Medicare

Medicare

While we do all types of insurance, Medicare is our specialty.  Medicare Part D Prescription Drug plans have been around since 2005 and so have we!  We are indepent – What does that mean?  While some agents work only with one carrier and may be inclined to steer you toward their single company, we work with and and represent top companies like Aetna, Mutual of Omaha, Humana, Aetna, Cigna, and many more.  We provide you with information to make decisions for your healthcare and select the company that best meets your needs.  Our goal is to educate you on the aspects of Medicare and help you make a decision on your plan choices.  The links below have some basic information regarding Medicare Parts A and B, Medicare Part D Prescription Drug Plans, Medicare Supplement Insurance Plans and Medicare Advantage Plans. 

Medicare Part D:

Original Medicare (Part A and B) does not cover most prescriptions you would pick up at a pharmacy.  If you wish to add  drug benefits to your Original Medicare (Part A and Part Bcoverage can choose to enroll in a Medicare Part D Prescription Drug Plan. These stand-alone plans are available from private Medicare-approved insurance companies.  Stand-alone Medicare Part D Prescription Drug Plans are available to beneficiaries who are currently enrolled in Medicare Part A or Part B.

Medicare Supplements / MediGap Policies

Medicare Supplement Plans, also called MediGap, are sold by private companies. Medicare Supplement plans pay AFTER Medicare pays.  Medicare is your primary insurance and the many different Medicare Supplement policies cover some or all of the health-care costs not covered by Original Medicare. These might include copayments, coinsurance, and deductibles often referred to a Gaps.

Medicare Supplement Plans, also called MediGap, are sold by private companies. Medicare Supplement plans pay AFTER Medicare pays.  Medicare is your primary insurance and the many different Medicare Supplement policies cover some or all of the health-care costs not covered by Original Medicare. These might include copayments, coinsurance, and deductibles often referred to a Gaps.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan.  Medicare Advantage Plans are an alternative to get Medicare benefits as Medicare Advantage plans pay INSTEAD of Medicare, while a Medigap policy only supplements your Original Medicare benefits.  When you have a Medicare Supplement policy, Medicare determines what is covered or not covered on your policy, your Medicare Supplement Insurance Company pays what Medicare determines, the Medicare Supplement company does not determine what is medically necessary, this part of the process is handled by Medicare when you are on Original Medicare with a Medicare Supplement plan.

Medicare Advantage Plans

Medicare Advantage Plans, offers an alternative way for beneficiaries who are currently enrolled in Original MedicarePart A, and Part B, to choose to take a private company benefits INSTEAD of Original Medicare Part A and Part B.  Medicare Advantage Plans are technically Medicare Part C, and often, but not always, include Medicare Part D Prescription Drug benefits as well.  These plans provide all the same medical and hospital coverage as Original Medicare, but often includes additional coverage for services like routine vision and dental care. In all types of Medicare Advantage Plans, you are always covered for emergency and urgent care.  Medicare Advantage Plans must cover emergency coverage outside of the plan’s service area, sometimes even out of the country.  You still must pay your Medicare Part B Premium (And Part A – although this is no charge for most individuals), and you may also be required to pay a monthly fee for your Medicare Advantage Plan.  Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans.  These companies must follow rules set by Medicare, but the insurance company – NOT MEDICARE makes decisions on your health care – such as if you need Physical Therapy before being approved for an MRI, etc.  Each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). Plan benefits can change from year to year, including the drug formulary and provider network.  Make sure you understand how a plan works before you join.