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Medicare Coverage Options
After enrolling in original Medicare you can enroll in plans with private companies for additional coverage such as Medicare Advantage Part C, Medicare Supplements, or Part D prescription drug plans.
Understanding Insurance
What is Medicare?
The advantage to having an individual plan is you can tailor it to meet your needs and you can make changes as needed. We help you select a plan that has your doctors in the network and your prescriptions covered. No worries if you are self-employed, in between jobs, or unemployed. Individual plans cover individuals and families from birth and up.
Types Of Plans We Can Help With
Option 1: Choose A Medicare Advantage Plan
Option 2: Add a Prescription Drug Plan and/or a Medicare Supplement
OR
Prescription Drug Plans
Also known as Medicare Part D
Medicare Advantage plans, also known as Part C, are provided by private insurance companies that are contracted by Medicare. The plans offer all the benefits of original Medicare and may include Part D coverage or supplementary benefits like dental, vision, hearing benefits, fitness programs, and over-the-counter benefits. Some plans provide a giveback towards your Part B premium.
Prescription Drug Plans
Also known as Medicare Part D
Prescription drug plans, also known as Part D, are provided by private insurance companies as a stand-alone plan to provide coverage for medication. Enrolling in a prescription drug plan when you are eligible is important to prevent future penalties.
Medicare Supplement
Also known as Medicare Part D
Medicare Supplements also known as Medigap, are provided by private insurance companies to help pay Original Medicare out-of-pocket costs. There are a variety of supplements to choose from.
Understanding The Types Of Insurance Plans
HMO
What is an HMO (Health Maintenance Organization) plan?
An HMO plan requires you to use in-network providers and to coordinate your care through your primary care physician. Referrals are required to see a specialist. Out-of-network benefits are only available in an emergency. HMOs are less expensive, have lower deductibles, and coinsurance.
PPO
What is a PPO (Preferred Provider Organization) plan?
A PPO plan does not require a primary care physician and referrals to specialists are not needed. PPO plans typically have a nationwide network and offer out-of-network benefits. Out-of-network providers are subject to an out-of-network deductible. You generally pay more for your services when seeing an out-of-network provider and may have to file your claim with the insurance company. PPO plans cost more, offer the most flexibility, and are ideal for those who like to travel.
We Are Here To Help
New To Medicare?
If you are just approaching 65, we are here to help you understand the ABCs of Medicare. We know it can be confusing. Allow us to share how Medicare Supplements, Advantage Plans, and Prescription Drug plans work. We will confirm that your doctors and medication are covered with the plans we present. We will also provide you with an estimate of prescription costs for each plan we share. We love working with beneficiaries and pride ourselves on making the transition easy.
We Are Here To Help
Already have Medicare?
If you are already in Medicare, we can be a valuable resource. It is recommended that you review your Medicare Advantage and Prescription Drug Plan annually to ensure how the changes will affect your plan for the new year. We are happy to review your plan and provide you with options for the new year. There is never pressure to change and our services are complimentary.
How Can I Change To A Medicare Advantage Plan?
You are 65 or will be 65 soon, even if you are still employed
If you already have Medicare Part A & B
You are a resident in a service area for Medicare Advantage Plan
OR
You are eligible for Medicare and have end-stage renal disease (ESRD)
When Can I Enroll?
Initial Enrollment Period
The period that you become eligible for Medicare. It is a seven-month period starting three months prior to your 65 birthday and ends three months after your 65 birthday.
Oct 1 - Oct 15
Discover New Plan Options
Oct 15 - Dec 7
Annual Open Enrollment
Jan 1 - Mar 31
Open Enrollment
Special Enrollment Period
A special enrollment period that allows changes to be made outside of open enrollment
Commonly Asked Questions
Find answers to generally asked questions
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What is a PCP?A PCP is a primary care physician that you see to maintain your health. By seeing a PCP regularly you can maintain better health and lower your healthcare costs.
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What is maximum out of pocket?The maximum out of pocket is the cap that you have to pay in covered health services before the plan pays 100% of covered services for the year.
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What is a deductible?A deductible is the amount that you pay for covered health services before the plan starts to pay.
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What is co-insurance?A percentage that you pay for covered health services after your deductible has been met.
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What is a co-pay?A fixed amount you pay for covered health services after your deductible has been met.
Call Us To Speak To An Agent Today
We are here to help you understand how the plans work, so feel free to ask us as many questions as you like. There is never a fee for our services.
(813) 450-8084
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