Medicare Eligible

Medicare is not so easy!

Although most of us have earned our Medicare Benefits it's not always easy to understand how to use them. Medicare Parts A, B, C and D all have different benefits and require different steps to initiate enrollment. There are also certain times that you may enroll in certain Medicare Plans and Supplements products regardless of your health condition. Some Medicare Parts can cost you penalties for not enrolling when you become eligible. And these penalties are in force for your entire time in the Medicare System. It's best to enlist the help of an experienced, knowledgable Broker to guide you through the process from the beginning. And it's just as important to make sure that your Broker Guide will be with you each year to provide reliable information to use as your circumstances change through life.

There are too many moving parts to list every aspect. You really need to talk to a trusted advisor for the details. In a nutshell, here is a brief explanation of the Parts of Original  Medicare.

 

Medicare Part A: (Most people do not need to pay a premium for this coverage) hospital insurance covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery and home health care. There are Deductibles and Out-Of-Pocket costs and there is no annual out-of-pocket maximum you could be liable for. (An extended hospital stay could drain your savings)

 

Medicare Part B: (Most people pay a premium for this coverage) covers, including doctor and other health care providers' services and outpatient care. Part B also covers durable medical equipment, home health care, and some preventive services. There is a Deductible and usually a 20% copay for most services and, again, no annual out-of-pocket maximum that you could be liable for.

 

Medicare Part D (Rx coverage):

All plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected "classes,” like drugs to treat cancer or HIV/AIDS. A plan’s list of covered drugs is called a “formulary,” and each plan has its own formulary.

 

What's not covere by Medicare:

Some of the items and services Medicare doesn't cover include:

Long-term care

Most dental care

Eye exams (for prescription glasses)

Dentures

Cosmetic surgery  

Massage therapy

Routine physical exams

Hearing aids and exams for fitting them

Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care)

Covered items or services you get from an opt-out doctor or other provider (except in the case of an emergency or urgent need)

 

Is there a way to minimize the risk to your bank account?

Absolutely there is! This is why you should discuss your options with a qualified, certified and insured professional.

 

Medicare Part C (Medicare Advantage):

Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.

In most cases, you’ll need to use doctors who are in the plan’s network. Plans may have lower out-of-pocket costs than Original Medicare. Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services. Medicare Advantage plans also usually provide an annual Out-Of-Pocket  maximum which provides protection from unexpected  Part B expenses and extended hospital stays.

 

Medicare Supplement:

Private Insurance Companies provide MediGap plans that will limit your out-of-pocket expenses by paying a portion or most of the Original Medicare Parts A and B covered expenses you may incur. You may not have a Medicare Supplement plan at the same time you are enrolled in a Medicare Advantage plan. It is for use only with Original Medicare. However, there are other plans that can help protect against high medical costs when enrolled in a Medicare Advantage Plan.

 

Dental and Vision:

You may also buy a Dental or Dental and Vision plan that will ensure that your teeth stay healthy and serve you as long as you need them. It depends on your individual needs and should be discussed with a professional.