Becoming Medicare eligible can be a stressful, confusing time. There are important, timely decisions to be made and delaying or making uninformed choices can cost you hundreds, even thousands of dollars! Our Medicare product consultants can help you make sense of it all. We recommend you start this process at least 3 months before turning 65 to give yourself time to fully understand your options.
We can take the mystery out of…
- Medicare Part B & D enrollment periods – don’t miss your chance to enroll and leave yourself uncovered
- Medicare Supplement Plans vs Medicare Advantage Plans – which is right for you?
- Do I need Medicare if I am covered by my employer plan?
- Who pays first – Medicare or my employer health plan?
- Late enrollment penalties & how to avoid them
- What Part D prescription plan is best for me?
- What is this “Donut Hole” I keep hearing about?
Understanding Medicare Basics
Medicare Part A (Hospital Insurance) helps cover inpatient hospital care, skilled nursing facilities, hospice care & home healthcare. For most eligible people Part A is free and automatic at age 65. However, some people must sign up and pay for Part A.
Medicare Part B (Medical Insurance) helps cover such services as doctor visits, outpatient care, physical therapy, diagnostic testing, and durable medical equipment. Most eligible people have to sign up and pay for Medicare Part B. There are strict guidelines regarding when you may enroll.
MEDICARE PARTS A & B ARE CALLED ORIGINAL MEDICARE
Medicare Supplement Plans: With Original Medicare you will most likely want to enroll in a Medicare Supplement Plan (also called Medi-Gap) to pick up the costs not covered by Medicare. There are many plans available with different levels of coverage and prices vary by plan and carrier. In general, you have a 6-month open enrollment period to enroll in a plan without medical underwriting.
Medicare Part C (Medicare Advantage) includes all benefits covered under Original Medicare. Plans often include Medicare prescription drug coverage. Some plans include extra benefits and services such as dental, vision or gym discounts. These plans are offered by private insurance companies approved by Medicare. When considering a Medicare Advantage plan you need to know the following:
- Monthly premium
- Network of doctors, hospitals & pharmacies
- Do you need a referral & can you go out of network
- Deductibles (if any) and the co-pays for services
- Does it include prescriptions
- Are there any extra benefits
Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs for people with Original Medicare. These plans are offered by private insurance companies approved by Medicare. Each plan has a list of drugs that they cover, called a formulary. Since formularies vary widely, it is important to ask the following:
- Are my prescriptions covered?
- Are there any restrictions (such as step therapy) for my prescriptions
- What are the co-pays at each level of coverage
You may only enroll in a Medicare Advantage Plan or a Medicare Part D Prescription Plan during a qualified enrollment period AND you may only dis-enroll during certain periods.