Medicare’s popular program, offering free gym membership and health education.

Once you turn 65, the world of Medicare opens to you, and you also gain access to its offshoot supplemental programs. You likely know about Part A, Part B, Medicare Advantage, and other sections, but you may not know about the senior fitness offering “SilverSneakers.”

SilverSneakers is a versatile and free fitness plan for Medicare recipients. Not every insurance company that has Medicare Advantage or other Medicare Supplement Insurance plans has SilverSneakers as a choice. But it’s definitely worth asking about whenever you add or change your coverage.

SilverSneakers grants free access to thousands of fitness locations across America. Call ahead to find out if your local gym participates. You might also inquire if their location offers special SilverSneakers classes. These fitness sessions are designed for Medicare-aged students.

Not all SilverSneakers’ benefits are centered around the gym, however. For those who prefer different types of exercise, FLEX, a feature within SilverSneakers, holds meetups at community centers, public parks, and places of worship. They provide fitness opportunities that might not be available at your gym, such as hiking groups, yoga, and swimming.

SilverSneakers also offers health seminars, wellness events, and other community-building options for their members. The emphasis is on getting engaged and getting moving.

Remember, though, that not all plans offer SilverSneakers. Communicate carefully when doing your research and make a selection that covers your needed treatments and prescriptions first. Any extras should be secondary. It’s also important to remember that SilverSneakers’ availability may vary from year to year and even be canceled to make room for other features. Make your decisions with that knowledge and your overall health needs in mind.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

Medicare takes a little time to understand.

As you approach age 65, familiarize yourself with its coverage options, costs, and limitations.

Certain features of Medicare can affect health care costs and coverage.

Some retirees may do okay with original Medicare (Parts A and B), others might find it lacking and decide to supplement original Medicare with Part C, Part D, or Medigap coverage. In some cases, that may mean paying more for health care than you initially figured.

How much do Medicare Part A and Part B cost, and what do they cover?

​Part A is usually provided with no charge; Part B is not. Part A is hospital insurance and covers up to 100 days of hospital care, home health care, nursing home care, and hospice care. Part B covers doctor visits, outpatient procedures, and lab work. You pay for Part B with monthly premiums.1

It’s best to prepare for the copays and deductibles linked to original Medicare. In addition, original Medicare does not cover dental, vision, or hearing care, nor prescription medicines or health care services outside the U.S. It pays for no more than 100 consecutive days of skilled nursing home care. These out-of-pocket costs may lead you to look for supplemental Medicare coverage as a way of paying for extended care.2,3

Medigap policies help Medicare recipients with some of these copays and deductibles.

Sold by private companies, these health care policies can pay a share of certain out-of-pocket medical costs (i.e., costs greater than what original Medicare covers for you). You must have original Medicare coverage in place to purchase one. The Medigap policies being sold today do not offer prescription drug coverage.4

Part D plans cover some (but certainly, not all) prescription drug expenses.

Monthly premiums are averaging $40 this year for these standalone plans, which are offered by private insurers. Part D plans currently have yearly deductibles of no more than $590.5

Creating a Medicare strategy is integral to your retirement preparation.

Should you try original Medicare for a while? Should you enroll in a Part C HMO with the goal of managing your overall out-of-pocket health care expenses? There is also the matter of eldercare and the potential need for interim coverage if you retire prior to 65. Discuss your concerns about Medicare in your next conversation with your financial professional.

1. Medicare.gov, 2024
2. Medicare.gov, 2024
3. Medicare.gov, 2024
4. Medicare.gov, 2024
5. CMS.gov, 2024
The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

You might qualify for Medicare if you’re under 65-years-old. This article will explain the conditions where you may qualify for Medicare early.

When you are under 65, you become eligible for Medicare if:

  1. You have received Social Security Disability Insurance (SSDI) checks for at least 24 months
  2. Or, you have been diagnosed with End-Stage Renal Disease (ESRD)

Eligibility for Medicare due to a disability

You may qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months, also known as the two-year waiting period. The two-year waiting period begins the first month you receive an SSDI check. You will be automatically enrolled in Medicare at the beginning of the 25th month that you receive an SSDI check.

If you receive SSDI because you have Amyotrophic Lateral Sclerosis, or ALS, Medicare automatically begins the first month that your SSDI benefits start. You do not have the two-year waiting period.

Social Security—not Medicare—makes the determination of whether you qualify for SSDI checks and administers the program that provides the checks. For more information on the Social Security Disability Insurance program, it is recommended that you contact your local Social Security Administration (SSA) office.

