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Medicare

Original Medicare

Download the Medicare And You 2018 guide to learn more about your overage options Click Here

Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

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 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, most 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.

We speak fluent Medicare. We are annually certified to provide education and assistance to all Medicare recipients.

 

Medicare Advantage

Download the Medicare And You 2018 guide to learn more about your overage options Click Here

When enrolling in Medicare, all of your medical expenses may not be covered.  Some expenses are missed entirely, while other coverage is exhausted after you reach a certain limit.

One way to protect you from incurring unexpected financial obligations is to enroll in a Medicare advantage plan.

How Does Medicare Advantage Work?

It all depends on the type of coverage you need, and what you ultimately purchase.  Here are some of the benefits a Medicare advantage plan offers:

  • Reduced costs – depending on your insurance carrier’s network, providers may offer services at a lower cost than out-of-network physicians and hospitals
  • Affordable premiums on most services
  • Flexibility – you can receive care from any doctor or hospital approved by Medicare that also accepts your carrier’s payment conditions
  • Prescription drug coverage that meets or exceeds coverage offered by Medicare Part D
  • You pay a fixed copayment on a per visit basis for care from a physician or per day for inpatient care
  • No copayment for most preventive care, such as a cancer screening or immunization
  • Coverage for emergency care anywhere around the globe

We speak fluent Medicare. We are annually certified to provide education and assistance to all Medicare recipients.

 

Medigap

What types of Medigap policies can insurance companies sell?
In most cases, Medigap insurance companies can sell you only a “standardized” Medigap policy. All Medigap policies must have specific benefits, so you can compare them easily.

What Medigap policies cover
The chart below gives you a quick look at the standardized Medigap Plans available. You’ll need more details than this chart provides to compare and choose a policy.

 

What Medigap policies don’t cover

Generally, Medigap policies don’t cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

* Plan F is also offered as a high-deductible plan by some insurance companies in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of ($2,200 in 2017) before your policy pays anything.

**For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible ($183 in 2017), the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

Types of coverage that are NOT Medigap policies

  1. Medicare Advantage Plans (Part C), like an HMO, PPO, or Private Fee-for-Service Plan
  2. Medicare Prescription Drug Plans (Part D)
  3. Medicaid
  4. Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
  5. TRICARE
  6. Veterans’ benefits
  7. Long-term care insurance policies
  8. Indian Health Service, Tribal, and Urban Indian Health plans
  9. Qualified Health Plans sold in the Health Insurance Marketplace

Let us help you!

There are a lot of ways to compare plan options! Medicare.gov is one option for Medigap comparisons; or you could read the pounds of mail you receive and try to decipher it by yourself. Why do-it-yourself when you could talk to a professional insurance agent? Option Insurance Group agents are licensed, certified and experienced. We are brokers; and that means we represent numerous carriers and plans. This is an advantage for you as the consumer because we can offer you more than one option.

Primary Source: Centers for Medicare and Medicaid Services (CMS) www.cms.gov, Medicare and You Handbook and www.Medicare.gov. This content may have been enhanced by Option Insurance Group,LLC to include further examples and explanations. Option Insurance Group, LLC is an independent insurance agency, not employed or endorsed by the Federal or any State government. Medicare has neither reviewed nor endorsed this information. This is for informational purposes only.

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