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Medicare


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Medicare Information

What is Medicare?

Medicare is a fee-for-service health care program for seniors, in which the government pays health care providers directly for services that fall under Parts A and B of Medicare benefits (see below). However, if you are looking for more coverage than Original Medicare, you can purchase one of our Medicare Advantage Plans to receive all your Part A and Part B benefits.

Medicare is divided into four categories. This allows you to customize your personal coverage when shopping for a comprehensive policy.

  • Part A (hospital insurance): Covers hospital care, emergency services, nursing home care, home health services and hospice.
  • Part B (medical insurance): Covers medically necessary services and supplies used for diagnosing and treating medical conditions, and preventative services for illness prevention and/or early detection. Examples include ambulance services, mental health care, outpatient procedures and clinical research.
  • Part C: Combines Parts A and B and often part D as well.
  • Part D: Offers prescription drug coverage.

What Medicare options are available?

Original Medicare offers coverage for services and supplies that are considered to be medically necessary, such as doctor visits, lab tests and wheelchairs. There are several alternative plans you can choose from for additional coverage, and each plan must offer at least the same coverage as Original Medicare. There are two Medicare plans that we can assist you with.

  1. A Medicare Advantage Plan, also known as Part C, combines Part A and Part B as a replacement to Medicare for more comprehensive health care coverage. This plan can be customized with additional coverage, such as a prescription drug program (Part D), vision and dental.
  2. A Medicare Supplemental Plan, also known as Medigap, has a higher premium but supplements the coverage gaps and deductibles that Part A and Part B leave behind.

What is Medicare Advantage?   

A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.


What is a Medicare Prescription Drug Coverage?  

Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan when you're first eligible, and you don't have other creditable prescription drug coverage, or you don't get Extra Help, you'll likely pay a late enrollment penalty.

To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

2 ways to get drug coverage

  1. Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
  2. Medicare Advantage Plan (Part C) (like an HMO or PPO) or otherMedicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance)and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

Why do you need Medicare?

Seniors are in the most need of health care, but once retired monthly premiums can become hard to maintain. Enrolling in the Medicare program allows you to get the care you need for a minimal charge.

Contact us today to learn more about coverage options. We are happy to work with you to determine which Medicare options works best for you.

   
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