Medicare

What is Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Types of Medicare

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part A—Hospital Insurance
Medicare Part B—Medical Insurance

Medicare Part B (Medical Insurance)

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services

Medicare Part C—Medicare Advantage Plans

A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Part D—Prescription Drug Coverage

Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Types of Medicare
Original Medicare—Medicare Parts A & B

Employee or Retiree Group Coverage

Your Group may require Medicare Parts A & B

Part D Prescriptions Drugs, Plan may be included or purchased separately

Medicare Supplement

Medigap* Plans A-N, You must have Medicare Parts A & B

Part D Prescriptions Drugs, Plan can be purchased separately.

*A Medigap policy is private health insurance that helps supplement Original Medicare. This means it helps pay some of the health care costs that Original Medicare doesn't cover (like copayments, coinsurance, and deductibles). These are “gaps” in Medicare coverage.

Medicare Advantage Plan

You must have Medicare Parts A & B

(HMO, HMO-SNP, PPO, PFFS)

Part D Prescriptions Drugs, Plan may be included purchased separately OR prohibited

Medicaid and Medicare Advantage Plan

You must have Medicare Parts A & B

(HMO,HMO-SNP)

Part D Prescriptions Drug, Plan is included

Steps for Enrollment
Step 1

Your first option is to select Medicare Parts A and B.  Not many folks stop there but it is an option.

Your next two options involve a choice.

If you choose to supplement Medicare, you may select one of two options if available to you. You may choose a federally standardized Medicare Supplement also known as Medigap policy or group insurance from your current employer (employee group) or a previous employer (retiree group).

Steps 2 & 3
Supplement Medicare

If you choose to replace your Medicare benefits, you may choose one of two options, if available to you. You may choose a federally standardized Medicare Advantage Plan, also known as Part C, or Medicaid if you qualify financially.

Steps 4 & 5
Replace Medicare
Some Things to Keep in Mind
Is keeping your doctors important?

1. Search all Medicare Advantage networks in your geographic area to determine the networks in which your doctor participates.

2. If you find your doctors, then you may consider the Medicare Advantage plans a viable option.

3. If you do not find your doctors you may consider Medicare and a Medicare Supplement (Medigap) your viable option.

Is saving money on prescription drugs important?

1. Make a list of exactly what you take. The exact name of the drug, the dosage and amount needed for each day. If mail order is more cost effective the plan will reveal the results automatically.

2. Visit Medicare’s website (www.Medicare.gov) to review every drug plan from every company at the same time.

Is saving money on prescription drugs important?

Would having the lowest monthly premium be important?


1. Schedule time with one of our certified planners to review every plan from every company at the same time.  We are available via chat, Facetime, in person, Skype or telephone. We will likely save you thousands in unnecessary premiums, co-pays and deductibles.

Reserve your Free Seat

Attend an Informational Workshop


Everything you need to know about Medicare in a short 45-minute presentation
 

What Will my Drugs Cost With Medicare?

Step 1

This is the home page of Medicare.gov. From here you need to hover your mouse over the “Drug Coverage” (Part D) tab. A drop down menu will appear; from this menu you need to click “Find health and drug plans” (Health Plans are the same thing as Medicare Advantage Plans).

When is it time for Medicare?

6 to 9 months before you turn 65
Meet with a qualified advisor, licensed and certified, with multiple Medicare insurance plans to learn about all of your Medicare options, including remaining on Employee and Retiree Group Insurance.
3 months prior to turning 65
Enroll in Medicare Part A
If you are not covered by Employer Group Health Insurance Plan, with more than 20 people insured, you will need to enroll in Medicare’s Part B and Part D.

Additionally

Choose Medicare as your insurance and enroll in a Medicare Supplement (Medigap) and a Part D Prescription Drug Plan.

OR

Replace your Medicare benefits by selecting a Medicare Advantage Plan including Part D prescription drugs.
Within 60 days of leaving an employer group but after age 65
Enroll in Part A and Part B of Medicare
then
Choose Medicare as your insurance and select a Medicare Supplement (Medigap) and a Part D Prescription Drug Plan.

OR

Replace your Medicare benefits by selecting a Medicare Advantage Plan including Part D prescription drugs.
October 15 to December 7th
Annual Election Period (Open Enrollment) for Medicare Advantage Plans and Medicare Part D Prescription Drug Plans. Select a plan that most appropriately meets your needs.
January 1st through February 14th
Annual Disenrollment Period for Medicare Advantage Plans and Medicare Part D Prescription Drug Plans. This is the when you can disenroll from your Medicare Advantage Plan, or Medicare Part D Prescription Drug Plan without being locked in for the rest of the year.
Any month in your first year on Medicare Part A
Medicare Trial Period for Medicare Advantage. Change from a Medicare Advantage Plan back to Original Medicare, then select a Medicare Supplement and a Part D Prescription Drug Plan.