What is Medicare and what are my choices?
Medicare is the federal health insurance program for those:
- 65 or older (or younger with certain disabilities)
- Of any age who have End-Stage Renal Disease (ESRD) – permanent kidney failure requiring dialysis or a kidney transplant.
Choose from Original Medicare or a Medicare Advantage Plan
Original Medicare Includes (Part A & B)
- Helps cover inpatient hospital stays, care in a skilled nursing facility, hospice, and home health care.
- You can choose any doctors/other providers and hospitals that accept Medicare.
- Generally, you or your supplemental coverage pays deductibles and coinsurances.
PART B (Medical Insurance)
- You’ll usually pay a monthly premium, which helps cover services from doctors/health care providers, outpatient care, durable medical equipment, and home health care.
PART D (Prescription Drug Plan)
- If you’d like prescription drug coverage, you’ll usually pay a monthly premium. We can help you figure out the plan that best limits your out of pocket costs.
Medicare Supplemental Insurance Plan (Medigap)
- You may want to purchase added coverage to fill in the gap (ex. Copayments, coinsurance and deductibles). You do not need to be in the Annual Enrollment Period to switch carriers, so you can change at any time. We partner with many carriers, and may be able to save you from shopping around for the best price.
Medicare Advantage Plan (Part C)
- Includes ALL benefits and services covered under Part A and Part B
- Operated by Medicare-approved private insurance companies (like HMOs or PPOs). If you join one, you don’t need a Medicare Supplement Insurance (Medigap) policy.
- Usually includes Prescription Drug Coverage (Part D)
- Specific doctors/providers, hospitals, etc. may need to be utilized.
- Some plans have a low or even $0 premium.
- Additional benefits (dental, vision and fitness programs) may be included or added.
- Benefits and prices of these plans often change annually. We can help you understand the benefits of these plans to ensure that your needs are met now and in the future.
A Medicare Advantage Plan or Medicare Supplement Insurance Plan?
Comparison is key. It’s important to understand the differences between:
- Doctor and healthcare facility restrictions
- Prescription drug expenses (pertaining to your medication usage)
- Anticipated plan costs per your regular use of healthcare and hospitalization services