MEDICARE

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Medicare can be very overwhelming for individuals when they turn 65. We provide educational seminars each month to answer many of the questions people have about Medicare insurance. See our events page for a seminar near you or email us to set up an individual meeting.

What you need to know…

Medicare has four parts (A, B, C, and D):

Medicare Part A - Covers hospitalization, skilled nursing, and hospice

Medicare Part B - Covers everything else: visits to the doctor or specialist, trips to the ER, and outpatient procedures 

Medicare Part C - This is also known as a Medicare Advantage Plan. These plans come in the form of HMO’s or PPO’s and usually include prescription coverage.  

Medicare Part D - Only covers prescription drugs (through local pharmacy or mail-order)

Medicare A and B generally covers 80% of your healthcare expenses, so, most individuals decide to purchase a secondary insurance plan to help cover the remaining 20%. You basically have only two choices for secondary insurance: 1) Medicare Supplement (Medigap) or 2) Medicare Advantage Plan (Part C). 

Medicare supplements and Medicare Advantage Plans both have pros and cons. We believe that one is not better than the other. While we find that many times insurance companies try to make people’s needs “fit” into their policies, we assess your health and financial needs, present you with the options and help guide you to the right solution.

Medicare Supplement

The Center for Medicare and Medicaid services (CMS) defines a Medicare supplement as a private health insurance policy that helps supplement original Medicare. 

This means it helps pay some of the healthcare costs that Original Medicare doesn’t cover like co-payments and deductibles. Many health insurance carriers offer supplemental policies and while the premiums may vary from carrier to carrier the coverage is the same.

Medicare Advantage 

Medicare Advantage Plans, sometimes called Part C or MA Plans, are an all in one alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. 

These advantage plans are most commonly found in the form of HMO’s, PPO’s or PFFS (Private Fee For Service) plans. Medicare Advantage Plans must cover all the services that Original Medicare covers. Most Medicare Advantage Plans offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Plans commonly include Medicare prescription drug coverage (Part D).