Frequently Asked Questions About Medicare

Contact us with any questions about Medicare or read more about San Diego Medicare on our website.

  • United Health Care Sharp
  • Blue Shield
  • SCAN
  • Medicare Enrollment
  • Eligibility
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  • 1. Can I receive Worldwide Coverage for Urgently Needed Services with Medicare?
     

    Yes, with many Supplement and Advantage plans, you will have access to emergency services anywhere in the world. You can be confident that you are able to travel and still receive emergency care.

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  • 2. Can I enroll in a Medicare plan with Personal Emergency Response System (PERS)?
     

    Can I enroll in a Medicare plan with Personal Emergency Response System (PERS)?
    Yes, Blue Shield offers PERS on their “Plan F Extra” plan. SCAN offers PERS for any of their Advantage plans. And UHC also has PERS for those who enroll with their plans.
    *SCAN and UHC also

    More
  • 3. Can I enroll in a Medicare plan with access to Tele-health services?
     

    Yes, Blue Shield offers Teladoc on their “Plan G Extra” plan. UHC offers a 24-7 nurse line as well as virtual medical visits with a licensed physician. SCAN also offers access to telehealth care from the comfort of your home.
    *SCAN and UHC also

    More
  • 4. Do all plans receive “Medicare Star Ratings”?
     

    All Part D PRescription Drug plans and all Advantage plans will always have a star rating. Many plans do not receive star ratings. Although some Supplement plans do receive star ratings, not all do. Blue Shield’s Supplement plans do not offer star ratings. Dental and Vision plan add-ons also do not have Medicare Star ratings.

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  • 5. Does UHC offer both Advantage plans and Supplement Insurance Plans?
     

    Yes, in fact, UHC has the largest number of both Supplement Insurance plans and Advantage plans to choose from.

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  • 6. Do I get access to SilverSneakers when I enroll in a UHC Medicare Plan?
     

    No, UHC has a partnership with AARP to offer its version of a gym membership: “Renew Active.” SilverSneakers is available for those who enroll in a SCAN Advantage plan or a Blue Shield plan.

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  • 7. Does Sharp offer Medicare Services in San Diego?
     

    Yes, Sharp Hospitals are available to you through UHC Advantage plans or a Supplement plan in San Diego.

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  • 8. Does UHC Medicare offer Medicare Plans in San Diego?
     

    Yes, the UHC Medicare Plans are a great way to get access to Sharp hospital networks with an Advantage plan.

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  • 9. Can I get dental, vision, and hearing insurance coverage through Medicare?
     

    Yes, when you enroll in Medicare you can pair additional services to your plan for an additional cost. For example, Blue Shield offers “Plan G Extra” which offers vision and hearing aid services. You can also add on a dental insurance plan for an additional cost.

    *SCAN and UHC also

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  • 10. Am I able to visit Scripps Hospitals in San Diego with an Advantage plan?
     

    Yes, you can select a SCAN Advantage plan if you wish to be in network with Scripps. UHC also offers Advantage plans with access to some Scripps locations.
    *UHC also

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  • 11. Do UHC Medicare Plans offer prescription drug coverage?
     

    Yes, UHC Advantage plans come with bundled prescription drug coverage. UHC also offers Part D Prescription Drug plans to pair alongside a Supplement Insurance plan.

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  • 12. Do UHC Medicare Plans offer dental insurance?
     

    Yes, some UHC Advantage plans have Dental insurance already included. Others you can pair with AARP dental insurance plans for a small price.

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  • 13. Does AARP offer Medicare Services?
     

    UHC has partnered with AARP to provide medicare services to its members. Although AARP doesn’t handle the administration of any Medicare products, it has helped UHC complete their Medicare offering.

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  • 14. Do I receive gym membership access when I enroll in a UHC Medicare plan?
     

    UHC offers its own “Renew Active” gym membership allowing you to find a gym that works for you. UHC also partnered with AARP’s “Staying Sharp” so you can support a healthy brain and body.

