FAQ

Capital Realm Insurance’s services are 100% free! All virtual appointments, help selecting and signing up for a plan, and questions at anytime throughout the year are offered at no charge.  The insurance company that you choose pays us a commission after you sign up.

It’s up to you! You do not need to enroll in Medicare if you have group health plan coverage. Cost may be the largest determining factor in your decision. Alex recommends answering these 3 questions about your current work coverage:
• How much is currently deducted from your paycheck for health insurance?
• What is your deductible?
• What is your annual out-of-pocket maximum (if applicable)?
If the cost of Medicare is greater than your current plan, it may make sense to delay Medicare Part B until you retire.

Let’s look at the cost of Medicare:
Medicare Part A is covered at $0 for most individuals. The average cost of Part B is [$148.50/month in 2021]. The cost of additional plans to pay for what Original Medicare (Parts A and B) doesn’t cover ranges from $0 to $150/month. Someone with a low healthcare premium through work and minimal healthcare needs may end up paying more by switching to Medicare.

Meet Barbara:
Barbara is turning 65. Her employer deducts $53/month from her paycheck for insurance, her deductible is $2,500, and her annual out-of-pocket maximum is $4,000. She doesn’t have many healthcare needs and is perfectly happy paying $53/month for insurance. Dropping her coverage at work and electing Medicare Part B would have raised her responsibility to a minimum of $148.50/month. Even though she could dramatically lower her deductible and out-of-pocket maximum, Alex would advise Barbara to delay Part B for the time being but contact him at least two months before retirement to start the process of choosing a Medicare plan.

You will not receive a penalty if you decide to delay your Medicare Part B as long as you have alternative coverage, like health insurance through your employer. Once you’re ready to sign up for Medicare, Alex will help you complete and submit two Social Security forms (Application for Enrollment, Request for Employment Information) proving coverage with your employer for this time period. The goal is to make the transition from coverage to Medicare coverage seamless to avoid the Part B penalty. Contact Alex for help making the switch!

At this stage, you will not be able to apply for Medicare Part B online. Alex highly recommends making a trip to your local Social Security office to hand-deliver both of these completed Social Security documents:
Application for Enrollment in Medicare Part B
Request for Employment Information

The first document is simply an application for Part B. The second document contains two sections. The first is completed by the applicant (you), and the second is filled out by your employer to certify that you had group health plan coverage to avoid a Part B penalty.

You have the option to mail these documents to Social Security, but numerous clients have reported that their Part B date was been delayed because the documents were not received.

Most likely, no. Alex recommends contacting your employer to confirm your monthly premium amount and plan benefits to ensure you’re happy with them moving forward. If have questions or concerns about this coverage, schedule a free virtual appointment to go over your options!

Medicare Supplements (Medigap) are used to help cover the cost of services not covered by Original Medicare (Parts A and B). Medicare Supplement plans cost more on average, but you may see any provider in the US that accepts Original Medicare. Depending on the plan, you may have the majority of your hospital and medical bills paid. However, prescription drug (Part D) coverage is not included and must be added at an additional cost. You may also need a separate policy for extra benefits like hearing, vision, and dental.

Medicare Advantage (Part C) plans usually include prescription drug coverage (Part D) – as well as extra benefits like hearing, vision, dental, gym memberships, and health/wellness products. These plans cost less on average, but you must stay in-network with your plan’s provider. Each plan has a summary of benefits detailing your expected cost for a particular service. You’ll also enjoy the benefit of set co-pay amounts and annual out-of-pocket maximums.

For a more in-depth explanation, please visit the Medicare Supplement and Medicare Advantage pages or contact Alex for personalized help.

The short answer is: to avoid a Part D (prescription drug) penalty. You may receive a Part D penalty for any continuous period of 63 days without creditable prescription coverage – even if you weren’t taking prescriptions during this time. The fee is 1% of the national base beneficiary premium [$33.06 in 2021] for each full month without coverage and is added to your plan’s monthly premium for the remainder of your time on Medicare.

Yes and no. While we love our friends and family, sometimes misinformation can cause confusion. Plans can vary in both cost and benefits depending on location.

For example, The same company might offer Medicare Supplement Plan G in both Idaho and Oregon, but the monthly premium will be different based on the zip code. Another company might offer Plan G at a much lower rate in your area.

Another example: The same company might offer a Medicare Advantage plan in both Nevada and Arizona. However, the Nevada plan might include dental, vision, and hearing while the Arizona plan does NOT.

That’s why Alex is here to help guide you! Schedule a free virtual appointment to discuss your healthcare needs. Alex will find the right plan for you at the lowest possible cost.