Eliminate gaps in insurance
coverage over age 65
Once you've reached your retirement years, there are a lot of decisions to make regarding your insurance. Specifically, when you turn 65 you become eligible for Medicare program coverage. It is important to know exactly what coverage you are getting – and what coverage you may still need.
Our agents are here to help you choose either a Medicare Supplement Plan (Medigap Policy) or a Medicare Advantage Plan.
What does Medicare cover?
Medicare Part A
Medicare Part A covers your hospital expenses like hospital stays, nursing care, hospice, and home health services. Just like other insurance, you are responsible for deductibles, coinsurance, and copayments. You earn Part A coverage by paying taxes toward Medicare while working for 10 years.
Medicare Part B
Medicare Part B covers services like doctor’s office visits, lab work, x-rays, and outpatient surgeries. It also covers preventive services like cancer screenings and flu shots as well as medical equipment like wheelchairs and walkers, if you require them.
Medicare Part C
This can be referred to as Part C or Medicare Advantage Plans. Private, Medicare-approved companies offer this coverage for benefits beyond Part A & Part B. These options usually have lower or no monthly premiums compared to alternatives.
Medicare Part D
This is also known as a prescription drug plan. You can get Part D coverage through an independent Prescription Drug Plan (PDP), or through a Medicare Advantage Plan. If you do not sign up for coverage when it is available, you may be financially penalized if you elect coverage at a later age.
What is a Medicare Supplement Plan?
A Medicare Supplement Plan (Medigap) is additional coverage added to your original Medicare. After you've enrolled in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), typically about 80% of your expenses will be covered. A supplement plan can be purchased to help cover the remaining 20% of expenses.
A Medicare Supplement Plan does not include coverage for prescription drugs, which you may require with later health conditions.
What is a Medicare Advantage Plan?
Medicare Advantage Plans, also known as Part C, are an all-in-one option. They are offered by private Medicare-approved insurance companies like Aetna, Humana, etc., or the Kaiser Family Foundation. Usually, these plans are managed like an HMO or PPO insurance plan.
If you join a Medicare Advantage Plan, you still have Medicare. These Part C plans are bundled insurance plans that include Medicare Part A (hospital insurance), Medicare Part B (medical insurance), and usually Medicare drug coverage (Part D).
What are Medicare Prescription Drug Plans?
Medicare Prescription Drug Plans (Part D) adds prescription drug coverage to your traditional Medicare coverage. 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.
If you do not enroll in Part D coverage when you select the rest of your Medicare coverage, you may be financially penalized if you decide to enroll at a later date.
If you do not enroll in Part D coverage when you select the rest of your Medicare coverage, you may be financially penalized if you decide to enroll at a later date.
Which Medicare plan do I need?
Firstly, it is important to sign up for the traditional Medicare coverage available to you. This health plan will cover a large number of your medical expenses, but still leaves about 20% as your responsibility – and that doesn't include prescriptions.
There are several types of Medicare Advantage Plans and Medicare Supplement Plans. A few aspects you should consider while choosing the coverage that is right for you:
- Cost of any premiums, copays, and other out-of-pocket expenses
- Any limits in coverage
- Whether Prescription Drug Coverage is included or must be purchased standalone
- If you require doctors outside Medicare Advantage networks
- Which local, covered providers are available to you
- If you travel frequently or have a secondary residence in another coverage area
- Any health needs related to a chronic condition or serious illness
A cost comparison can be complex but is important to guarantee you are getting the coverage you need. Our insurance agents are able to help you price compare options so that you choose the
Medicare coverage that is right for you.
Stay up-to-date on Medicare changes
Government programs like Medicare are always changing with new legislation. You can always refer to official sources like www.medicare.gov for researching the most up-to-date information.
Does Medicare
cover dental?
Original Medicare coverage does not include routine dental services. Without additional coverage from a Medicare Supplement Plan or Medicare Advantage Plan, you would be responsible for all your dental costs.
If you have a particular medical test, item, or service that you would like to check original Medicare coverage for, you can visit www.medicare.gov/coverage to search.
When can I get Medicare?
As you approach age 65, you should check your eligibility for Medicare. You can use this tool. For most people, you will want to sign up for Part A and Part B coverage in the seven-month window beginning 3 months before your birthday month.
You'll want to consider additional coverage at the same time as your enrollment, and our agents can help you identify your Medicare needs.
What is the difference between
Medicare and Medicaid?
Medicare is a federally-run insurance program. It is primarily for people over age 65 or with a qualifying disability. It is usually managed the same in every state.
Medicaid is a medical assistance program that serves low-income people regardless of age. It operated at the state level with federal guidelines.
Can I change my
Medicare coverage?
Just like other insurance plans, Medicare has an enrollment period every year where you can make changes to your coverage. The enrollment period typically begins in mid-October and runs through early December.
You should know before enrollment whether later changes will involve penalties. For example, you may pay a penalty for selecting Prescription Drug Coverage at a later date.
When you first sign up for Medicare Part A and Part B, supplement plans are typically obligated to sell you a policy regardless of pre-existing conditions. This is not always true if you have already enrolled, switched plans, and are attempting to switch back to the original Medicare and a supplement plan at a later age.
You need to be informed about all aspects of your Medicare coverage, and we are happy to help. Get started today by contacting us.
Do you have a question
about Medicare?
Our agents are ready to answer any of your questions.