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Cheat Sheet for Medicare

Here’s what you need to know about three key Medicare topics: a handy checklist of dos and don’ts to remember before starting the program; a fast rundown of the optimum times to enroll, based on your unique circumstances; and a mini-directory of organizations that can assist you with Medicare difficulties.

A few crucial Medicare dos and don’ts Medicare is a vital program for millions of elderly and disabled Americans, yet many are unaware of how it operates due to a lack of reliable information.

Medicare is a complicated program, but there are a few crucial features you should be aware of right away:

Give yourself plenty of time to learn everything there is to know about Medicare. It’s a system that has a lot of options and deadlines. Being well-informed is the greatest approach to prevent traps and costly blunders.

When it’s time to sign up, don’t expect to be notified. Unless you’re currently receiving Social Security retirement or disability payments, you’ll need to apply for Medicare — but you won’t be notified when or how to do so.

Don’t forget to enroll when the time comes. You must know your unique deadline for enrolling in order to avoid permanent late charges and maybe a delay in coverage. It’s either during your first enrollment period around age 65 or during a special enrollment period if you or your spouse continue to work for a company that offers health insurance after age 65.

If you haven’t yet been at that position long enough to qualify, don’t be discouraged. On your current or former spouse’s work, you may be eligible for Medicare Part A (hospital insurance) without having to pay any premiums. You may also be eligible to pay premiums to join Part A. However, regardless of how long you worked (or if you never did), you can get Part B (doctor’s services, medical equipment, and outpatient care coverage) and Part D (prescription drug coverage) by paying the required premiums — as long as you’re a citizen of the United States or a green-card holder who has lived here in America for at least five years before applying.

Keep in mind that Medicare is not a free service. If you don’t qualify for a low-income program or have supplementary insurance from another source, you may have to pay premiums for coverage and co-payments for most services.

Don’t assume that Medicare will cover all of your expenses. It covers many medical services, prescription medications, and medical equipment (including pricey procedures like organ transplants). However, there are several areas where coverage is lacking, such as routine vision, hearing, and dental treatment. Furthermore, Medicare does not pay the non-medical costs of long-term care in nursing homes or assisted living facilities.

Medicare will not cover your dependents. Except for individuals who qualify due to disability, no one under the age of 65 can get Medicare. There is no family coverage under Medicare.
If you require assistance, seek it. You may be eligible for low-income programs that pay your premiums or cover your prescription drugs at a reduced cost. Regardless of your income, you can obtain free personal assistance — in English or another language — in sorting through your Medicare alternatives and selecting the one that best meets your needs.

SEP (Special Enrollment Period): If you’re over 65, have group health insurance via the current employer of you or a spouse, and the employer has 20 or more employees, you’re eligible for a SEP. It’s possible that you may be able to postpone enrolling in Medicare until after you reach 65. The SEP lasts for the duration of your coverage and for an additional eight months after it ends or until your employment terminates, whichever happens first. If you stop working at the end of February, for example, you can enroll in Medicare without risking late penalties until your SEP ends on October 31 — but to prevent a coverage gap, you should enroll in February so that your Medicare benefits begin March 1. (However, if you work for a small business with fewer than 20 workers, your employer may force you to enroll in Medicare at the age of 65 in order to keep your health insurance.) To learn more about this, contact your employer.)

Automatic enrollment: If you begin receiving Social Security or Railroad Retirement Board retirement payments at age 65 or later, you will be automatically enrolled in Medicare Parts A and B without having to apply. If you want to postpone Part B enrollment because you qualify for a SEP, as mentioned in the preceding General enrollment period (GEP), you can decline: If you did not sign up for Medicare during your I EP or SEP, this GEP permits you to do so now. Each year, it lasts three months, from January 1 to March 31. If you enroll during a GEP, your Medicare coverage won’t start until July 1 of the following year. You could also face late fines, which will be added to your Part B premiums for the rest of your life.

What if you live in another country? Medical care in other nations is almost usually less expensive than in the United States, so paying out of pocket may not put you out of business. In some cases, the national health program of the country you’re visiting may be able to help you.

However, purchasing health insurance on the free market can be complex and costly. One alternative is to join the Association of Americans Resident Overseas, a non-profit group that has long battled Congress to make Medicare available to Americans living abroad. Members of AARO have access to a wide range of private health insurance plans that may be used in a number of countries. (However, you may be allowed to sign up for Medicare while residing abroad.)


Six Factors to Keep in Mind When Choosing a Health Insurance Plan

It is critical to get health insurance to safeguard both your health and your wallet. If you are unable to obtain insurance through your work, Medicaid, or Medicare, you may need to look for a suitable plan among California’s individual health insurance plans.

When choosing an individual health insurance plan, keep the following these things in mind.

Keep Track of any Enrollment Deadlines That Apply to You.

In general, you are unable to enroll in a standard individual health insurance plan at any time. Rather, you must enroll during specific enrollment periods.

