Medicare 101: Everything you need to know to get started

You hear the term all the time, and clearly, it’s health-related, but what exactly is Medicare, and who is it for? If you qualify, do you also need a Medicare supplemental plan? If you’re looking for these answers, you have come to the right place. We’ll start with the basics and work our way up. 

First of all, what is Medicare? Who qualifies? 

Medicare is health insurance. It’s for people who are: 

  • age 65 or older 
  • under 65 with certain disabilities 
  • any age with end-stage renal disease (otherwise known as permanent kidney failure) 

Exploring the ABCs (and D) of Medicare 

Here’s where things get a little trickier. There’s more than one type of Medicare. In fact, there are four, and they cover different forms of care you might be receiving. Then, you might also consider adding a supplemental plan to close any gaps in your coverage. Plus, each option has a different cost structure attached to it. Let’s review. 

Part A covers the inpatient care you receive in hospitals, skilled nursing facilities, and hospice and home health care.  

What does Part A cost you? If you qualify (see above) and paid Medicare taxes while working, there’s usually no monthly premium. 

Part B covers services not included by Part A. Think doctor’s visits, outpatient care and other medically necessary services. 

What does Part B cost you? It depends on your income. Once you enroll, you pay a monthly, income-based premium as well as an annual deductible.  

Mind the gapMany opt for a supplemental insurance policy, like a Medigap plan, to cover any gaps in coverage across Parts A and B. Supplemental insurance helps you pay any remaining health care costs associated with things like copayments, coinsurance and deductibles. 

Part C can also be referred to as Medicare Advantage Plans. These are combination plans managed by private insurance companies that have been approved by Medicare. Usually, the plans include Part A, Part B and (sometimes) Part D coverage. Whatever the combination, the plan must cover medically necessary services. 

What does Part C cost you? Again, it depends. Private insurance companies assign the copays, deductibles and coinsurance attached to these plans at their own discretion.  

Part D covers prescription drugs, and it’s available to everyone who uses Medicare. 

What does Part D cost you? Like with Part C, Part D plans are provided by private companies approved by Medicare, so you pay a monthly premium. 

One more note about payment: If you have Medicare along with another type of insurance, the question of who should pay, or who should pay first, can get complicated. For example, generally, a group health plan would pay before Medicare, but there are also many exceptions. If you have a current Medicare plan in place that is not administered by Acentria, please visit www.Medicare.gov or call 855.798.2627 to speak to someone about the specifics of your situation. If you are interested in reviewing your plan options or have already purchased a plan with Acentria, please contact us directly for more information.

How do I get Medicare?  

Now that we know the different parts, how do you actually get up and running? Let’s review the key steps and information you need. 

Step 1: Fill out the questionnaire 

You should receive this from Medicare about three months before you’re entitled to start coverage. Medicare uses your responses, like whether you have group health insurance through an employer or family member, to set up your file and make sure claims get paid in the right way. 

Step 2: Communicate any updates post-questionnaire 

Let’s say something about your health insurance or coverage changes after you submit the questionnaire. All you have to do is call the Medicare Coordination of Benefits Contractor at 855.798.2627 and they will update your file. 

Step 3: Schedule a free visit 

Once you’ve started on Medicare, be sure to take advantage of a free preventive visit during the first 12 months of your coverage. The visit will allow you to assess your current health status and set up a roadmap for the future.  

Step 4: Create an account  

To access your information and track claims, head over to Medicare.gov and create an account. This is where you can also complete an Authorization Form that allows your family and friends to call Medicare on your behalf. 

We’re here for you.  

Got more questions? If you or a loved one is nearing retirement age, we’re here to help you with everything you need to know. Don’t hesitate to reach out and discuss your options today!

Share

Share on facebook
Share on linkedin
Share on twitter

More Posts

Rob Wagner

Executive Vice President
Southwest Florida Region

Jason Cruse

Executive Vice President
Central Florida Sales

Mitch Weinstein

Partner

As partner of Acentria Insurance, Mitch plays an integral role in mergers & acquisitions. He focuses on seeking out strategic like-minded partners and agencies, across the southeastern United States, to partner and join the Acentria family.

Mitch has over 42 years of business leadership experience that ranges from law enforcement to the finance, healthcare and insurance industries. He was instrumental in developing the nation’s first “at-risk” managed care network for physical and occupational therapy serving the worker’s compensation industry. This network paved the way for a new managed care system, based on incentives.

Mitch is passionate about giving back to the youth of his community. He is an active supporter of the Boys & Girls Clubs of Polk County and believes in helping all young people reach their full potential. He is also the founder of Fallen First Reserve which is a non-profit organization dedicated to financially assisting those family members of First Responders killed in the line of duty and military members killed in action. Mitch also serves on the board for Fund the First.

Mary Lawless

President & Chief Operating Officer

As President and Chief Operating Officer, Mary brings over three decades of industry expertise to Acentria Insurance. With a strong focus on Mergers & Acquisitions, Mary is passionate about partnering with new agencies and leaders to continue the overall upward growth of Acentria. She works in conjunction with the CEO to lead and deliver specialized sales products, services and industry leading capabilities while implementing business and sales strategies to the Acentria sales team and carrier partners. Mary has direct oversight of all operational leaders throughout the entire organizational footprint and is responsible for operational financials and budgets.

