Medicare is the federal health insurance program for people who are 65 and older and certain people under 65 who have disabilities. Medicare has many different parts, plans, dates, gaps and combinations thereof. Our team of highly trained agents are available to make it easy for you to understand and enroll in only the options you need. Together we will assess your health and budget, then determine the best way to maximize your benefits and keep your cost as low as possible.
Note: If you are receiving your Social Security retirement benefits and continuing to work, you may not want to be automatically enrolled in Medicare. Even enrolling in Medicare Part A with no premium can limit certain benefits your employer may provide. Request an in-home visit with a local agent to avoid costly mistakes 4-6 months prior to your 64th birthday.
If you are already receiving your Social Security Benefit three months before your 65th birthday month, you should be automatically enrolled into Medicare and receive your red, white and blue card within 30 days. If you have not received your card and are within two months of your 65th birthday month, please give us a call as soon as possible.
Original Medicare
Part A is your hospital coverage. If you have worked and earned at least 40 credits during your life you have earned Part A, free of premium. It does come with some steep copays. If you are unsure if you have enough credits, take a look at your last social security statement or give us a call.
Part B is your doctor coverage. Your premium for Part B is determined by your income from two years ago. Part B also comes with a deductible and 20% coinsurance.
Part D is your prescription coverage. The plan premium for Part D is also determined by your income from two years ago. You will also have copays associated with most prescriptions. We will be able to narrow down the 30+ prescription plans to the ONE that will be the least out of pocket cost for you.
With Original Medicare your network of doctors and hospitals are simply those that agree to accept Medicare. The gaps in coverage with having just Original Medicare can be catastrophic as there is no out-of-pocket maximum.
You should enroll in Medicare Part A when you first become eligible. Enrollment in Part B and D should be completed when you leave other credible coverage such as employer group coverage. Be sure to speak with an agent if you are unsure of when to enroll. Costly penalties may be incurred if you miss certain deadlines.
Medicare Advantage
Medicare Advantage plans (aka Health Plans or Part C plans) are pay as you go type plans. These plans will have a network of doctors such as a PPO or HMO. It is very important you check each of your current doctors to make sure they are in the network of the plan you choose.
Medicare Advantage plans must offer benefits at least as good as Original Medicare. When you select to enroll in an Advantage plan, you are essentially converting your Original Medicare into a Private health plan that will offer additional benefits that Original Medicare does not. Most Advantage plans come with a drug plan included as well as additional benefits such as Vision, Dental, Hearing, Transportation, Over the Counter catalogs or some combination thereof. Medicare does dictate certain standards for Medicare Advantage plans that all carriers must adhere to at a minimum.
Some of the plans will have deductibles for medical costs, however most will only have copays for services as they are used. Most have a deductible associated with their prescription benefit. ALL of the plans have coverage gaps just like Original Medicare; however, they will have a limit on out-of-pocket maximums. Generally, $10,000 or less per year.
You may enroll in an Advantage plan when you first become eligible for Medicare, during the Annual Election Period of October 15th – December 7th or during Special Election Periods as determined by special circumstances. There are generally numerous plans available in every county. It is important to understand the details of a plan before you sign up. Benefits can differ greatly from plan to plan. Our agents can help you narrow down the plans to what is important to you whether it is customer service, cost, prescription coverage, dental benefits or something else.
Medicare Supplements
Medicare Supplements may be the best gap coverage plan for Medicare however it has its costs. There are 12 different supplement or Medigap plans available today. If you turn 65 on or after January 1, 2020, you will only have 9 options as C, F and HDF are no longer available to new enrollees.
Each plan offers a different level of gap coverage and cost will vary based on carrier, location, tobacco usage, age, and gender.
It is important to note that Medicare Supplement plans are designed by Medicare. The only differences between between carriers that offer the same plans is the name of the carrier, customer services, history of rate increases and the current price you pay for it. If you currently have a Medicare Supplement plan, we recommend a review every couple years to try and reduce cost associated with the annual increases.
Most Medicare Supplement plans do not offer any extra benefits such as dental, vision, hearing, etc. Those are important to your overall health and can be added as supplemental policies.
Medicare Supplement premiums increase with age. The amount of the increase is determined by the carrier and your location, not by the amount of claims you have filed. The good thing with supplements is that you can apply to change and lower your cost at any time during the year. The application process does require you to pass a health questionnaire. Ask an agent for assistance. We work with 30+ carriers that offer Medigap plans across the states and will assist you in finding the coverage that meets your needs and fits your budget.
Choosing the Right Plan
Choosing the right supplemental coverage can be overwhelming and complex. Please do not hesitate to reach out to us to help you narrow down the options that are available to you and to make it super easy to get signed up.
