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How Insurance Works

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We’re an Insurance Agency that specializes in Life and Health Insurance coverage for individuals and businesses. We can provide what best suits your needs because we are an independent agency not tied to any one carrier. Learn more about how insurance works below.

How Medicare Works

Centers For Medicare and Medicaid Services 2022 Guide to Medicare 

Medicare is the federal health insurance program for people over 65 years of age and people with certain disabilities or End-Stage Renal Disease (permanent kidney failure). There are four parts to Medicare:

Part A – Hospital Insurance
Part B – Optional Medical Insurance
Part C – Optional Medicare Advantage Insurance
Part D – Optional Prescription Drug Insurance

 

2022 Medicare Part A

Helps pay for care in hospitals, some skilled nursing facilities, hospices, and some health care. For most people, Part A is premium-free because they paid Medicare taxes.

 
HospitalizedMedicare CoversIndividuals Pay
1-60 daysMost confinement costs after the required Medicare Deductible.$1,556 deductible
61-90 daysAll eligible expenses, after the patient pays a per-day co-payment.$389 per day co-payment
91-150 daysAll eligible expenses except per-day co-payment. 60 Lifetime Reserve days may not be reused.$778 per day co-payment
151 days or moreNothing100%
Skilled Nursing Confinement*All eligible expenses for the first 20 days, then all eligible expenses for days 21-100, after the patient pays a per-day co-payment.$194.50 per-day (after 20 days)

*Must be receiving skilled nursing care in a Medicare-approved skilled nursing facility that begins within 30 days after hospitalization of at least 3 days.

 

2022 Optional Medicare Part B

Optional coverage to help pay for doctors, outpatient hospital care, and some other medical services not covered by Part A. The chart below shows the Part B monthly premium amounts based on income. These amounts change each year. There may be a late enrollment penalty.

 
File Individual ReturnFile Joint ReturnIndividual Pays
$91,000 or less$182,000 or less$170.10*
$91,000 – $114,000$182,000 – $228,000$238.10
$114,000 – $142,000$228,000 – $284,000$340.20
$142,000 – $170,000$284,000 – $340,000$442.30
Above $170,000 and less than $500,000Above $340,000 and less than $750,000$544.30
$500,000 or above$750,000 or above$578.30

* Most people will pay the Part B premium of $170.10 in 2022.

The Medicare General Enrollment Period is from January 1 through March 31 of each year at a Social Security Administration office. Part B coverage will start on July 1 of that year. 
Special Part B Enrollment Periods – while covered by employer or union group health plan or within 63 days of the date when the employer or union group health plan coverage ends, or when employment ends.

ExpenseMedicare CoversIndividuals Pay
Medical Expenses – Physician’s services for inpatient and outpatient medical/surgical services; physical/speed therapy, diagnostic tests80% of the approved amount$233 deductible plus 20% of approved amount
Clinical Laboratory Services – Blood tests, urinalysisGenerally 100% of the approved amountNothing for services
Home Health Care – Part-time or intermittent skilled care, home health aide services, durable medical supplies and other services100% of the approved amount, 20% of the approved amount for durable medical equipmentNothing for services, 20% of approved amount for durable medical equipment
Hospital Outpatient – Hospital services for the diagnosis or treatment of an illness or injuryMedicare payment to hospital, based on outpatient procedure payment rates20% of approved amount, in all other cases co-payment based on outpatient payment rates
 

Part C Optional Medicare Advantage Plan Monthly

An alternative to traditional Medicare, Part C is another way to get Medicare benefits. It combines Part A, Part B, and, sometimes, Part D (prescription drug) coverage. Medicare Advantage Plans are managed by private insurance companies approved by Medicare. These plans must cover medically necessary services. However, plans can charge different copayments, coinsurance, or deductibles for these services.

 

Part D Optional Medicare Prescription Drug Plan

This optional coverage may help lower an individual’s prescription.