She empowers her team members and because of it, is well respected by her peers and those she leads. Since her time with Acentria, Mary’s leadership has contributed to the agency’s exponential growth from 15 to well over 50 locations, increasing employment to over 700 team members, across the southeastern United States. Due to her leadership and contributions to the insurance industry, she has been nationally recognized as one of Insurance Business America magazine’s Elite Women and serves as a valuable member on the Executive Committee for Foundation Risk Partners, Acentria’s parent company. Prior to joining Acentria Insurance, Mary led operations for another national broker. Throughout her tenure, she has held a variety of management positions in Personal Lines, Select Business and Employee Benefits. Mary specializes in agency operations, partnerships and acquisitions and is truly passionate about developing team members to become great leaders.

When not shaping the future industry leaders at Acentria Insurance, Mary enjoys traveling and spending time with her husband, Pat and their family and friends.

Kendall McEachern

Co-Founder

Kendall was a fundamental part of Acentria Insurance. As a co-founder, he brought more than 30 years of industry expertise to Acentria, helping transform the organization into a leading insurance provider. Beloved by team members, carrier partners and clients, he oversaw more than 400,000 insured multi-family units with property values greater than $22 billion, and over four million square feet of commercial office space and real estate buildings. Kendall has received numerous industry awards to include being recognized as a National Top Producer and Agent of the Year by both Insurance Business America and Insurance Journal. Away from the office, he served as chairman for the American Heart Association, actively participated in his church and golfing, watching sports and spending time with his family. Kendall passed away in January of 2021, leaving a lasting legacy on Acentria’s culture, success, industry-wide reputation – and on all of us fortunate to have worked alongside him.

Liz Bevelacqua

Senior Vice President
Personal Lines Sales

Doreen Castro

Senior Vice President
Personal Lines Operations

Jessica Davis

Senior Vice President
Marketing & Branding

Jackie Shaw

Senior Vice President
Commercial Lines

Nathan Marks

Executive Vice President
Northwest Florida and Tallahassee

Alan Florez

Executive Vice President, National Sales

Alan leads new business growth strategies and expansion, guides the development of resources and training for Sales Producers and their partnerships with Carriers. With over 15 years of industry experience, Alan also leads the Acentria Public Risk divisions working with municipalities and government entities for their coverage needs. He was appointed to the Halifax Health Board of Commissioners December 2020 and also serves as an Executive Committee member for our parent company, Foundation Risk Partners.

Previously, Alan served as Governor Jeb Bush’s Deputy Director of Legislative Affairs and Special Assistant. He is a former member of the University of Central Florida Board of Trustees and currently volunteers his time with the Florida Council of 100, Futures Foundation of Volusia County Schools and the Community Foundation of Flagler and Volusia. Alan holds a bachelor’s degree in Political Science from the University of Central Florida.

Brian Stanton

Executive Vice President
West Palm Beach, Fort Lauderdale, Florida Keys

Chris Tolland

Executive Vice President
Northeast Florida Sales

Luke Wolkers

Executive Vice President
Benefits

Eric Austin

Operations Lead
Port St. Lucie & West Palm Beach

Alex Doberstein

Vice President
Benefits Resource Leader

Teresa Fillmon

Vice President
Small Business Unit

Anne Kraus

Vice President
Panhandle of Florida Region

Kevin Mason

Chief Executive Officer & Co-Founder

As Chief Executive Office of Acentria Insurance, Kevin focuses on developing insurance solutions that strengthen Acentria’s presence in the market and its commitment to client-relationships and exceptional service. With over 35 years of industry experience, he specializes in the overall growth of Acentria as is passionate about bringing new talent to the organization both organically and through mergers and acquisitions. Through his leadership and the support of the Executive Leadership team, Acentria Insurance instills a positive corporate culture which has led the agency in being recognized as a leader within our industry as a Top 100 Workplace, Employer of Choice, Best Agency to Work For and several other national and regional accolades.

Before co-founding Acentria Insurance, Kevin served as Branch Manager for another national broker. Kevin holds the prestigious title as an Agent of the Year and five-time National Top Producer. He is also a key member of the Foundation Risk Partners Executive Committee, which is the parent company of Acentria Insurance, while also serving as the National Director for Carrier Relations. In addition, Kevin oversees the Sales Leadership Council, which encompasses sales leaders across the entire FRP footprint in an effort to develop and refine shared resources while offering producer training and development programs.

Kevin received a Bachelor’s Degree in Management from the University of West Florida. He is very active in his community and served over a decade on the Board of Directors of Destin Charity Wine Auction Foundation and remains as a trustee, which funds over 14 children’s charities along the Florida Panhandle. He is also a member of the Destin Chamber of Commerce, Community Association Institute and Florida Association of Insurance Agents. In his spare time, Kevin enjoys golfing, tennis, boating and spending time with his wife Laura, and their children.