn’t cover 100%. Original Medicare only covers about 80% of the Medicare allowed billable rates. So if that procedure costs $1,000 and you don’t have any other insurance to help pay for it, you may be billed up to $200 for that procedure. And since there are no spending limits (called Max-Out-Of-Pocket), if you end up in the hospital, the costs could skyrocket past your financial means. This is why it’s important to understand what options are available to you when you turn 65.

Turning 65 triggers several “additional” options for Medicare insurance such as Supplemental Gap Plans, Medicare Advantage Part C plans and Prescription Drug Plans (PDP). All of these have their pros and cons. 

While I won’t go into great detail in this article about your Medicare gap insurance options, I will say that it’s best to call me for a free Medicare consultation. These plans offer something for everyone, and can be pretty robust in their benefits.

I can explain in simple terms what all your options are so you understand the scope of offerings. I’m licensed and authorized to sell all the different types of plans in Maryland and the surrounding states. I can be contacted directly at (410) 896-1212.

choose a maryland medicare insurance plan

 

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