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  • 15. Do UHC Medicare plans offer Vision Services?
     

    UHC’s Medicare partner AARP offers vision discounts by EyeMed.

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  • 1. Can I receive Worldwide Coverage for Urgently Needed Services with Medicare?
     

    Yes, with many Supplement and Advantage plans, you will have access to emergency services anywhere in the world. You can be confident that you are able to travel and still receive emergency care.

    More
  • 2. Can I enroll in a Medicare plan with Personal Emergency Response System (PERS)?
     

    Can I enroll in a Medicare plan with Personal Emergency Response System (PERS)?
    Yes, Blue Shield offers PERS on their “Plan F Extra” plan. SCAN offers PERS for any of their Advantage plans. And UHC also has PERS for those who enroll with their plans.
    *SCAN and UHC also

    More
  • 3. Can I enroll in a Medicare plan with access to Tele-health services?
     

    Yes, Blue Shield offers Teladoc on their “Plan G Extra” plan. UHC offers a 24-7 nurse line as well as virtual medical visits with a licensed physician. SCAN also offers access to telehealth care from the comfort of your home.
    *SCAN and UHC also

    More
  • 4. Does Blue Shield offer Medicare Supplement Insurance Plans?
     

    Yes, Blue Shield offers Plan A, Plan N, Plan G, and Plan F. These plans are very popular because of the additional benefits you can add on to it.

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  • 5. Does Blue Shield offer Medicare Part D Prescription Drug Plans?
     

    Yes, Blue Shield offers two Part D prescription drug plans you can add alongside your Supplement plan.

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  • 6. Does Blue Shield offer an Advantage plan?
     

    Yes, Blue Shield has an advantage plan that offers access to major hospitals in San Diego. This advantage plan is limited on the doctors you may visit. Our team will always check to see which Advantage plans are best for you and the doctors you visit. If you are interested in this Blue Shield Advantage plan, reach out to our team to learn more.

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  • 7. Do all plans receive “Medicare Star Ratings”?
     

    All Part D PRescription Drug plans and all Advantage plans will always have a star rating. Many plans do not receive star ratings. Although some Supplement plans do receive star ratings, not all do. Blue Shield’s Supplement plans do not offer star ratings. Dental and Vision plan add-ons also do not have Medicare Star ratings.

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  • 8. Does Blue Shield offer Medicare Services in San Diego?
     

    Yes, Blue Shield offers a great Supplement plan and an Advantage plan in San Diego.

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  • 9. Can I save money by bundling my medicare services?
     

    Yes, for example, if you enroll in a Blue Shield plan, you can pair it with a Prescription Drug plan, dental insurance, vision insurance, and more. By bundling services with Blue Shield you can receive a small discount on your monthly premium.

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  • 10. Can I get dental, vision, and hearing insurance coverage through Medicare?
     

    Yes, when you enroll in Medicare you can pair additional services to your plan for an additional cost. For example, Blue Shield offers “Plan G Extra” which offers vision and hearing aid services. You can also add on a dental insurance plan for an additional cost.

    *SCAN and UHC also

    More
  • 11. Can you add dental insurance to your Plan F or Plan G from Blue Shield?
     

    Yes, you can add one of two PPO dental insurance plans offered by Blue Shield. Click here to learn more.

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  • 12. Do I get access to SilverSneakers when I enroll in Medicare?
     

    Many carriers offer SilverSneakers to their members when they enroll in one of their plans. Blue Shield and SCAN Advantage plans offer access to SilverSneakers when you enroll in a Supplement plan.

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  • 1. Can I receive Worldwide Coverage for Urgently Needed Services with Medicare?
     

    Yes, with many Supplement and Advantage plans, you will have access to emergency services anywhere in the world. You can be confident that you are able to travel and still receive emergency care.

    More
  • 2. Can I enroll in a Medicare plan with Personal Emergency Response System (PERS)?
     

