There are more than 740,000 beneficiaries enrolled in Medicare. Your health is going to vary from your neighbor’s, and it’s crucial that you find a plan that fits your specific needs and budget. Fortunately, Medicare Plan Finder is your best source for understanding Medicare Oklahoma plans, providers, and eligibility requirements.
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Your first step into the confusing world of Medicare is enrolling in Original Medicare (Part A and Part B). Original Medicare is regulated by the federal government. This means that it is the same regardless of which state you live in. Part A includes coverage for things like hospital stays, nursing homes, hospice care, and home health services. Part B includes coverage for ambulance travel, medical equipment, mental health, partial hospitalization, lab tests, and x-rays.
Once you enroll in Medicare, you can start to explore other plan options. This includes Medicare Advantage, Medicare Supplements, and Part D plans.
Your Part A premium is dependent on how long you have worked and paid Medicare taxes. If you have worked and paid Medicare taxes for 40 quarters, you will not have to pay a monthly premium for Part A. If you only worked and paid taxes for 30-39 quarters, you will pay $240/month. Lastly, if you worked and paid taxes for less than 30 quarters, you will need to pay $437 per month.
The standard Part B premium is $135.50/month in 2019, but this will change based on your income. The annual deductible for all Medicare Part B beneficiaries is $185 in 2019. If you choose to enroll in a Medicare Advantage, Medicare Supplement, or Part D Plan, your costs will vary based on plan benefits, carrier, and location.
Medicare was designed for older adults over the age of 65. However, if you are under 65, there are still ways to qualify for Medicare. If you have been diagnosed with ESRD (end-stage renal disease) or ALS (Lou Gehrig’s Disease), you may be eligible for Medicare regardless of your age. Plus, once you have received Social Security Disability Income (SSDI) for 24 months, you’ll be automatically enrolled in Medicare on your 25th month of receiving benefits. If you have a question regarding your eligibility, fill out this form or give us a call at 833-438-3676.
Medicare and Medicaid can be easily confused. They are both regulated by the federal government, but Medicare was designed for older adults over the age of 65 and people with specific disabilities and Medicaid was designed for low-income individuals and families.
There are more than nine million beneficiaries who are enrolled in both programs. If you qualify for both programs, you will likely be eligible for a Dual Special Needs Plan (DSNP). A DSNP is a special type of Medicare Advantage plan that provides extra benefits at lower costs. Plus, DSNPs qualify you for a Special Enrollment Period (SEP). SEPs give you the ability to enroll outside of the Annual Enrollment Period. If you qualify for a DSNP, you may be eligible for other programs like Medicare's prescription drug program Extra Help, or other Medicare Savings Programs.
Beyond Original Medicare, you can enroll in a Medicare Advantage, Medicare Supplement, or Part D plan. Each option provides different benefits or coverage at a different price point. It’s essential to enroll in some type of prescription drug coverage, so you avoid any late-enrollment penalties down the road. You can enroll in a Medicare Advantage plan with prescription coverage, a stand-alone Part D plan, or a Medicare Supplement plan that offers prescription coverage (but those are rare). You can not be enrolled in a Medicare Advantage and Medicare Supplement plan at the same time, so you’ll have to choose.
Medicare Advantage plans must cover, at a minimum, the same benefits as Original Medicare. However, most plans include additional health benefits that Original Medicare does not. These benefits can include vision, dental, hearing, over-the-counter drugs, non-emergency transportation, and group fitness classes like SilverSneakers. MA plans are offered through private insurance companies, and the pricing will vary based on provider, location, and benefits. As always, our licensed agents can help you enroll in a plan that is in your area and fits your needs and budget. Fill out this form or give us a call at 833-438-3676.
Medicare Supplement plans provide financial benefits rather than health benefits. There are ten standardized plans (A, B, C, D, F, G, K, L, M, and N), and each plan offers the same benefits regardless of which carrier you enroll with. Plus, most plans are “guaranteed life,” which means that as long as you pay your premium on time, you should not be canceled from your plan if a new health condition develops. Medicare Supplement plans are great for beneficiaries who would rather pay a small annual deductible for financial protection in the event of an unforeseen health expense.
Medicare Supplement plan benefits can include financial assistance with Part A coinsurance and hospital costs, Part B coinsurance and copayments, blood work copays (up to three pints), hospice coinsurance and copayments, skilled nursing facility coinsurance, Part A deductible, Part B deductible, Part B excess charges, and foreign emergency travel.
The Department of Aging in Oklahoma offers programs that provide places where seniors, family members, caregivers, and healthcare professionals can find resources for the elderly and disabled. These programs include:
Adult Day Services: Adult Day Services is a program that helps seniors stay in the community and allows caregivers and families to continue caring for their loved one at home with the help of various services.
Legal Assistance: The Legal Assistance Progam provides seniors with legal information regarding elder rights, end-of-life issues, and grandchildren rights.
Ombudsman: The Ombudsman Program helps resolve issues from those who are living in long-term settings like nursing homes or assisted living facilities. This program helps educate residents on their rights and advocate for those who may not be able to.
Pharmacy Connection: The Pharmacy Connection Program helps to improve the lives of seniors who do not have access to proper prescription coverage and lack the resources to purchase their medically necessary prescription drugs.
Transportation: Oklahoma’s Transportation Program helps provide public transportation to seniors in urban and rural areas.
Elder Abuse: The Elder Abuse Program helps protect seniors against physical, emotional, and financial abuse. If you think you or a loved one is being abused, call the statewide abuse hotline 1-800-922-2275.
You can apply for Medicare in three main places. You can visit www.SocialSecurity.gov, call 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday 7 AM to 7 PM, or apply in person at your local Social Security office.
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