Agent FAQ

Does SIM offer leads?

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What are this years deductibles?

The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same amount as in 2017. However, a statutory “hold harmless” provision applies each year to about 70 percent of enrollees. For these enrollees, any increase in Part B premiums must be lower than the increase in their Social Security benefits. After several years of no or very small increases, Social Security benefits will increase by 2.0 percent in 2018 due to the Cost of Living adjustment. Therefore, some beneficiaries who were held harmless against Part B premiums increases in prior years will have a premium increase in 2018.

The 30 percent of all Part B enrollees who are not subject to the “hold harmless” provision will pay the full premium of $134 per month in 2018. Part B enrollees who were held harmless in 2016 and 2017 will see an increase in the monthly Part B premium from the roughly $109, on average, they paid in 2017. An estimated 42 percent of all Part B enrollees are subject to the hold harmless provision in 2018 but will pay the full monthly premium of $134, because the increase in their Social Security benefit will be greater than or equal to an increase in their Part B premiums up to the full 2018 amount. About 28 percent of all Part B enrollees are subject to the hold harmless provision in 2018 and will pay less than the full monthly premium of $134, because the increase in their Social Security benefit will not be large enough to cover the full Part B premium increase.

Medicare Part B enrollees not subject to the “hold harmless” provision include beneficiaries who do not receive Social Security benefits, those who enroll in Part B for the first time in 2018, those who are directly billed for their Part B premium, those who are dually eligible for Medicaid and have their premium paid by state Medicaid agencies, and those who pay an income-related premium. These groups represent approximately 30 percent of total Part B beneficiaries.

The annual deductible for all Medicare Part B beneficiaries will be $183 in 2018, the same annual deductible in 2017. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans are already finalized and are unaffected by this announcement.

Contact us!

Senior Insurance Marketing

TF - 877.800.3080

PH - 402.434.7761

FX - 402.434.7764

info@simkt.com

7160 S. 29th Street, Ste 10

Lincoln, NE 68516

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Client FAQ

How do I enroll in Medicare?

If you are turning 65 and you're already getting benefits from Social Security or the Railroad Retirement Board (RRB), you'll automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.) If you are not automatically enrolled, you can enroll by calling Social Security at (800) 772-1213, visit their website www.ssa.gov, or apply at your local Social Security office. The best time to do this is three months before your 65th birthday that way you can make the correct insurance decisions in plenty of time.

When can I join a health or drug plan?

Joining a health or drug plan
When you decide how to get your Medicare coverage, you might choose a Medicare Advantage Plan (Part C) and/or Medicare prescription drug coverage (Part D).

There are specific times when you can sign up for these plans, or make changes to coverage you already have. You don’t need to sign up for Medicare each year. However, each year you’ll have a chance to review your coverage and change plans.

Is Part B required?

No Part B is optional.

If you or your spouse (or family member if you're disabled) is still working and you have health coverage through that employer or union, contact your employer or union benefits administrator to find out how your coverage works with Medicare. This includes federal or state employment, and active duty military service. It may be to your advantage to delay Part B enrollment. You can sign up for Part B without paying a penalty any time you have health coverage based on your (or your spouse’s) current employment. COBRA and retiree health coverage don’t count as current employer coverage.

Once the employment or coverage based on current employment ends (whichever happens first):

You have 8 months to sign up for Part B without a penalty. This period will run whether or not you choose COBRA. If you choose COBRA, don’t wait until your COBRA ends to enroll in Part B. If you don't enroll in Part B during the 8 months after the employment ends, you may have to pay a penalty after you enroll for as long as you have Part B. You won’t be able to enroll until the next General Enrollment Period, and you'll have to wait until July 1 of that year before your coverage begins. This may cause a gap in your health care coverage.

How much do I pay for Medicare?

Part A costs:
1. You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy Part A if:

  • You’re 65 or older, and you have (or are enrolling in) Part B and meet the citizenship and residency requirements.
  • You’re under 65, disabled, and your premium-free Part A coverage ended because you returned to work. (If you’re under 65 and disabled, you can continue to get premium-free Part A for up to 8 1/2 years after you return to work.)

2. In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both. If you have limited income and resources, your state may help you pay for Part A and/or Part B

Part B costs:
You pay the Part B premium each month. Most people will pay the standard premium amount, which is $104.90 in 2015.

Some people may pay a higher Part B premium
If your modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount ($85,000 if you file individually or $170,000 if you’re married and file jointly), you may pay more. This doesn’t affect everyone, so most people won’t have to pay a higher amount. Your modified adjusted gross income is your adjusted gross income plus your tax exempt interest income.

Paying your Part B premium

If you get Social Security, RRB, or Office of Personnel Management (OPM) benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments and choose to sign up for Part B, you’ll get a bill.

What is the charge for your services?

There is never a charge for our services for any insurance decisions. Simply put, brokers are compensated from the insurance company you choose to go with.

What is the Part D enrollment penalty?

The late enrollment penalty is an amount that’s added to your Part D premium. You may owe a late enrollment penalty if at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Part D or other creditable prescription drug coverage.

To avoid incurring this additional fee, make sure to sign up for either a Medicare Advantage Plan that offers drug coverage or a stand-alone Part D plan during your Initial Enrollment Period. Please note that if you have employer coverage, you may not need to enroll until that coverage ends. When your employer coverage ends, you caould have a Special Election Period to enroll in a Medicare Plan and may not be subject to an additional Part D premium.

Note: If you get Extra Help, you don’t pay a late enrollment penalty.

What is the Donut Hole?

Most Medicare drug plans have a coverage gap (also called the “donut hole”). The coverage gap begins after you and your drug plan together have spent a certain amount for covered drugs.

In 2015, once you enter the coverage gap, you pay 45% of the plan’s cost for covered brand-name drugs and 65% of the plan’s cost for covered generic drugs until you reach the end of the coverage gap. Not everyone will enter the coverage gap because their drug costs won’t be high enough.

Once you get out of the coverage gap, you automatically get “catastrophic coverage.” With catastrophic coverage, you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.

Note: If you get Extra Help, you won’t have some of these costs.

877-800-3080
402-434-7761
Fax: 402-434-7764
info@simkt.com
Mon - Th 8AM - 5:30PM CST
Fri 8AM - 3PM CST
7160 S. 29th Street, Ste 10
Lincoln, NE 68516