As we get older, changes occur in a variety of ways – one of the most important is our healthcare requirements. Whether you are approaching eligibility for Medicare or looking ahead to what this involves for retirement, there is a lot to appreciate about your available options. People we speak with are often overloaded with mailings and phone calls from everyone trying to sell them health insurance. Our licensed insurance professionals are happy to provide an overview of your options, and provide a bit of guidance so you can make a fully informed decision.

What is Original Medicare?

Medicare is offered by the Federal Government and becomes available on the month of your birthday when you turn 65. (If your birthday is on the 1st, you become eligible the month prior.)

Original Medicare includes hospital insurance (Part A) and medical insurance (Part B). Enrollment into Original Medicare is required through the Social Security office, unless you are automatically added. If you have worked and paid Medicare taxes for at least 10 years, there will likely be no premium for Part A – there is however a premium for Part B.

In order to sign up for Medicare Supplement, Medicare Advantage or a Prescription Drug Plan (PDP), you must have a red, white and blue Medicare card with Part A and Part B. These coverages help with services not covered by Original Medicare.

Medicare Supplement Plans

Medicare Supplement plans do just what the name implies, they “supplement” the coverages not provided by original Medicare. These plans are identified by letters and the coverages for each plan are identical from carrier to carrier. For example, coverages for Carrier #1’s Plan G are identical to Carrier #2’s Plan G. Where they differ is in the monthly premium.

Networks for doctors and hospitals are not an issue with Medicare Supplement Plans. If the provider accepts Original Medicare, they will also accept your Medicare Supplement Plan coverage.

It’s extremely important to note that prescription drugs are not covered under a Medicare Supplement Plan. As a result, a Prescription Drug Plan (PDP) is required even if you do not take any medications (see section below for more details).

If you select this route, you will have Original Medicare, a Medicare Supplement Plan, and a PDP. Our licensed insurance agents also help in the event you need to make connections with these carriers at no additional cost.

Prescription Drug Plans

If you enroll in Medicare Advantage Plan (see the section below for details), your prescription drugs are included. However Medicare Supplement Plans do not include prescription drugs. Even if you do not take any medications, enrollment is necessary at the time you are eligible to avoid penalties. In order to find the best plan, a full list of medications with strengths and directions is necessary to align with a plan’s formulary.

It is important to review your prescription drug plans each year during open enrollment from October 15 to December 7 for two reasons:

The medications you take can change over the course of a year.

The insurance carrier’s formulary can change each year.

This is another area where our licensed insurance agents are happy to review and ensure you have the best plan for you!

Are dental, vision, and hearing coverages provided in these plans?

These coverages depend on the type of plan you select. Medicare Supplement Plans do not provide these ancillary coverages. However, these coverages may be included with some Medicare Advantage Plans. The good news is that Dental & Vision can but purchased as stand-alone policies.

Your First Step

First, (if you do not have one) request your Medicare card from the social security office. Next, give us a call! We will start collecting the information needed to personalize your options. Finally, we will get you scheduled for an appointment to talk and get your questions answered.

“You made this so easy.” We hear this frequently after our appointments. The mailings and commercials cause a lot of confusion and leave you wondering what is best for you. Our focus is on YOU and making sure you are comfortable and educated about your choice. We look forward to hearing from you!

Medicare Advantage Plan

Private insurance companies manage Medicare Advantage Plans, including Original Medicare. The benefit – one plan manages it all and you just have to show your Medicare Advantage Plan card.

Prescription Drug coverage is also a part of this one plan, unlike Medicare Supplement. Additional benefits like dental, vision, and hearing could also be included with this option.

Doctors and hospitals will be extremely important with Medicare Advantage Plans. In-network and out-of-network providers will determine how claims are paid. For example, with an HMO, there is no coverage for out-of-network services. If sticking with a current doctor or specialist is important to you, consideration of these types of networks is a necessary conversation we would be happy to have with you!

Tired of talking to a computer to get the right Insurance?

Give us a call and speak with one of our ‘people first’ agents.