The Basics Of Medicare Health Plans

 

Medicare is the federal health insurance program for people age 65 and older. Certain people younger than age 65 can qualify for Medicare, including those who receive Social Security Disability Income and those who have permanent kidney failure.

Medicare is divided into a number of parts. Original Medicare (Part A and Part B) covers many health care services and supplies, but there are many costs and co-payments (gaps) it doesn't cover. For more detailed information on Medicare benefits go to www.medicare.gov.

Medicare Part A

Part A helps pay for inpatient hospital, skilled nursing facility (followed by a hospital stay), home health care, and hospice care.  Part A is premium free for most people, but you may share costs through deductibles and co-insurance.

Medicare Part B

Part B helps pay for doctors' services, laboratory and x-ray services, durable medical equipment (wheelchairs, hospital beds, etc.), ambulance services, outpatient hospital care, home health care, and medical supplies.

In most cases, Medicare Insurance pays 80% of the cost of covered services. Medicare Part B also pays for some preventive services. There is a fee for Part B.

Medicare Part C

Instead of getting your Medicare benefits through the original federal government program, you can get them through a private insurance company's Medicare Advantage (MA) plan. These plans combine all your Medicare-covered Part A and Part B benefits in a single package and can also include prescription drug coverage (Part D).

You must have Parts A and B before you can enroll in a Medicare Advantage plan. Medicare Advantage plan members pay a premium for Part B, and co-pays or co-insurance for services. The good news is that there is often no extra premium for Medicare Advantage plans. Please call us to get further information about Medicare Advantage plans in your area.

Medicare Advantage plans are not the same as Medicare Supplement plans (Medigaps), which work only with Original Medicare. Medicare Supplement plans fill in the gaps (like Part A deductibles and Part B co-insurance) where original Medicare does not pay. There is a relatively low premium associated with Medicare Supplement plans.

To get a quote: Click Here.

Medicare Part D

Prescription Medicare coverage is offered through private companies – either as part of a Medicare Advantage plan or as a stand-alone prescription drug plan for those with Original Medicare. Having either Part A or Part B, or both, makes you eligible for Part D. Part D plan members pay a premium and pharmacy co-pays; some plans also include a deductible. Some people can get Part D through their employer group plan or the Department of Veterans Affairs.

 

HOW WE CAN HELP

As you can see, Medicare is confusing. About three months before you turn 65, you will be inundated with mail from many insurance companies. These marketing materials are designed to encourage you to join their plan and can oversimplify the benefits, which can cause confusion

We can sit down with you and in thirty minutes help you understand how Medicare works and discuss the benefits of getting either a Medicare Supplement plan or a Medicare Advantage plan. As independent brokers carrying a wide selection of plans, our goal is to educate and help you determine what the right solution is for you.

For a quote for a Medicare Supplement plan: Click Here.

Please call us at 424-288-4254 to talk about Medicare Advantage plans and Medicare Supplement plans. We will help to clear up all the confusion!