Medicare Agents In My Area

medicare agents in my area going over a medicare supplement plan

Many in the central valley have lots of questions and confusion about Medicare, how it works and are always looking for “Medicare agents in my area.” Here we will understand the basics about Original Medicare: how you qualify, what it actually covers, and if there are services you need that aren’t included.

Medicare Agents In Your Area Explain Medicare Benefits:

Original Medicare Monthly Costs

Medicare Part A

Part A will be free if you have worked and paid Medicare taxes for at least 40 quarters (10 years) in the United States. Most people don’t pay a monthly premium for Part A, due to work history; however, if you don’t automatically qualify you can pay for your Part A with a monthly premium. You may also qualify through your spouse if they qualify. Our Medicare agents in your area are here to help you with your Part A questions.
https://www.medicare.gov/your-medicare-costs/part-a-costs

Medicare Part B

Part B premium will cost $148.50 per month and may be deducted from Social Security checks, Railroad Retirement checks or personal check each month. This amount may vary in a few situations. Individuals with income over $88,000, or filing jointly with incomes over $176,000 pay an increased premium, up to $504.90 per month based on the income related monthly adjustment amount (IRMAA). Those with Medi-Cal may have their Part B premium paid by the state.
https://www.medicare.gov/your-medicare-costs/part-b-costs

Senior Indian asian couple accounting, doing home finance and checking bills with laptop, calculator and money also with piggy bank while sitting on sofa couch or table at home getting ready to call Medicare agents near me.

If you are unsure of what you may have to pay or if you qualify we recommend that you call the Fresno Social Security office. There are a few around town. We have found the office on Locust ave to be the quickest and best service. They are located behind the Walmart off of Palm and Herndon. Their number is (866) 931-9041. If you’re looking for local medicare agents in my area, call us!

Part A Deductible and Coinsurance

Hospital

$1,484 deductible for days 1-60 following inpatient hospitalization.
Days 61-90: $371 coinsurance per day
Days 91 and beyond: $742 coinsurance per day after day 90 for up to 60 days over your lifetime.
This resets and a new deductible is owed once discharged and the 90 day window has closed.

Example: If you get hospitalized at Fresno Community or Saint Agnes hospital then you would pay a flat deductible of $1,484 whether you are there one day or one month. If you get released and are readmitted within 3 months of your release date then you do not have to pay another deductible. Call a Medicare insurance agent in your area to learn more about hospitalization costs and deductibles.

Home health care

$0 for medically necessary home health care services.
20% of the Medicare-approved amount for durable medical equipment (DME).

Hospice care

$0 for hospice care.

Medicare agents in my area with a hand on a senior patient's shoulder.

Mental health inpatient stay

Mental inpatient hospitalization is treated the same as medical hospitalization.

Skilled nursing facility stay

Days 1–20: $0 for each benefit period.
Days 21–100: $185.50 coinsurance per day of each benefit period.
Days 101 and beyond: all costs.

Part B Deductible and Coinsurance

Part B annual deductible:

You pay $203 per year in 2021 for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for these:

Most doctor services
Outpatient therapy
Durable medical equipment (DME)
Clinical laboratory services: You pay $0 for Medicare-approved services.
All services listed below

Outpatient mental health services:

You pay nothing for your yearly depression screening.
20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition.

Outpatient hospital services:

You usually pay 20% of the Medicare-approved amount for the doctor, hospital, or other health care provider’s services. For services that can also be provided in a doctor’s office, you may pay more for outpatient services you receive in a hospital than what you would pay if you received the same care in a doctor’s office. However, the hospital outpatient copayment for the service is capped at the inpatient deductible amount of $1,484.

What Original Medicare Doesn’t Cover

Non-medical Home Health Explained By Medicare Agents In Your Area

Original Medicare will not cover any home health services that are not medically necessary. This includes having someone help you with bathing, going to the bathroom, cleaning the house, shopping, or any other service that can fall under assisted living with home health. This would also include any nursing homes or assisted living facilities. To receive coverage for these services you must either pay out of pocket, have a long term health policy, or have Medi-Cal.

If you do have Medi-Cal and live in Fresno or Madera county, we recommend that you call the In Home Supportive Services here in Fresno. They provide home nurses for custodial care for those on Medi-Cal. They can be reached at (559) 600-6666. If you want to speak with “Medicare agents in my area,” call us today!

Ancillary Services

There are many services that are considered “extra” that aren’t covered under Original Medicare. These include:

Most dental care, including dentures, dental procedures or cleanings, fillings, dental plates, tooth extractions, and checkups
Cosmetic surgery
Hearing aids
Routine foot care
Eye exams for prescription glasses
Acupuncture

Medicare Agents In Your Area Can Help You With Medicare Part D

Original Medicare does not include prescription drug coverage. Some medications may be covered when administered within a doctors office. Outside of the doctors office any pharmacy filled medications will require a prescription drug plan (PDP) to be purchased from a private company. Medicare requires you to purchase a PDP, and you may be subject to a penalty if you do not enroll into a PDP when you first receive Medicare benefits.

Any Medicare Beneficiary who does not enroll into a PDP and does not have Creditable Coverage will incur a 1% penalty of the National Drug Premium average for every month the beneficiary is without Creditable Drug Coverage. If you have any of the following below then you are not required to buy a PDP and will not incur a penalty. Local Medicare agents in your area are ready to answer any of your questions about Medicare Part D.

Examples of Creditable Coverage:

✓ Group/Employer Coverage

✓ VA

✓ TriCare

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