MEDICARE

When you become eligible for Medicare you will have to choose a plan that works best for your personal needs. Before choosing a plan, we want to be sure you know the difference between your many options; In particular how Medicare Supplements and Medicare Advantage Plans differ. There is are also educational videos you can review under the resource tab. You can either look through the entire site or call Mary and she will explain everything to you and help you to pick a plan that will work for you.

Medicare Supplement Insurance Plans

A Medicare Supplement Insurance Plans is used with original Medicare. Any caregiver that accepts Medicare will take a Supplement because they only need to bill Medicare. Medicare pays their part (generally 80% of Medicare covered benefits) and sends the remainder of the bill to the Supplement which pays their part (generally 20%). It is important to note that Supplements do NOT include Prescription Drug Coverage (Part D, PDP) so you need to purchase a separate drug plan or you will pay a penalty later.

The advantage to a Medicare supplement is most doctors accept it and they have no copays or deductibles. The disadvantage is they are more costly up front and they increase as you get older.

Medicare Advantage

A Medicare Advantage Plan follows the same type of module as many group plans such as HMO or PPO. With this type of plan, it is important to remember several things.

First, most Advantage Plans have Networks so you want to make sure your Doctor, Hospital, and auxiliary care are within the network.

Second, Advantage Plans have co-pays associated with them.

Third, most Advantage Plans have the Part D “built in” which is a nice bonus.

Lastly, Advantage Plans typically have value added benefits. These benefits vary between plans but typical benefits include Health Club membership, limited dental, eye and/or vision. Many people prefer advantage plans because are less expensive.

Also, not all Plan D’s are the same so it’s important to have your broker look them all up to ensure you pick the right plan for your personal needs. It is important to call your broker every year because they sometimes change annually.

Because these plans vary even from county to county, we strongly recommend that you talk to an independent insurance agent to help you choose the one that best suits your needs put this in bold

Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan when you're first eligible, and you don't have other creditable prescription drug coverage, you'll likely pay a late enrollment penalty. Please let your broker know if the person who is getting health insurance is low income They will instruct you as to which program may help you the best In the resource tab there are educational tabs that show you exactly where to go to get help

2 ways to get drug coverage

1. Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare and some Medicare Cost Plans.

2. Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

What drug plans cover

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.

A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.