The Modern Medicare Agency Blog
Before you choose a Medicare plan, think about your options carefully and read through the information that is available on all the plans. Attend a seminar or online Medicare 101 webinar. Speak with an insurance broker who represents many carriers to get unbiased advice. It is wise to get a good education on Medicare and what it has to offer before making decisions.
Medicare has many different parts. The original Medicare Part A & B leaves a lot of needs uncovered as well as a high out-of-pocket risk for many medical situations.
To help with the cost of prescription drugs, Medicare uses private companies to offer what is called part D. Many people would probably consider this the most complex part of Medicare, and for many of us prescription coverage is very important. Most states offer over 20 different options for part D with each one having variations of the Medicare coverage model. Which means they have different deductibles, copays, coinsurance, formularies and rules.
Medicare supplement plans, AKA(medigap), are offered to help alleviate costs such as Medicare Part A & B deductibles and coinsurance. Some of these supplement plans cover all out-of-pocket Medical costs, with the exception of prescription drugs. There are 10 standardized Medicare supplement plans offered by many companies in most states with the exception of MA, WI and MN. These states offer a different model of supplement coverage.
Medicare advantage plans, also known as part C, is another option to help control Medicare costs. With a Medicare Advantage plan you receive traditional style health insurance through a private insurer contracted with Medicare. These plans are generally HMO or PPO plans which cover costs associated with hospital stays, medical coverage and part D prescription coverage, all under one plan. These plans are subsidized by the government and coverage varies greatly from plan to plan as well as by zip code. Some areas have as many as 50 plus choices while others may have just a few.
There is no one plan that is best for all, everyone has different medical needs and budgets. One thing we all want is the best coverage to meet our personal needs and budget, when getting ready to choose a coverage option here are some questions you should ask.
Ask yourself the following questions:
Don’t let Medicare overwhelm you, start early and do your homework so you can make an educated decision.
To compare Medicare plans, use the Medicare Plan Finder at www.medicare.gov/find-a-plan, on the official U.S. government site for people with Medicare. This site allows you to compare plans by cost, quality and other features that may be of importance to you. If you have specific questions about Medicare, or Medicare plans Paul Barrett Insurance Agency offers free guidance, you can schedule a call or zoom meeting at http://www.paulbinsurance.com/
Medicare Open Enrollment what is it?
Medicare is a super confusing topic for most individuals and Medicare open enrollment does not make things and easier. Most clients and even insurance agents will confuse this enrollment period with when it is, who it’s for and what exactly can be done.
Medicare has a few enrollment periods the most well known is the Annual enrollment period which occurs from October 15th and runs until December 7th, during that time anyone on Medicare can make as many changes as they like to there Medicare advantage plans or prescription drug plans also known as part D. The last change made will go into effect for January 1st in the new year. Ok so what is the Medicare open enrollment? The Medicare open enrollment happens from January 1st - March 31st during this enrollment period anyone on a Medicare advantage plan can make one change, this change will go into effect the 1st of the following month the change was made. So what changes can be made? Members of a Medicare advantage plan can change to a new Medicare advantage plan or go back to original Medicare and a drug plan. Members may apply for Medicare supplemental coverage as well depending on the individual's residence medical underwriting may be required.
This is not a well known enrollment period unlike the Medicare annual enrollment period, insurance carriers, brokers and agents are not allowed to advertise and promote changing plans during this time. This is a great opportunity for many people on Medicare who missed out on the annual election period, or did not realize plan changes that were made to their current coverage until after the new year . The Medicare open enrollment period is essentially Medicare trying to give people one last opportunity to improve their coverage situation without all the sales pressure that comes with the annual enrollment period which has really gotten out of control. So if you are on a Medicare advantage plan and have not really examined how well it will fit your current health and budgetary needs for the new year, you really should do yourself a favor and take a look at your current plan and any changes it has made for the new year. Stay safe, and as always if you have any questions regarding,
Medicare or your coverage please feel free to message me or give me a call directly at 631-358-5793 email email@example.com http://www.paulbinsurance.com/
Medicare Advantage vs. Medicare Supplement Insurance Plans AKA( Medigap)
Medicare, is a multilayered federal health insurance program for people 65 or older or for people under 65 with certain illnesses or disabilities, can be confusing. While Medicare Part A covers inpatient hospital stays, hospice care, skilled nursing facilities and some home health care services, Medicare Part B covers outpatient care, doctors’ services, preventive services and medical supplies. These come standard in every original Medicare plan.
Medicare Advantage, also known as Part C, is an alternative plan that adds extra benefits. Stand-alone prescription medication coverage, called Plan D, allows you to keep your original Medicare plan with the added benefit of covering the costs of your prescription medicines.
However, as you may remember during your experiences with insurance while you were working, there are always other expenses to consider. Many people think Medicare covers all health care expenses, but this is not so. It does not cover some copays and fees.
Here are some examples of costs you may be responsible for when using Medicare for health care needs:
Medicare Advantage Plans are best suited to individuals who are on a limited budget or those who would rather have a smaller premium in lieu of high out-of-pocket costs. Here are five things to consider when choosing a Medicare Advantage plan:
Medicare Supplement Insurance
How it relates to Medicare Parts A & B
Private supplemental coverage that pays all or most Part A & B out-of-pocket costs
Private health plan; provides Part A and B benefits in place of original Medicare
Varies greatly by plan and state may also be more depending on health and age.
$0-$100 a month; all enrollees pay the same regardless of age, health history
Low to none (except for premium)
In-network medical deductibles, copays up to $3,400-$7,200 a year, depending on plan
Doctor, hospital choices
Any that participate in Medicare
HMOs: Plan providers only
PPOs: Any provider; out-of-network costs more
When you can buy
First six months after you sign up for Part B and at least 65; you can be turned down or charged extra in most states after this period
When you first enroll in both Medicare A and B; annually thereafter during open enrollment Oct.15-Dec.7
Part D (drug) coverage
Most plans include Part D
Quality info available
No standardized ratings
Medicare.gov has star ratings, with higher stars being the best
Proof of coverage
Little to none; usually automatically sends payment to providers after Medicare’s fulfillment
Some, because you pay deductibles and copays directly to providers
Medicare Supplement Insurance Plans (Medigap)Medicare supplement insurance plans are a different option for additional Medicare coverage. If you plan to keep your original Medicare insurance and pay your Part B premium, consider a Medicare supplement insurance plan instead to cover the “gaps” in traditional Medicare costs. Some plans even pay the Medicare Part A deductible, so it truly matters that you do your research before making a decision.
Five things to consider when choosing a Medicare supplement insurance plan include the following:
Why do I have to pay attention to Open Enrollment? I am happy with my current Medicare plan.
You are happy with the plan you have today.... But the Part D drug plan or Medicare Advantage plan you have today is NOT the same plan you'll have in the next calendar year.
Each January 1st marks the start of a new plan year.
A new plan year means insurance companies can – and often do – make changes to their plans that can cost you. If you're not paying attention and simply let your plan renew, these are changes you’ll have to live with for better or worse in new year.
Here are some important things that insurance companies can change in your coverage. For Part D plans:
If you have concerns about your coverage, you can use the Medicare Plan Finder to compare plans. Or, if you prefer to have an unbiased Medicare expert review your coverage and ensure you're making the most cost-effective choices, Paul Barrett Insurance offers free Medicare plan reviews.
Local Office: (631) 358-5793