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Medicare Information

What is a Medicare Advantage Plan?

Medicare Advantage (MA) plans are health plans offered by private insurance companies that contract with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNP), and Medicare Medical Savings Account Plans (MSA). If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and are not paid for under Original Medicare.
 http://www.medicare.gov

Most Medicare Advantage Plans offer prescription drug coverage (Part D).  If the plan provides prescription drug coverage, it is called a Medicare Advantage Prescription Drug (MAPD) plan. It is important to note that MA and MAPD's are not Medicare supplemental plans.

How do you qualify for a Medicare Advantage Plan?

You can generally qualify for a Medicare Advantage Plan if you meet these conditions:

  • You have Medicare Part A and Part B coverage.
  • You live in an area serviced by the plan you want to join.
  • You do not have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)

What will a Medicare Advantage Plan cost?

The costs of a Medicare Advantage Plan depend on a number of factors. Questions to consider when purchasing a Medicare Advantage Plan are:

  • Does the plan charge a monthly premium in addition to your Part B premium?
  • Does the plan pay any of the Part B premiums?
  • Does the plan have a yearly deductible?
  • Does it charge any deductibles for any of the services?
  • How much will you pay for each service or visit (copayments), both in network and out of network?
  • What type of health services do you need? How often?
  • Will you be using network providers or out-of-network providers?
  • Are there any additional benefits in the plan, such as vision and dental coverage? Do you need them? What do these benefits cost?

What is Supplemental Medicare?

Supplemental Medicare, or Medigap, is a plan sold by private insurance companies to fill in the coverage gaps and deductibles that Original Medicare does not cover. For instance, if Medicare covers 80 percent of a doctor’s visit, Medigap will cover the remaining 20 percent. With Supplemental Medicare, there is little additional cost to you for health care beyond your premium.

Medigap policies are standardized and regulated by law. This means that each company must offer the same plans (Parts A-N) with the only difference being the price. However, prices can vary widely between companies. We can help you weed through the options to find the right provider with the right price for you.

What should you know about Supplemental Medicare?

Medigap policies are available to anyone enrolled in Part A and Part B (hospital and medical insurance) of Medicare. Open enrollment, a time frame in which you cannot be declined coverage, begins either when you first enroll in Part B or when you turn 65. This six-month window is the best time to purchase your Medigap policy.

Your Medigap premium will be an additional charge on top of your Medicare Part B premium (Part A is free), and in return you will receive more comprehensive coverage for your health care needs. If you have a Medicare Advantage Plan (Part C), be sure to cancel your coverage before your Medigap policy begins.

Why do you need Supplemental Medicare?

It is important to remember that Medicare does not completely cover your health care costs. A supplemental plan ensures a broader range of coverage so you do not have to pay out-of-pocket with each doctor visit. A low monthly premium will give you peace of mind as your need for health care grows.

Get started today!

Since private companies sponsor Medicare Advantage and Supplemental plans, costs will vary. Contact us today to learn more and what the plans can offer you. We will gladly answer any questions and help you select the plan that best meets your needs.

 



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