    Can I enroll in a Medicare plan with Personal Emergency Response System (PERS)?
    Yes, Blue Shield offers PERS on their “Plan F Extra” plan. SCAN offers PERS for any of their Advantage plans. And UHC also has PERS for those who enroll with their plans.
    *SCAN and UHC also

    More
  • 3. Can I enroll in a Medicare plan with access to Tele-health services?
     

    Yes, Blue Shield offers Teladoc on their “Plan G Extra” plan. UHC offers a 24-7 nurse line as well as virtual medical visits with a licensed physician. SCAN also offers access to telehealth care from the comfort of your home.
    *SCAN and UHC also

    More
  • 4. Do all plans receive “Medicare Star Ratings”?
     

    All Part D PRescription Drug plans and all Advantage plans will always have a star rating. Many plans do not receive star ratings. Although some Supplement plans do receive star ratings, not all do. Blue Shield’s Supplement plans do not offer star ratings. Dental and Vision plan add-ons also do not have Medicare Star ratings.

    More
  • 5. Can I get dental, vision, and hearing insurance coverage through Medicare?
     

    Yes, when you enroll in Medicare you can pair additional services to your plan for an additional cost. For example, Blue Shield offers “Plan G Extra” which offers vision and hearing aid services. You can also add on a dental insurance plan for an additional cost.

    *SCAN and UHC also

    More
  • 6. Does Scripps offer Medicare Services in San Diego?
     

    Yes, Scripps Hospitals are available to you through SCAN Advantage plans or a Supplement plan in San Diego.

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  • 7. Does SCAN Medicare offer Medicare Plans in San Diego?
     

    Yes, the SCAN Health Plans are a great way to get access to Scripps hospitals with an Advantage plan.

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  • 8. Do SCAN Medicare Plans offer prescription drug coverage?
     

    Yes, SCAN plans are all Advantage plans which will always bundle in Prescription drug coverage in their services.

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  • 9. Do SCAN Medicare Plans offer dental insurance?
     

    Yes, some SCAN plans have Dental insurance already included. Others you can add dental insurance plans for a small price.

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  • 10. Do I get access to SilverSneakers when I enroll in Medicare?
     

    Many carriers offer SilverSneakers to their members when they enroll in one of their plans. Blue Shield and SCAN Advantage plans offer access to SilverSneakers when you enroll in a Supplement plan.

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  • 11. Does SCAN offer Supplement Insurance Plans?
     

    No, SCAN only offers Advantage plans. These plans offer members access to Scripps hospitals.

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  • 12. Am I able to visit Scripps Hospitals in San Diego with an Advantage plan?
     

    Yes, you can select a SCAN Advantage plan if you wish to be in network with Scripps. UHC also offers Advantage plans with access to some Scripps locations.
    *UHC also

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  • 13. If I am Medi-Cal eligible, are there certain plans that I should look at?
     

    Yes, there are special plans for people who are both Medicare and Medi-Cal eligible. For example, SCAN offers the Scripps Plus Advantage plan and it has even better benefits if you are Medi-Cal eligible.

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  • 1. How do I get my Medicare Number?
     

    You can get your medicare number at medicare.gov This is where you will start the enrollment process in Original Medicare.

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  • 2. Should I enroll in Medicare by myself or with the help of a broker?
     

    You should enroll with a Medicare Specialist like HealthyMarks. The services offered by our team are free to you, and our goal is to ensure you enroll in the best plan for you.

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  • 3. Should I stick with my Large Group Employer health insurance policy or switch to Medicare?
     

    For companies larger than 100 employees, health insurance policies are no longer age based. The group takes the entire age of the company, averages it out, and provides the same rate for all employees no matter their age.

    Even though you at age 65 will get a better deal than someone at age 30, these group health insurance plans still do not match the price or quality of care you can receive from a 2020 Medicare Supplement plan.

    For example. I have a family member approaching her 65th birthday. She has awesome insurance through her employer Nordstrom. Her company pays half the monthly plan costs meaning she only pays $230 a month. This is extremely inexpensive considering a similar plan on the age based market would cost $800 or more.

