New to Medicare
What is Medicare?
Medicare is the government insurance program that provides health care coverage for Americans age 65 or older, Americans under 65 who receive Social Security Disability already or under 65 and have End-Stage Renal Disease.
Parts of Medicare
Medicare Part A (Hospital Insurance)
Part A covers 80% of inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B (Medical Insurance)
Part B covers 80% certain doctors’ services, outpatient care, medical supplies, and preventive services.
Medicare Part C (Medicare Advantage Plans)
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 Part D (Prescription Drug Coverage)
Part D is your prescription drug coverage. This Part of Medicare helps pay for the prescriptions you will fill throughout the year. It is for both medications you take currently and will possibly take in the future.
• We know this seems overwhelming at times and we are here to help with the process. If you desire more info or to speak to a licensed agent, please call or email us and we will be happy to discuss it with you.
Medicare Supplement options (Medigap Plans)
Medicare Supplements are an alternative option to Medicare Advantage plans. These types of plans will offer greater coverage for you and your out of pocket costs. These plans will allow you to see any Doctor that accepts Medicare, not just doctors in the network. They will also help pay for your co-pays, co-insurance and deductibles, helping to limit your out of pocket costs annually.
With these plans you can apply for coverage throughout the year, but acceptance to the plan is not guaranteed, unless you are just joining Medicare for the first time. So it is important to consider this option and the cost of the plan. While it may not seem necessary at 65 to buy this type of plan, later when you want or need it, you may not medically qualify to join.
Medicare Supplements do not include Prescription drug coverage (Part D) so we will need to discuss adding an additional drug plan.
Medicare Advantage Plans
Medicare Advantage plans are also commonly referred to as Medicare Part C. This type of plan is when a Private Health Insurance company takes over both your Medicare Part A and Medicare Part B and often will add Prescription drug coverage to the plan.
You will pay one low monthly fee and it works almost like a traditional employer plan, you will want to use the plans network of doctors to maximize benefits. These plans offer co-pays for primary care doctors and specialists. In addition, these plans will offer an annual Maximum Out of Pocket to help limit your annual costs.
Each year during open enrollment you can change your Medicare Advantage plan, so if you are unhappy with the plan or the coverage, you have the option to change it.
Medicare Part D
Medicare Part D is your Prescription drug coverage. Depending on what you pick for your Medicare Coverage, this can be included in your plan(Medicare Advantage) or be an additional plan you add to your Medicare Supplement.
Your Agent can help explain how this works, determine it you even need it, and if you do need it, explain what plan will help cover your drugs and prescriptions the best, with the least amount of out of pocket costs to you.