Choices in Health and Life Insurance

Choices in Health and Life Insurance - Mike Eblen Insurance Agency

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MEdicare

Turning 65

When we turn 65 the world of Medicare becomes available to us! While Medicare plans offer great coverage, they leaves gaps that need filling. We can explain the differences between Medicare Advantage Plans and Medicare Supplements, and help determine what is right for you and year after year monitor to make sure your not paying too much for your Medicare coverage.

PRESCRIPTION Drugs

Prescription coverage is a must!

Did you know that a Part D plan is not required? But if you decline to join a plan when you become eligible for Medicare, then there will be a permanent penalty you will have to pay when you DO choose to join a program? So why hesitate? Prescription plans are included in a lot of Medicare Advantage Plans and are very affordable even as a stand alone product.

What is Original Medicare ?

Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you get them, from any provider in the US who accepts Medicare assignment. When you receive services, you’ll pay a deductible at the start of each year, after which you usually pay 20% of the cost of Medicare-approved services, this is referred to as coinsurance.

The beauty of Medicare is there are no Networks, you are free to see most providers. The downside of Medicare is there is no Maximum Out of Pocket amount, so no matter how big the bill, you'll be responsible for 20% of it... A second big shortcoming of Medicare is it has no Prescription coverage included, you have a purchase it separately, this is a Part D plan.

So as you become eligible for Medicare you will find two distinctly different ways to handle it. You either purchase a Medicare Supplement plan (Medigap) combined with a stand alone Prescription Drug Plan (Part D)or you purchase a Medicare Advantage plan, also know as a Part C plan.

(Yes we realize someone got carried away with all the letter assignments!)

Twisted roads with signs that say different coverage plans

Medicare Advantage Plans:

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C Plans” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Advantage plans often include extras like vision, dental, hearing, and health club benefits & over the counter products.Key Elements:

Very low monthly premium, many have a $0 premium.
Rx coverage is included at no extra cost in many plans (however you will have co-pays for the medicines themselves)
They accept anyone with a valid enrollment period even those with pre-existing conditions.
There are tons of extras like Dental, Vision, Hearing and Over the Counter products included at no extra cost.

Medicare Supplement Plans:

A Medicare Supplement Insurance (Medigap) policy is health insurance that can help pay some of the health care costs that Original Medicare doesn’t cover, like coinsurance, copayments, or deductibles. A medicare Supplement plan works with original Medicare to offer coverage nationwide, there are no networks, you just have to make sure your doctor accepts Medicare Assignment. With a Medicare Supplement we always recommend to our clients to join a Part D plan to add prescription coverage. Combinding a Medicare Supplement with a Part D plan makes a very comprehensive insurance package.

Key Elements:
High monthly premium.
NO NETWORKS
should/must add a Part D plan (Rx)
No extras. You will have to add Dental, Vision or Hearing if you wish to have it.