    Here is the kicker. The plan is not as good as a Supplement Plan from Medicare. Currently, her deductible through work is $2500. A great Supplement plan like Plan N or Plan G has a deductible of $198. All in with Original Medicare and the Supplement Plan N here in San Diego, she's looking at $256.28 a month and a much better plan with almost no deductible. So for a few extra dollars a month, she can reduce her $2500 deductible to $198, have a more robust and encompassing plan, and visit any network of doctors and hospitals in San Diego.

    In short, you should move from your Large Group Employer plan to a Medicare plan as soon as you turn 65.

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  • 4. What are the major parts of Medicare?
     

    Original Medicare Parts A + B are the basic start to Medicare. To cover more of your medical expenses, you’ll want to pair your Original Medicare with a Supplement Plan or an Advantage Plan. Medicare Part D is to cover prescription drugs.

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  • 5. Should I still switch if my awesome health insurance is better than what's available through Medicare?
     

    Every once in a while I will come across an employee who does have awesome health insurance coverage, even better than what's available through Medicare. This means they are paying less than $300 a month in premiums, they have a deductible less than $200, and they are able to see the doctors they want to see. This is rare but amazing.

    Our Medicare Office Team is the best at evaluating your current plan and whether or not it is better for you to switch or stay. If you are enrolled in a plan better than what is offered through Medicare, you will want to know if you are subject to any late enrollment penalties. If you do not enroll in Original Medicare at the age of 65, you may end up paying more for it in the future due to late enrollment fees. However, you can avoid all penalties if you are receiving your health insurance from your employer. Our team is great at helping you avoid those penalties so you can stay with your awesome insurance.

    In these cases I like to discuss the process of moving to Medicare WHEN the right time comes. Our team is able to make sure you do not incur any penalties by not enrolling in Medicare. We'd love to help you evaluate your plan options and navigate the enrollment process.

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  • 6. Are my prescription drugs covered under Medicare?
     

    Prescription drugs are not covered by Original Medicare. You'll want to cover your prescription drug costs with a Medicare Advantage Plan or a Part D Prescription Drug Plan.

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  • 7. Should I still switch to Medicare even if my family is covered by my insurance plan?
     

    Yes! The savings you receive by switching to medicare is significant. So significant that it is still worth the switch to Medicare even if your family is covered by your current plan. Pairing your entire family into a single health insurance plan offers a handful of benefits. You'll all share a "family deductible" which can help save some out of pocket costs during an unhealthy year. However, pairing your entire family into a single plan does not save you money on monthly premiums.

    The best thing to do is enroll yourself in a medicare plan and enroll your family members in their own plan. You'll save money each month with your new, less expensive, Medicare plan and your family will be able to continue coverage through their individual plan.

    One scenario that may be difficult to evaluate is when you are eligible for Medicare but your employer is covering the costs for both your family members premiums and your own premiums. Our HealthyMarks team is excellent at evaluating these two options and figuring out the best course of action for you. We can calculate how much money you would save by switching to Medicare and how much money are you sacrificing by giving up your employer's contribution towards your dependent's plans. If you employer contributes a lot, you'll likely want to stay with that employers plan cause they are spoiling you and your family. In a majority of cases, employers only offer a small amount of money to cover dependents plan costs. In fact most businesses do not cover dependents at all because they are not required to.

    It is a very easy process to enroll your family members on a great individual plan. Our health insurance team is able to help you move to Medicare and move your family to an individual plan.

    Give us a call today so we can share with you the best path forward so you can save hundreds of dollars each month by moving to a San Diego Medicare plan.

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  • 8. Do Advantage plans cover prescription drugs?
     

    Yes. If you enroll in an Advantage plan you are bundling all of your medical services including prescription drugs.

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  • 9. Should I stick with my group health insurance policy or should I switch to Medicare?
     

