Discover helpful strategies “sandwich-ers” can utilize when providing assistance and guidance to those they care about, while also balancing and protecting their own financial nest eggs in this two-part series.
By Heather Conway, Vice President & Relationship Manager
As we find ourselves in the midst of Medicare Open Enrollment, a refresher on the basics of this national health insurance program is in order. Additionally, some changes in 2023 may affect you, your family, and your healthcare coverage choices.
What Is Medicare?
Medicare is a complex web of parts, options, and elections. Medicare generally intends to provide health care for those aged 65 and older. You will need to enroll in Parts A and B during the 7-month period that begins three months before the month you turn 65 and ends three months after you turn 65.
New for 2023 – if you sign up the month you turn 65 or during the last 3 months of the initial enrollment period, coverage starts the first day of the month after you sign up (not 2-3 months later).
The first decision to make is whether to enroll in Original Medicare or Medicare Advantage.
What Is Original Medicare?
Original Medicare’s Part A (hospital insurance) and Part B (medical insurance) covers approximately 80% of your Medicare-approved medical costs. For the remaining 20%, Original Medicare participants usually purchase a Medicare Supplement plan and a prescription drug plan (Part D). Part A is offered at no cost to you, but you will pay a monthly premium for Part B ($164.90 for 2023).
New for 2023 – For those with prescription drug coverage, most vaccines recommended for adults by the CDC will be offered at no cost to beneficiaries. This includes shots for the flu, COVID-19, pneumonia and shingles.
What Is Medicare Advantage?
Medicare Advantage (Part C) is offered by a private company and usually includes Parts A, B, and D. These plans may have lower out-of-pocket costs than Original Medicare and may provide benefits that the former does not – such as vision, hearing, and dental treatment. Usually, you are limited to in-network physicians and may need referrals to specialists. Part C plans vary significantly by company, so it is important to compare benefits and costs thoroughly between the Medicare Advantage plan you are considering and Original Medicare.
What Should I Know About Medicare Going In?
A common misconception about Medicare (whether you choose Original or Part C) is that it will pay for long-term (nursing home) care costs. Part A covers skilled nursing facility care – but only for short-term stays preceded by a qualifying inpatient hospital admission. The daily rate at the nursing home is covered in full for days 1-20; thereafter, you pay a coinsurance amount for days 21-100. After day 100, you are responsible for the full amount of nursing home costs – and per the most recent state statistics, the average cost for nursing home care in Missouri runs around $6,000 per month.
When going through the Medicare enrollment process, take advantage of all resources available to you so you can make the best decision for your situation. In addition to consulting the Medicare & You handbook located online at medicare.gove/medicare-and-you, every state offers free personalized counseling. In Missouri, that is provided by Missouri SHIP, missouriship.org or 1-800-390-3330.
Fun Fact: Former President and fellow Missourian Harry S. Truman and his wife, Bess, were the first to receive Medicare registration cards after the program was enacted in 1965.
Learn More About Medicare With the Help of the Central Trust Company
Turn to the Central Trust Company for a professional second opinion about Medicare expenses and finances. To get started, contact our team or find your nearest branch online today!
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