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February 24 2016


"Getting Ready For Medicare" A stride by Step Guide ~ Kevin Angle (Agent) Alvin, Texas

Obamacare Medicare Supplement Health Insurance Agent

Congratulations, you switch 65 and are entitled to Medicare. Your monthly benefits from the Federal Government include social security along with deductions for Medicare part a and B of Medicare. Below we are going to give you a brief synopsis and direct you through the first steps of learning the Medicare options available to you. Under no circumstances is this a comprehensive review. In order to understand fully the benefits you will receive under Medicare, look at comprehensive brochure for seniors "Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare".

Original Medicare parts A & B

To be sure it, there are 3 parts to Medicare-Part A, B and D. Managed by the Federal Government, Part A (hospital insurance) covers inpatient hospital costs so helping cover skilled assisted living facilities, hospice and some home healthcare costs. Medicare Medicare part b covers physicians and services, outpatient care plus some preventative services to assist maintain your health if you are ill. The premium for Part A is $443.00 per month and unless you are disabled and have survivor benefits from a spouse who was covered by Social Security, these prices are the same for everyone and the main benefit. Part B premium starts at $96.40 (may cost more depending on your annual income) and is also withdrawn directly from your social security check. You'll be able to opt out of Medicare part b coverage if you choose. Both A (hospital benefits) & B (Physician and medical benefits) have deductibles, co-insurance/co-payments, and maximum benefits with extra lifetime reserve days. You will find gaps in the government plan and payments you may be directly responsible to pay. Selecting a supplemental plan from your private insurer can cover portion of these gaps.

Medicare Medication Coverage (Part D)

Section D, added to law effective January 1, 2006, was enacted under the Bush administration which is funded with taxpayer dollars. Should you have had a Medicare plan before January 2006, you might have a Medicare Supplement policy that includes drug coverage. If you happen to be new to Medicare, you might select a separate policy for drugs. There are two solutions to buy a Drug plan-as section of a Medicare Advantage Plan or possibly a separate Medicare Medication Plan. Since Part D provides basic coverages with large deductibles and co-payments, besides premium differences, these drug supplemental policies must offer Formulary or Generic Drugs in each and every category of treatment. Deciding which drug plan's best for you may be challenging. Knowing your drugs and dosages prior to you buying the plan is helpful. For approved drug plans check out the department of insurance site in your state.

Obamacare Medicare Supplement Health Insurance Agent

Medicare Advantage Part C Plans

Contained in the description of Medicare is an element C, which you might assume is a second benefit you receive --it's not. Part C is coverage you'll be able to select instead of traditional Medicare. Available from private insurance companies, Medicare Advantage Plans (MA) are private plans which can be approved by the federal government. Deciding on a MA plan means you may decline coverage through traditional Medicare. The insurer has rigorous regulations and rules to follow and can be suspended for misleading material or infractions. An unbiased agent must be certified separately to sell Medicare Advantage Plans since they're perceived to be an extension from the Federal Government. These plans may be HMO (Health Maintenance Organizations), PPO (Preferred Provider Organizations), PFFS (Private Fee for Service), MSA (Medical Savings Accounts, or SNP (Special Needs Plans). With MA plans, you'll not purchase a Medicare Supplement plan because the supplemental benefits will probably be included in the Part C, MA plan.

Which plan's best for you? Listed below are many of the differences between Medicare Advantage (MA) and Medicare Supplement (a.k.a. Medigap) plans.

Health related conditions you choose

Your real choice having a MA versus a regular Medicare Supplemental plan's to make sure you get the doctors and hospitals you want. Most MA plans are regional and also the insurance company may not provide a MA plan within your zip code but may give you a Medicare Supplement plan in your area. MA plans designate a medical facility and the doctor you need to see. If you like HMO plans, you would probably be satisfied with a MA plan. If you prefer to select your own doctor and hospital, you would best be served having a PPO/Medicare Supplement plan. Many doctors will take Medicare patients but are not on the list to take Medicare Advantage patients. Research your options first and find out what sort of plan your doctor will honor.

Guaranteed Issued Rules

Legislation strictly regulated with Medicare is Guaranteed Issue. You can get Medicare, Medicare Supplement or a Medicare Advantage plan in case you have health problems (preexisting conditions) the very first month that you are permitted to be covered under Medicare Part B age 65 or older. However, this guaranteed issue right is good for only 6 months once you are eligible. After that the insurer can underwrite your track record and you can be declined, excluded for preexisting conditions or surcharged. If you are covered under a group health insurance program at your work once you are eligible for Part B, you are able to wait until your group plan is over before you pick a supplement or MA plan, guaranteed issued. You need to provide proof of enrollment of Medicare Part A and B so that you can purchase a supplement. (There are many other exceptions for guaranteed issue.) In any case, if you plan on choosing a supplemental intend to fill in the gaps of Medicare or perhaps you wish to take a benefit plan, you are better to choose the coverage when you are first eligible or when group benefits end along with your employer.

Medicare Supplement Plans (Medigap Policies)

Medicare Supplement policies are available to complete the gaps of traditional Parts A & B. These plans are standardized and called Plans A through L and should offer the same benefits, whichever company sells the master plan. Not all companies sell A - L. Premiums and contracted doctors and hospitals are usually the major differences in these plans. Plans F & J provide you with the riches coverages for Medigap plans and also cover foreign travel emergencies which might be important if you travel away from US. The Department of Insurance in your state can provide a list of firms that provide Medicare Supplemental plans. These supplemental plans are generally less than $180 per month depending on the company you select and quite a few doctors that accept Medicare encourage the supplemental plan benefits you select as long as the plan is just not an HMO or MA plan. Again, check with your physicians billing department to make sure your plan will probably be accepted before one last selection.


There are benefits not paid by Medicare. These include: Long lasting Care, Vision, Dental, assistive hearing aids, eyeglasses, and private duty nurses during recovery from illnesses. As you approach age 65, your mailbox will explode with offers for Medicare Advantage and Medigap plans. Marketing material from A.A.R.P. and also other senior organization can be confusing. Understanding the differences can save you time and money. Choosing a completely independent agent who is contracted to trade both Medicare Supplement and Medicare Advantage Plans is always to your advantage. Call or contact our agency for more information and for your free self-help guide to "Choosing a Medigap Policy: Helpful information for Health Insurance for People with Medicare".

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