    Perhaps you are not enrolled in a plan through the individual exchange but instead you are enrolled with a plan through your company. Similar to individual plans, group health insurance policies for businesses with 100 employees or fewer are also age based. When you approach your 65th birthday your group health insurance policy plan will be very expensive.

    The major difference between an individual policy and one through your company is that your employer is required to contribute some money to cover your monthly costs. By law, your company is required to pay for 50% of your health insurance premiums each month. Even after calculating the costs, 50% of a plan through your employer is more expensive than 100% of a medicare plan.​

    It is also nice to keep in mind how much money you can help your company save when you switch to Medicare. Employers are excited to help employees move to Medicare because they appreciate not paying so much each month for your insurance.

    I personally sell group health insurance policies here in San Diego and I can confidently say that a plan through Medicare, with either a supplement plan or an advantage plan, is going to be better than what you are receiving from your business.​

    However, some companies are extremely generous with their health insurance offering and it can make it difficult to switch over to Medicare. For example, I work with a company in Carlsbad that pays 100% of the employees health insurance costs and 80% of the family's costs. This is an unbelievably generous offer. Even in this scenario, it was worth it to evaluate the newly 65 year old's Medicare options. Both the employer and employee agreed that moving to Medicare was best.

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  • 10. Do Supplement plans cover prescription drugs?
     

    No. You will want to pair your Supplement plan with a Part D prescription drug plan.

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  • 11. Should I stick with my current Individual Health Insurance policy or switch to Medicare?
     

    You can get individual health insurance plans from the California Health Exchange called Covered California. You can also get an individual plan if you contact the insurance carrier directly and sign up with them. However, these plans are very expensive and get more expensive as you get older. The plans monthly premiums are age based meaning the older you get the more expensive they are.

    For example, let's assume you want access to Scripps Doctors in North County. The best option on the individual market for a 64 year old is to select the Silver HMO Trio plan from Blue Shield. This plan premium is $931.84 per month! With this plan you have a $4000 deductible!

    Now let's compare that to Original Medicare with a Supplement plan N here in San Diego. For most people, Original Medicare Parts A + B cost $144.60 per month. We can then add $111.68 per month to join plan N, one of the best Supplement plans here in San Diego for 2020. For a total of $256.28 per month, you now have a deductible of $198. Clearly, you'll want to switch to medicare from your Individual plan.

    Although the individual health insurance market has some solid silver and gold plans that will help you in your time of need, there is no question in my mind that not a single plan on the individual health experience exchange through Covered California is close to the benefits that you will receive from a Medicare Plan.

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  • 12. What’s the difference between Medicare and Medicaid?
     

    Medicare is a federal government-sponsored healthcare program for those 65 and over, and for younger people who are disabled. Medicaid is a healthcare program for low-income individuals who could not otherwise afford health insurance.

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  • 13. Should I switch to Medicare or Should I stay with the insurance I currently have in San Diego?
     

    Medicare is an incredible health insurance offering that you should absolutely take advantage of.

    It is our recommendation that you switch to Medicare as soon as you turn 65 years old. As a United States citizen you have been contributing money towards your Medicare policy for your entire working life. Now is your chance to take advantage of this government-sponsored Medicare health insurance plan. The plan premiums, deductibles, and out of pocket costs are all going to be a much better deal for you the consumer when you switch to Medicare. There are almost no examples of a non-Medicare plan that is better than the San Diego Medicare offerings.

    Medicare is fantastic. It is much better than all of the other San Diego health insurance offering you have. So let's take a look at your current situation and why it is going to be better for you to switch to Medicare.

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  • 14. Should I switch to Medicare if I have insurance elsewhere?
     

    Yes. By switching to Medicare you will likely save a lot of money and receive a better plan.

    Whether you are getting health insurance from your employer or even if your spouse is covered too, HealthyMarks would be happy to help you evaluate your options.

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  • 15. What doctors will accept Medicare?
     

