More than 107,000 beneficiaries are enrolled in Wyoming Medicare. Some are enrolled in a stand-alone Medicare Advantage plan, while others have a Medicare Supplement or Part D plan alongside Original Medicare. You know your health (and budget) better than anyone, so which type of plan is right for you?
Original Medicare consists of Part A (hospital coverage) and Part B (medical coverage). Part A covers hospital stays, nursing homes, hospice, and home health services. Part B covers ambulance travel, medical equipment, mental health, partial hospitalization, lab tests, and X-rays. Once you are enrolled in parts A and B, you can start to explore other plans that offer health and financial benefits, or prescription drug coverage.
There are four types of Medicare plans in Wyoming. Original Medicare is regulated by the federal government and is the same no matter which state you live in. Beyond parts A and B, plan options include a stand-alone Medicare Advantage plan, or a Medicare Supplement or Part D plan that works alongside your Original Medicare coverage. These can be purchased through private insurance companies and availability varies based on your location.
Medicare Advantage (MA) plans provide the same coverage as Original Medicare, but most plans offer several additional benefits that parts A and B do not include. Some of the most popular benefits include hearing, vision, dental, over-the-counter drugs, non-emergency transportation, and group fitness classes (like SilverSneakers and Silver & Fit). MA plans are sold through private insurance companies. If you are interested in learning about plans in your area, click here to call 833-438-3676 to get in contact with a licensed agent.
Medicare Supplement (Medigap) plans can be purchased to work alongside Original Medicare (you must be enrolled in parts A and B first, and a Medigap plan does not replace Original Medicare). Medigap plans provide financial protection through a range of benefits, including:
These benefits are offered in various combinations through ten different plans (A, B, C, D, F, G, K, L, M, and N). Generally, the more benefits a plan has, the higher the monthly premium will be. For example, Plan N is a more comprehensive plan, but typically costs more than a plan with fewer benefits (like Plan K). One of our licensed agents can show you plans in your area and help you enroll. To get started, click here or call 833-438-3676.
Part D plans work alongside Original Medicare to provide prescription drug coverage. If you purchase a Part D plan, you’ll need to meet your deductible ($415 in 2019) before your coverage begins. You will continue to pay a copay per each prescription drug your purchase until you reach a spending limit of $3,820. After this point, you are considered to be in the “donut hole,” but don’t worry - it’s going away in 2020. While you’re in the donut hole, you will pay 37% of generic drug costs and 25% of brand-name drug costs. This will continue until you reach catastrophic coverage ($5,100 in spending) where you will only be responsible for 5% of your total prescription drug costs for the remaining portion of the year.
The cost of Medicare will vary depending on which type of plan you choose. The Part A premium will vary based on how many quarters you worked and paid Medicare taxes. If you have worked for 40 or more quarters, you will not have to pay a monthly premium. If you have worked 30-39 quarters, you will have to pay $240 per month. For any amount worked less than 30 quarters, you will have to pay $437 per month. The Part B premium is based on your income rather than how long you worked, and most beneficiaries will pay $135.50 per month. The cost for additional plans (Medicare Advantage, Medicare Supplement, or Part D), will vary based on the carrier, location, and benefits.
Most people don’t qualify for Medicare until they turn 65. However, if you have ESRD (end-stand renal disease) or ALS (Lou Gehrig’s Disease), you can qualify for Medicare before your 65th birthday. You’ll be automatically enrolled in Original Medicare if you have been receiving SSDI (Social Security Disability Insurance) for at least 24 months. To qualify for Medicare Advantage, Medicare Supplements, or Part D, you must be enrolled in Original Medicare first.
There are more than 9 million people across the U.S. that qualify for both Medicare and Medicaid. If you qualify for both programs, you may also be eligible for a Dual Special Needs Plan (DSNP). DSNPs provide extra benefits, lower costs, and a Special Enrollment Period (SEP). SEPs allow you to make changes to your plan regardless of the time of year.
You could also qualify for other cost-saving programs. Medicare’s prescription drug program, Extra Help, can help you save more than $4,000/year on prescription drug costs. Other Medicare Saving Programs can help provide coverage for other Medicare-related costs like premiums, deductibles, copayments, and coinsurance.
Several programs throughout Wyoming help older adults, disabled individuals, and families maintain their health, independence, and comfort. These programs include:
Caregiver Support: The Caregiver Support Program provides education, training, support, and respite care to families and caregivers.
Legal Assistance: The Legal Assistance Program helps older adults find lawyers who practice elder law in their area and can provide advice and resources regarding their case.
Meals: The Meals and Nutrition Program provides hot meals at neighborhood centers and delivers hot lunches to homebound older adults.
Transportation: The Transportation Program helps provide transportation to those who are unable to go to doctor offices, pharmacies, and grocery stores by themselves.
Independent Living: The Home Services and Independence Program provides services like bathing, cooking, cleaning, prepping meals, managing money, and other daily-living tasks to those who may be unable to complete the tasks themselves.
You can sign up for Original Medicare through your Social Security office. Visit their website (www.socialsecurity.gov), give them a call (1-800-772-1213), or visit your local office. Once you are enrolled in parts A and B, you can schedule an appointment with a licensed agent to start exploring Medicare Advantage, Medicare Supplements, and Part D plans in your area. Click here or call 833-438-3676.
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