Medicare is a federally-administered health insurance program that covers a portion of the costs for hospitalization, medical care, and some other related health services for seniors over age 65 and individuals eligible due to a disability. While Medicare is available at a lower cost for people that worked an equivalent of ten years or forty quarters and paid into the Medicare program, most Medicare beneficiaries find that they need another type of insurance plan to fill in the gaps.
A few months before you plan to enroll in Medicare, you will want to find out more about additional coverage options because some Medicare plans are only available during specific periods of time called enrollment periods. Many seniors may choose one of the Traditional Medicare Supplement Plans, but Medicare Advantage Plans are also very popular options.
Crosspointe Insurance Advisors can help you compare all your options when it comes to Traditional Medicare Supplements, Medicare Advantage Plans and Medicare Prescription Drug Plans.
Original Medicare includes Parts A and B. While basic Medicare insurance is fairly straightforward; there have been many changes over the past five years that have made the decision-making process a bit more complicated for seniors. If you have questions about how Original Medicare's coverage has changed, Crosspointe Insurance Advisors has the answers.
Medicare Part A, or Hospital Insurance, covers inpatient care while you are in a hospital, skilled nursing facility or hospice. It can also cover the cost of home health care. Most people will qualify for "premium-free Part A" because they paid Medicare taxes while working if you worked and paid into Medicare for at least ten years or the equivalent of forty quarters. However, if you are ineligible for premium-free Part A, you may purchase this insurance under certain conditions or you may qualify for state-sponsored aid to help pay for Medicare Part A and or Part B
Medicare Part B provides medical insurance for services such as doctors' visits, home health services, outpatient care and other medically necessary services. It can also cover some preventive care services such as flu shots and early detection of illnesses. While not free, most people will pay an affordable standard premium for this insurance. However, it is important to sign up for Part B when you first become eligible, or you may need to pay a penalty for late enrollment. The Medicare Part B premium is around $115 per month in 2011.
Traditional Medicare Supplement plans, also known as Medigap, consists of several different options for improving your original Medicare coverage. Each of the standardized supplements, Plans A through N, are designed to offer seniors additional insurance to reduce their out-of-pocket expenses with Original Medicare. No matter what insurance carrier you choose for your Medicare Supplement plan, each respective plan and coverage are identical. The easiest way to compare the benefits offered in these supplements is to look at a Medicare Supplement Grid, but keep in mind that not every health insurance carrier offers all plans in your area. To find out which plans are available in your area and compare the difference prices with each carrier, call one of our many respected senior advisors.
Medicare Advantage Plans (Part C) are a lot like traditional health insurance, such as an HMO or PPO, and are often referred to as Medicare "Part C". Basically, Medicare contracts with private insurance companies to offer a Medicare Advantage plan, which provides everything from Medicare Parts A and B, plus some additional supplemental coverage for vision, dental, hearing and wellness programs. Most of these plans include Medicare's Part D prescription drug coverage as well. If you choose a Medicare Advantage plan, Original Medicare is no longer your primary insurance coverage but is still involved in the administration and regulation of your medical and prescription coverage.
Before an insurance company can offer a Medicare Advantage Plan, they must follow certain guidelines set forth by Medicare. However, your out-of-pocket expenses will depend greatly on the plan you select because each of these plans may charge different rates for co-pays and deductibles. Unlike Medicare Supplement plans, their coverage benefits may change on an annual basis. Medicare Advantage (Part C) plans sometimes may operate a lot like a traditional health plan you may have had before you enrolled in Medicare. They can include HMO plans, PPO plans, Private Fee-for-Service (PFFS) or Special Needs Plans (SNP), and some offer a Medical Savings Account (MSA) or HMO Point-of-Service (HMOPOS) options as well.
It is important to remember that not all Medicare Advantage Plans are the same, so it makes sense to do a comparison of the Medicare Advantage Plans available in your area before choosing one. The team at Crosspointe Insurance Advisors will help you choose the right Medicare Advantage Plan that meets your healthcare needs and budget.
Medicare Prescription Drug Coverage (Part D) is offered by a Medicare-approved insurance company. Also known as PDPs, these Prescription Drug Plans can add drug coverage to other Medicare Plans such as a Traditional Medicare Supplement that does not offer prescription drug benefits. Remember, some Medicare Advantage plans will include your Part D Medicare prescription drug coverage.
Like many other optional Medicare benefits, it is important to enroll in a Medicare drug plan as soon as you become eligible or you may have to pay a late enrollment fee. The cost of a Medicare Prescription Drug Plan (Part D) will vary based on where you live and the level of prescription drug benefits that you choose.
Joining a Medicare Prescription Drug Plan is easy, but you must have Medicare Part A or Part B first, and you must live in the specified geographic area serviced by the prescription plan. Some seniors may qualify for extra help from Medicare or Medicaid to help pay for prescription drug costs, which can cover up to 95% of their drug costs.
Crosspointe takes tremendous pride in educating our clients about all their Medicare options. Contact us to learn more about Medicare Supplements and Medicare Advantage programs available in Georgia, Illinois, Indiana, Kentucky, Michigan, Missouri and Ohio.