Medicare Facts

Qualifying for Medicare

You will be automatically enrolled in what is called Original Medicare if you already get Social Security, Railroad Retirement or disability benefits. Otherwise your initial enrollment period (IEP) begins 3 months before the month you turn 65 and continues through the third month after you turn 65. Call or stop in at your local Social Security office 3 months before you turn 65 to sign up.

Visit Medicare.gov for general information about enrolling.

Parts A, B, C & D

Part A is hospital insurance that helps cover inpatient care in hospitals and skilled nursing facilities, hospice and home health care. Part A is free for most people.

Part B is medical insurance that helps cover doctors’ services, outpatient care, home health care and some preventive services. How much you pay for Part B depends on your situation. The average monthly Part B premium is $134 in 2018, but you could pay less or more than this amount.

Part C Medicare Advantage plans combine Parts A and B and can also include Part D coverage. Medicare Advantage plans are run by private insurance companies such as Security Health Plan which are approved by and under contract with Medicare.

Part D is Medicare’s coverage that helps cover the cost of prescription drugs. This coverage is also offered by private insurance companies approved by and under contract with Medicare.

Basic Medicare Options

Original Medicare pays for some hospital charges and some of your doctor visits and outpatient care. When you only have Original Medicare, you pay for the remainder of the costs for all of these services, including large deductibles and coinsurance.

Medicare has no out-of-pocket limits for how much you will have to pay in a year. Most people who use health care can help protect themselves from high costs by enrolling in a Medicare supplement or a Medicare Advantage plan.

One significant benefit of a Medicare Advantage plan is that the premium is the same whether you are 65 or 90 years old. It isn’t higher because you are older or may be using more health care services.

Income-Related Monthly Adjustment Amount (IRMAA)

Modified Adjusted Gross Income (MAGI) Part B Monthly Premium Amount Part D IRMAA Total Monthly Medicare Premiums
Individuals with a MAGI of $85,000 or less

Married couples with a MAGI of $170,000 or less
$134.00 N/A $134.00
Individuals with a MAGI above $85,000 up to $107,000

Married couples with a MAGI above $170,000 up to $214,000
$187.50 13.30 $187.50
Individuals with a MAGI above $107,000 up to $160,000

Married couples with a MAGI above $214,000 up to $320,000
$267.90 $34.20 $302.10
Individuals with a MAGI above $160,000 up to $214,000

Married couples with a MAGI above $320,000 up to $428,000
$348.30 $55.20 $403.50
Individuals with a MAGI above $214,000

Married couples with a MAGI above $428,000
$428.60 $76.20 $504.80