    At medicare.gov/physiciancompare/ it is easy to find out if you find your doctor “accepts medicare-approved payment amounts.” If so, you can be confident you’ll pay less out of your own pocket when visiting this doctor with your medicare plan.

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  • 1. When am I eligible for Medicare?
     

    You can begin the medicare process on the 1st day of the month 3 months prior to your 65th birthday. Your application will be effective the 1st day on the month of your 65th birthday. Your initial enrollment period is 7 months long. This period includes your birthday month, the 3 months prior to your birthday month, and the 3 months after.

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  • 2. What is IRMAA and why do some Medicare beneficiaries have to pay more?
     

    The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an amount you may pay in addition to your Part B or Part D premium if your income is above a certain level. If you are a higher earner, you will likely pay more for your Medicare plans.

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  • 1. Why Do I need a Supplement or Advantage Plan when I sign up for Original Medicare?
     

    Original Medicare is an awesome product however it does not cover all of the costs associated with your health care. As you get older it's important to make sure that you are going to be completely covered for any of your medical needs. A Supplement Plan or an Advantage Plan will make sure that the costs out of your own pocket stay small anytime you need to go to the doctor. The best thing about a Medicare Advantage or a Medicare Supplement Plan is how little you need to pay out of pocket for your services.

    Although you do not need to sign up for a Supplement or an Advantage Plan I highly recommend it. Especially here in San Diego Medicare Supplement and Medicare Advantage plans are going to be extremely beneficial help you see the doctors that you want to see at the coverage that you want and you will pay very little out of your own pocket.

    The most robust Supplement Plan in San Diego for 2020 is Plan G. This plan will only cost a newly eligible 65 year old $153.12 per month. This is the route most of my clients take because Supplement Plans offer more robust services and access to doctors compared to Advantage Plans. You'll pay $144.60 for Original Medicare and $153.12 for the best Supplement Plan here in San Diego in 2020.

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  • 2. How Do I Choose between a Supplement plan and an Advantage Plan?
     

    Both Supplement Plans and Advantage Plans will serve your needs. However we can identify which plan is better for you by laying out the specific needs you may have. The first thing is that a Supplement Plan will provide you access to any doctor throughout the United States whereas an Advantage Plan will make you sign up for a San Diego network of doctors. You can think of a Supplement Plan as a really robust PPO plan with access to every doctor in America for an in-network cost. You can think of an Advantage Plan as having an HMO network of doctors that you need to stay within to make sure your care is handled a proper out of pocket cost for you.

    Supplement Plans are a bit more expensive because of that robust network of doctors and because most of your out of pocket costs will be covered immediately after a small deductible. Advantage Plans are usually a lot less expensive each month in premiums compared to Supplement Plans. Advantage Plans allow the carriers to get creative to offer unique solutions to their services so they can better serve you and save money. Those savings by the insurance carrier are passed along as monthly premium savings to you the insured. Sometimes these plans can be as inexpensive as only a few dollars a month. Advantage Plans are also unique because they can bundle dental and vision services as well as your prescription drug services into one plan offered by one insurance carrier. An Advantage Plan offers a one stop shop for all of your medical needs for only a few dollars a month.

    If you want access to all the San Diego doctors and doctors throughout the United States, you want that strong PPO in network plan. You should select the Supplement Plan and be confident because all of your costs will be covered. You will have no problem finding doctors who will accept your plan and you can always feel confident that you will have the best health insurance available to you.

    If you are interested in bundling all your prescription drugs needs, your medical needs, as well as dental and vision insurance, Advantage Plans can do this for you. When you select your Advantage Plan, make sure you can visit the doctors that you want to see for in network costs.

    Note that Blue Shield has been offering Supplement Plans alongside Part D Prescription Drug Plans that can be paired with a Blue Shield Dental and Vision VSP Plan. So if you want the power of a Supplement Plan paired with all the added benefits, I suggest Blue Shield here in San Diego.