It’s critical to be aware of the enrollment period dates if you wish to sign up for health insurance. Save the date, so you don’t forget to sign up before the deadline for enrollment. If you don’t, you may have to wait months before you can enroll again. If during that time an unexpected health issue arises, you could end up financially responsible for those medical expenses out of pocket!

Do Extensive Research into all Your Options.

It’s critical to conduct your homework in order to get the ideal plan for your needs. There are numerous health insurance policies from which to pick.

You must investigate what is covered under each plan in order to thoroughly research health insurance policies. You should also look at the plan’s specifics, like as deductibles, co-pays, and health-care institution restrictions.

When selecting an individual health insurance plan, there are numerous details to consider. This means you shouldn’t make any snap decisions before conducting thorough investigation.

Calculate how Much you Spend or save by Comparing prices.

Premiums for health insurance might be a major monthly outlay. You should think about how much you can afford to pay each month for your health insurance payments. Make a financial plan. You don’t want to have your coverage canceled for nonpayment. If you suffer an injury or require medical attention, you will be without coverage. Many times medical staff has to consider what you can pay for, when determining the course of treatment. Medical coverage helps you get the best treatments, putting you on the fast track to a complete recovery.

When comparing health insurance choices, cost should not be the only factor to consider. However, it’s critical to pick the plan that will provide you with the greatest value while remaining affordable longterm.

Think about your Healthcare Requirements.

Some people require a higher level of health insurance coverage than others. If you’re young and healthy, you might be able to get by with less coverage than someone who is older and more likely to have health issues now and in the future.

You should also think about any chronic illnesses you may have. If you have a chronic illness, such as diabetes, make sure the plan you choose covers the care and meds you’ll need to manage your condition.

Educate yourself about the types of health insurance that are available, and the different types of health insurance plans. These plans differ in terms of how the network of health-care providers covered by the plan is set up.

Health maintenance organizations (HMOs), preferred provider organizations (PPOs), and exclusive provider organizations are examples of plans and networks (EPOs). Before you sign up for a health insurance plan, it’s critical to understand how these networks work.

Consult Agents or Experts if you have any Questions.

Health insurance is difficult to understand. You’ll almost certainly have questions regarding the plan’s specifics. More so if you’re signing up for the first time on an individual health insurance plan.

Don’t sign up for a plan until you’ve spoken with a representative from the health insurance provider in question and have all of your questions answered.

Health insurance can provide you with peace of mind by ensuring that you will be able to pay for your medical expenses. Examine your alternatives and get the coverage you require right away.


What Does the Texas Ruling Against Obamacare Mean?

By Daniel Murphy

After the December 14th ruling by a federal judge against the legality of ACA healthcaremany people are wondering whether or not they will continue to have coverage. Catchy headlines ran on news media for weeks implying all sorts of possible scenarios. Between the media war and political noise, the average person hasn’t been able to piece together exactly what to expect. Here at the office it’s been one of the most common questions for the past two weeks; “Is Obamacare still going to be around for 2019?” So as professionals in the industry, here are our thoughts down at Hummingbird.


This entire event needs to be put in it’s actual context. The supreme court did not strike down Obamacare – a federal judge in Texas did. Though this has powerful implications, especially in a judiciary system where establishing precedent is important for future laws, it can not bring everything to a grinding halt all by itself. There is almost always an appeal process. The ruling in Texas is important, but it will take many months ifnot several years to see precisely how it is going to pan out.


For some added perspective, consider that this is actually the seventieth time that the ACA has been challenged in court and/or sued by an assembly of politicians. The Supreme Court itself has even examined it once before and upheld the entire structure as legal and constitutional. There is a lot of political attention and validation in certain groups for the mere effort to bring down the Affordable Care Act. This results in many symbolic attacks against the law for the sake of bolstering one’s constituency and increasing funding for political campaigns. More often than notthese lawsuits are just tigers without teeth.


A majority of people want to continue to see some sort of inclusive healthcare for our country, and this is true on both sides. Laws often get empowered or diminished in a democratic system whose hallmark is a revolving door of different parties, people, and plans. Different ideologies hold power throughout any given era. Often times, however, the core laws are upheld. The ACA, I think at least, has become a core law in the United States. That doesn’t mean it won’t be transformed or even renamed as time goes on, but it does mean that some form of government-supported healthcare that accepts most pre-existing conditions is here to stay. Even President Donald Trump has voiced his support for a healthcare structure that provides this sort of coverage.


The Texas decision may indeed climb its way to the supreme court. A newly confirmed Republican on the seat there is a valid concern for people afraid that the Supreme Court may overturn its own earlier ruling. No matter what the outcome this is going to be a long and cumbersome process. Even if the law were repealed in totality tomorrow, there would still be at least a year involved in actually dismantling it. That means that for 2019, at least, no one should need to worry too much about their coverage. The future is harder to predict, but I’m comfortable betting that some form of inclusive healthcare will continue to exist at the federal level indefinitely, hopefully as a reliable pillar of U.S. law.