San Diego Original Medicare 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 the services covered by Original Medicare.  Part A is most commonly paired with Part B to complete the Original Medicare package. We can then learn how much these services will cost you each month in premiums, what services are covered and for how much, and why adding a Supplement plan or an Advantage plan from a San Diego Health Insurance carrier may be a good idea.

Original Medicare has two elements called Part A and Part B. This will cover hospital stays, doctor visits and inpatient or outpatient care.  Part A is considered "entitled" while the standard monthly premium for Medicare Part B will be $144.60 for 2020

How to Enroll in San Diego Original Medicare 

You are able to enroll in Original Medicare 3 months prior your 65th birthday. The easiest way is to visit medicare.gov

 

If you would like some assistance please give us a call and you can enroll with an Original Medicare specialist from HealthyMarks.

What are the Costs for San Diego Original Medicare

Part A Original Medicare Costs

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

        • Many 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, you typically will pay a monthly cost to be a part of Part A Medicare.

        • 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.

Part B Original Medicare Costs

    • What is the typical Monthly Premium for Part B?

        • It is a good question to ask what you will pay monthly for Part B.   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 and you will likely qualify for the least expensive Part B monthly premium cost bracket to pay your Part B.There are typically 2 reasons you will have to pay more for your Part B in San Diego. If you haven’t been working and paid your taxes for ten (10) years, you will likely qualify for the least expensive bracket to pay your Part B. The other reason is because you are making a ton of money.

      • IRMAA Extra Premium Charges for Higher Earners

        • If you are making more than $87,000 a year as an individual or you are making a combined more than $174,000 as a couple, you will be making too much money to qualify for the straight $144.60 Part B monthly premium.  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 the high earners should join Original Medicare because the costs to get quality plans will likely be much cheaper than the other options out there. 

      • Part B costs extra because you didn’t earn ten years of work credit

        • If you have not been working in the United States for a long time you may not have earned your ten years of work credit. In this case, you will likely pay extra.  This amount increases based on how many years of credit you earned.

      • Spouses and domestic partners who didn’t earn ten years of credit

        • Because you were married to someone else who was making the money for the family doesn’t mean you are not earning your credits.  If your husband earns credits while you are raising a family, you will earn tax credits filing jointly.

What Services are Covered by Original Medicare in San Diego?

    • Part A Medicare - What services are covered?

      • Original Medicare’s first element is Part A. This will cover hospital stays and inpatient care. There are many other services including but not limited to skilled nursing facilities or nursing homes and critical access hospitals and critical care hospitals. 

    • Will I have any Co-pays or deductibles with Part A?

      • There is a reason people pair their Original Medicare with a Supplement Insurance or an Advantage Medicare Plan.  Medicare Part A offers you services but you will have a large deductible.  The Medicare Part A inpatient services deductible you will pay when admitted to the hospital will be $1,408 in 2020, an increase of $44 from $1,364 in 2019.  When comparing your list of medicare plan options, you’ll quickly see it is better to pair your Part A with a Supplement or Advantage plan to nearly eliminate that large deductible.

      • Inpatient vs Outpatient care for a medicare provider

        • An inpatient is one who has to “stay in” the facility after an operation. On the other hand, outpatients leave the same day they arrive. Many outpatient services can be simple like testing. For example, you may have surgery or a procedure in the morning.  After a few hours staying in the facility, a family member can help you leave and recover at home. Many of those elected services will be covered by Part B. With Part A, any overnight stays at a hospital will be covered.

      • Hospital Stays

        • Medicare covers most of the costs with your hospital stay including a private room or a shared room. Many times these services will be needed in an emergency situation and the patient will stay at the hospital until they have recovered well enough to return home.  Other times patients stay at these hospitals for long-term rehabilitation or critical life care.

      • Skilled Nursing Facilities and Nursing Homes

        • San Diego offers a lot of Skilled Nursing Facilities and Nursing Homes to Medicare qualified patients.  If a patient leaves a hospital stay and requires additional long-term care, these facilities are the perfect solution.  Many doctors in San Diego will determine patients need additional time and resources to recover from a hospital related medicare condition and will help you qualify for Skilled Nursing Facilities and Nursing Homes.

      • Hospice Care

        • Hospice Care is typically an end of life service offered to San Diegans through their Medicare plans.  If a doctor believes you have less than six (6) months to live, you will likely qualify.  These services are there to help you through your daily activities and keep with your medical routine. Hospice care teams are not to be confused with a home caregiver.  In fact, many home caregivers will take a long break when the hospice care team comes for the day so the two work well paired together.

    • Part B Medicare - What services are covered?

      • Part B of medicare is for you to visit doctors here in San Diego. Most doctors in San Diego accept medicare. This will cover your screenings and routine care and primary care visits with doctors.

    • Will I have any Co-pays or deductibles with Part B?

      • The annual deductible for all Medicare Part B beneficiaries is $198 in 2020, an increase of $13 from the annual deductible of $185 in 2019. You can help pay for those gaps with an advantage plan or supplement plan. 

      • ​​​Under Part B, in most cases you will pay 20% of the Medicare-approved amount for each item or service. A deductible may also apply.

      • Preventive services and Routine Care from your Primary Care Physician

        • Part B Medicare stresses the value of preventive care and encourages all members to continue to monitor their wellness. For example, when a new member joins Medicare Part B they are entitled to a one time “New Medicare Wellness Visit” and each year all members are entitled to an “Annual Wellness Visit”. Common screenings that can be obtained include heart and lung screenings, diabetes testing, and colon screenings. Many tests can be done yearly and other tests are available every five (5) years.

Why So Many People pair their Original Medicare with a Supplement plan or Advantage plan here in San Deigo

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.  Plus Parts A and B won’t cover your 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.

To learn more, please visit our home page at HealthyMarks.com

© 2020 by HealthyMarks Insurance Services

Keaton Marks License #0L47187

760-484-0979    -    San Diego

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