    As always it is best that you speak to us, Medicare Professionals. Our HealthyMarks Medicare team can evaluate your needs and make the best decision for your health insurance. Our services are free to you, HealthyMarks has partnered with the insurance carriers in San Diego and they are willing to pay for our services to help you enroll in their plans.

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  • 3. What Are Supplement Plan Costs in San Diego?
     

    What is the typical monthly premium for a Supplement Plan in San Diego for 2020?

    Supplement Plans are paired with Original Medicare and a Part D Prescription Drug plan. So you'll first pay the $144.60 for Original Medicare each month and then you'll add on the costs for the Supplement Plan and the Part D Prescription Drug Plan.

    Plan F was the most popular Supplement Plan because it had a $0 deductible. However, Plan F is no longer available in 2020 and the new best plan is Plan G with a $185 deductible. This deductible is a reduction the Original Medicare Part B deductible of $1408.

    A 65 year old will pay $139.20 per month in 2020 for Plan G in San Diego.

    Original Medicare $144.60 + Plan G $139.20 = $283.80 per month.

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  • 4. What are Advantage Plan Costs in San Diego?
     

    What is the typical monthly premium for an Advantage Plan in San Diego for 2020?

    While Supplement Insurance Plans are straightforward, Advantage Plans are more complicated in their design. Each Advantage Plan is unique because the plans are designed by the insurance carrier. For this reason you will likely be able to sign up for an Advantage Plan for only a handful of dollars each month. There are plans available to you for single digit premiums each month.

    However I don't want new Medicare members to select the least expensive plan. We want to select a plan that matches your needs. Here at HealthyMarks we have created an amazing business by pairing the right plans with the right people.

    These Advantage Plans have deductibles and out of pocket costs you will not run into with a Supplement Plan. These deductibles change drastically depending on which carrier and which Advantage Plan you select. If you are looking for an inexpensive plan that covers most of your costs, you may want to search for an Advantage Plan that allows you to visit the San Diego network of doctors that matter most to you.

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  • 5. Should I pair my Original Medicare with a Supplement Plan or Advantage Plan?
     

    YES! You should absolutely pair your Original Medicare Plan with additional coverage. Do not sign up for Original Medicare and think you have completed the process. You will be much better off if you pair it with one of the strategies above.

    Do not go this decision alone. HealthyMarks Medicare is a team of professionals who excel at helping new Medicare members better understand their options. Our team wants to help you so you can select the best plan for you and your family. We offer all the best plans from all the best San Diego carriers. Our team is excited to talk to you about your medical needs and do not hesitate to give us a call so we can provide you with any information you need to select the best Supplement Plan or Advantage Plan here in San Diego.

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  • 6. How Do I Enroll in Original Medicare?
     

    To enroll in Original Medicare, you'll visit Medicare.gov.

    You Initial Enrollment Period lasts 7 months, starting 3 months prior to your 65th birthday and 3 months following your 65th birthday. That means you can start the enrollment process more than 90 days before you turn 65 years old. We recommend enrolling in Original Medicare as soon as you are eligible. It takes the Social Security office a few weeks to send you your new Medicare Number and you'll need that to enroll in Supplement Insurance or Advantage Plans.

    You do not have to enroll in Original Medicare alone. HealthyMarks would be happy to assist you with your enrollment. Please give us a call today.

    What Are San Diego Original Medicare Plans Parts A + B?

    Understanding your services and what will be covered with your Medicare Plan is essential to understanding your benefits and making a smart decision about your new health insurance medicare plan here in San Diego. For this reason let’s take a look at Original Medicare, how to enroll, and why pairing it with Supplement Insurance or an Advantage Plan will make sure your Medicare package is complete.