Note: Railroad workers should contact the Railroad Retirement Board for information about disability annuity and Medicare eligibility.

Eligibility for ESRD Medicare

You may qualify for ESRD Medicare if you have been diagnosed with kidney failure and you:

  • Are getting dialysis treatments or have had a kidney transplant
  • And:
    • You are eligible to receive SSDI
    • You are eligible to receive Railroad Retirement benefits
    • Or, you, a spouse, or a parent have paid Medicare taxes for a sufficient amount of time as specified by the Social Security Administration

If you are under 65 and have ESRD, when your Medicare benefits begin depends on your specific circumstances, including when you apply for Medicare, whether you receive dialysis at home or at a facility, and whether you get a kidney transplant. If you are eligible for ESRD Medicare, you can enroll in Parts A and B together at any time. Part A will be retroactive up to 12 months, but it cannot start earlier than the first month you were eligible for ESRD Medicare.

Note: If you are a railroad worker with ESRD, you must contact Social Security—not the Railroad Retirement Board—to find out if you are eligible for Medicare.

Because Social Security and Medicare eligibility rules are complex, it is recommended that you call Social Security at 800-772-1213 to get the most accurate information regarding your particular situation.

© Medicare Rights Center. Used with permission.
The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

Do you need to enroll in Medicare Part D? Read this article to learn more about whether you need this coverage

Medicare’s prescription drug benefit (Part D) is the part of Medicare that provides outpatient drug coverage. Part D is provided only through private insurance companies that have contracts with the federal government—it is never provided directly by the government (unlike Original Medicare).

If you want to get Part D coverage, you have to choose and enroll in a private Medicare prescription drug plan (PDP) or a Medicare Advantage Plan with drug coverage (MAPD). Enrollment is optional (though recommended to avoid incurring future penalties) and only allowed during approved enrollment periods. Typically, you should sign up for Part D when you first become eligible to enroll in Medicare.

Whether you should sign up for a Medicare Part D plan depends on your circumstances. You may have creditable drug coverage from employer or retiree insurance. If so, you don’t need to enroll in a PDP until you lose this coverage. Also, some people already enrolled in certain low-income assistance programs may be automatically enrolled in a Medicare drug plan and receive additional financial assistance paying for their medicines.

© Medicare Rights Center. Used with permission.
The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

65 or older? It may be time to enroll in Medicare. Read to learn if you’re eligible.

When you turn 65, you become eligible for Medicare if you:

  1. Either receive or qualify for Social Security retirement cash benefits
  2. Or, currently reside in the United States and are either:
    a. A U.S. citizen
    b. Or, a permanent U.S. resident who has lived in the U.S. continuously for five years prior to applying

How you enroll at age 65 depends on whether or not you are already receiving Social Security retirement benefits or Railroad Retirement benefits. Also, there are circumstances in which someone may become Medicare-eligible at age 65 but defers Medicare enrollment without future penalties—for instance, if an individual has qualifying insurance from an employer.

How much you have to pay for your Medicare coverage depends on your work history (i.e. if and how long you have paid Medicare taxes). Everyone owes a monthly premium for their medical insurance (Part B). Most people with Medicare get their hospital insurance (Part A) premium-free.

For questions regarding Medicare eligibility, call the Medicare Rights Center’s free national helpline at 800-333-4114.

© Medicare Rights Center. Used with permission.
The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

Medicare Part C allows you to choose a Medicare Advantage plan. This article will help you decide if it’s right for you.

Medicare Part C is not a separate benefit. Part C is the part of Medicare law that allows private health insurance companies to provide Medicare benefits. These Medicare private health plans, such as HMOs and PPOs, contract with the federal government and are known as Medicare Advantage Plans. If you want, you can choose to get your Medicare coverage through a Medicare Advantage Plan instead of through Original Medicare.

Medicare Advantage Plans must offer, at minimum, the same benefits as Original Medicare (those covered under Parts A and B) but can do so with different rules, costs, and coverage restrictions. You also typically get Part D as part of your Medicare Advantage benefits package (MAPD). Many different kinds of Medicare Advantage Plans are available. You may pay a monthly premium for this coverage, in addition to your Part B premium.

If you join a Medicare Advantage Plan (like an HMO, PPO, or PFFS), you will not use the red, white, and blue card when you go to the doctor or hospital. Instead, you will use the membership card your private plan sends you to get health services covered. You will also use this card at the pharmacy if your health plan has Medicare prescription drug coverage (Part D).

© Medicare Rights Center. Used with permission.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.
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