 
Individual tax returnJoint tax returnIndividuals pay
$91,000 or less$182,000 or lessYour plan premium
Above $91,000 up to $114,000Above $182,000 up to $228,000$12.40 + your plan premium
Above $114,000 up to $142,000Above $228,000 up to $284,000$32.10 + your plan premium
Above $142,000 up to $170,000Above $284,000 up to $340,000$51.70 + your plan premium
Above $170,000 and less than $500,000Above $340,000 and less than $750,000$71.30 + your plan premium
$500,000 or above$750,000 or above$77.90 + your plan premium

Health Savings Account Contribution Limits

 
Plan20212022
Contribution Limits$3,600 Single, $7,200 Family$3,650 Single, $7,300 Family
Minimum Deductible$1,400 Single, $2,800 Family$1,400 Single, $2,800 Family
Max out of Pocket (Includes Deductible)$7,000 Single, $14,000 Family$7,050 Single, $14,100 Family

* Catch Up Contribution age 55+ $1,000.

Tax Deductions For Long-Term Care Insurance

Premium payments for a tax-qualified long-term care insurance policy are deductible as personal medical expenses for those taxpayers who itemize their deductions.

 
Age2022
40 & Under$450
41 to 50$850
51 to 60$1,690
61 to 70$4,510
71 & Older$5,640

The prices above are for individuals. Prices for couples would be twice those of the individuals. Deductions can be taken for individuals, their spouse and tax dependents (such as parents) and are subject to the same tax rules as traditional medical expenses (such as 7.5% adjusted gross income [AGI] floor).

 

FOR SELF EMPLOYED

Payments for a tax-qualified long-term care insurance policy purchased by a self employed individual or sole proprietor are currently treated as medical insurance premiums with the same limits as those for individuals taxpayers.

 

FOR C-CORPORATIONS

Premium payments for a tax-qualified [TQ] long-term care insurance policy are fully (100%) deductible as a reasonable and necessary business expense similar to traditional health and accident insurance premiums (IRC Sec 702B[a][3]).

 

FOR S-CORPORATIONS

LIMITED LIABILITY COMPANIES PARTNERSHIPS

Premium payments for policies purchased for a non-partner/non-owner or less-than-2% shareholder-employee are fully deductible as a reasonable and necessary business expense so long as the entity does not retain any interest in the policy. The same is true for their spouse or tax dependents.

 

IRA Fact Sheet

 
YearMax ContributionCatch-Up age 50+Max Contribution with Catch-Up
2021$6,000$1,000$7,000
2022$6,000$1,000$7,000
  • Individuals age 50 and above can contribute a total of $13,000 jointly
  • Individuals cannot make an IRA Contribution during the year they turn 70 1/2. Note: If they wait until April 1, individuals must take two distributions during that year.

IRA Eligibility Limits

 
Tax YearSingleMarried Filing Jointly
2021$125,000 to $140,000$198,000 to $208,000
2022$129,000 to $144,000$204,000 to $214,000

* Please note there is no eligibility limit for self employed individuals. The above tax charts are based on current IRS regulations and may be subject to future changes. Please consult your financial advisor.

Business Retirement Plan Contribution Limits

 
Plans20212022
401(k) and 403(b) Plans$19,500$20,500
SIMPLE Plans$13,500$14,000
Catch-Up Contribution Amounts* (401(k), 403(b) SIMPLE Plans)$6,500, $3,000$6,500, $3,000
Defined Contribution PlansLesser of 100% of compensation or $58,000Lesser of 100% of compensation or $61,000
Defined Benefits PlansLesser of 100% of average compensation for 3 years or $230,000Lesser of 100% of average compensation for 3 years or $245,000
Annual Compensation Limit$290,000$305,000

* For employees age 50 and older.

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Stark & Associates Insurance is a local agency in Boca Raton, Florida, specializing in Life and Health Insurance coverage for individuals and businesses.