    Part A is most commonly paired with Part B to complete Original Medicare. Part A covers hospital stays and inpatient care. Part B covers doctor visits and outpatient care. Part A is considered "entitled" while the standard monthly premium for Medicare Part B will be $144.60 for 2020. So all of Original Medicare will cost you $144.60 in 2020

    Original Medicare should be paired with Supplement Insurance or an Advantage Plan

    Original Medicare is a great program but alone will not cover all your healthcare costs. You’ll still pay for a lot of your medical bills out of your own pocket. Furthermore, neither Parts A nor B cover the costs for prescription drugs. You’ll want to pair your Original Medicare with Medicare Supplement Insurance and a Part D Prescription Drug Plan, or a Medicare Advantage Plan. HealthyMarks is your best resource for enrolling in these plans, so don't hesitate to call and ask for our help.

     

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  • 7. What are the Costs for Original Medicare in San Diego?
     

    Part A Original Medicare Costs

    What will I pay monthly for Medicare Part A in San Diego?

    If you worked less than 30 quarters, you’ll likely pay $458 monthly in 2020. If you worked more than 30 but fewer than 40 quarters, your premium is $252 monthly in 2020.

    Most people here in San Diego will not have to pay anything for their Part A medicare plan because we have all been paying our taxes over the years. If you have worked ten (10) years or forty (40) quarters and have paid your taxes for each of these then you are fully qualified to receive your Part A “premium free” or without additional costs. If you have not earned your ten years of working in the United States, you typically will pay a monthly premium to be a part of Part A Medicare. The amount depends on how many quarters you have worked.

    Part B Original Medicare Costs

    What will I pay monthly for Medicare Part B in San Diego?

    The standard monthly premium for Medicare Part B will be $144.60 for 2020, up $9.10 from $135.50 in 2019. This is because you have contributed your taxes for ten (10) years or forty (40) quarters and you will likely qualify for the least expensive Part B monthly premium cost bracket.

    There are typically 2 reasons you would have to pay more for your Part B in San Diego. Similar to Part A, if you haven’t earned ten (10) years or forty (40) quarters of working in the United States, you will likely pay more for your Part B. The second reason you may pay more for Part B is because you are still a high earner.

    Part B Costs Extra Without Ten Years of Work Credit

    If you have not earned your ten years of work history credit in the United States, you are still eligible to enroll in Original Medicare. However, you will pay extra. The extra amount you pay is reduced based on how many credits you have earned.

    Spouses and domestic partners who didn’t earn ten years of credit - Don't stress if you were a stay at home mother or father. Because you were married to someone who was earning money and paying taxes means you also earned your work credits. If your spouse earns credits while you are raising a family, you will earn those credits by filing jointly.

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  • 8. What is the IRMAA Extra Premium Charge for Higher Earners?
     

    IRMAA stands for income-related monthly adjustment amount and is an additional amount that some people might have to pay along with their Medicare premium.

    I​f you are making less than $87,000 a year as an individual or you are making a combined less than $174,000 as a couple, you earnings are below the IRMAA line and you'll pay a $144.60 monthly premium for Part B. If your income exceeds these numbers, you will pay an additional amount each month depending on how much you earn. For example, the next tier up pays $202.40 per month; this is nearly a $60 increase in monthly premiums.

    Even though your additional income results in a more expensive Medicare Product, the high earners should still join Original Medicare. Medicare offers the highest quality plans at a very inexpensive cost.

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Which is Better? A Co-Pay or a Co-Insurance?

Which is Better? A Co-Pay or a Co-Insurance?

A Co-Pay is a dollar amount that you will pay for your medical services.  A Co-Insurance is a percentage amount.  For example, I went to my primary care physician and had a Co-Pay of $50.  I then took an x-ray and paid my Co-Insurance of 30%. So which is better? A Co-Pay is always going to be better.

4 Common Medicare Enrollment Mistakes During the COVID-19 Pandemic

4 Common Medicare Enrollment Mistakes During the COVID-19 Pandemic

I know it is tempting to put this decision off until a later date but it is important to understand that you are responsible for signing up during your initial enrollment period. The initial enrollment period is 7 months long, starting 3 months before your 65th birthday month and ending 3 months after. If you don’t enroll during this time you risk incurring penalties that could make your plan cost more in the future. COVID is not an excuse, you are still responsible for signing up properly.