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What is Medicare?
Medicare is a federal health insurance program for people who are 65 years old, younger people with disabilities and people with end-stage renal disease. Once you are in Medicare you will receive a card that looks like this.
Part A (HOSPITAL INSURANCE)
Part A Covers
-inpatient hospital stays
-care in a skilled nursing facility
-hospice care
-home healthcare
You usually don’t pay a monthly premium for Part A if you or your spouse paid Medicare taxes for 10 years or 40 quarters while working. This is sometimes called “premium-free Part A.”
If you don’t qualify for a premium-free Part A, you can buy Part A.
Part B (MEDICAL INSURANCE)
Part B Covers
-doctors’ services
-outpatient care
-medical supplies
-preventative services
Most people will pay the standard Part B premium amount. The standard Part B premium amount in 2024 is $174.70 per month. If your modified adjusted gross income is reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMMA is an extra charge added to your premium.
In 2024, you pay $240 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-approved amounts for doctor services, outpatient therapy, durable medical equipment.
Medicare Part D (Prescription Drug Coverage)
Helps cover the cost of prescription drugs (including many recommended shots or vaccines.)
Medicare Part C/ Medicare Advantage
Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans.
- Health Maintenance Organization (HMO) Plans
(You will need referrals from the primary care doctor. Services rendered must be in-network.)
- Preferred Provider Organization (PPO) Plans
(You don’t have to get a referral from your primary doctor to see a specialist in PPO plans. If you use plan specialist, your cost for covered services will usually be lower than if you use non-plan specialist.)
- Private Fee for Service (PFFS) Plans
(PFFS Plan that has a network, you can also see any of the network providers who have agreed to always treat plan members. You can also choose an out-of-network doctor, hospital, or other provider, who accepts the plan's terms, but your costs will usually be lower if you stay in the network.)
- Special Needs Plans (SNPs)
(SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve. These plans are for Medicaid/Medicare DSNP, Chronic Conditions CSNP)
Medicare Supplement/Medigap
Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:
• Copayments
• Coinsurance
• Deductibles
We are Independent Insurance Brokers who have partnerships with top companies like United Healthcare, Humana, Aetna, Cigna, Anthem Blue Cross Blue Shield, Wellcare, CarePlus, Baycare, Devoted, Freedom/Optimum, Ultimate, Mutual of Omaha, Thrivent Insurance, Guarantee Trust Life and many more.
Contact us to speak to a licensed insurance broker at a no cost consultation.
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What are my options?There are different options for Medicare, because the Medicare is confusing here are your options. -Select Original Medicare and receive coverage under Medicare Part A (hospital) and Part B (medical). This does not include prescription coverage or many other medical expenses. -Select Original Medicare and add Part D to cover your prescriptions. -Select Medicare Advantage aka Part C as your form of healthcare. This will include your services that Original Medicare covers. Most plans will include prescription drug coverage, dental, vision and hearing benefits. -Select Original Medicare with a Medicare Supplement aka Medigap plan. You will still have Original Medicare to cover 80% and Medigap plan will cover some if not all additional costs and expenses. You will need to purchase as separate Part D drug plan.
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Do you offer a Free Consultation?Yes we do & there is no obligation! Call Elliot Monsod at 727-202-2995
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What is Medicare?Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant).
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What are the different parts of Medicare?Medicare Part A (Hospital Insurance) helps cover: • Inpatient hospital care • Skilled nursing facility care • Hospice care • Home health care Medicare Part B (Medical Insurance) helps cover: • Services from doctors and other health care providers • Outpatient care • Home health care • Durable medical equipment • Some preventive services, including certain vaccines and cancer screenings Medicare Part C (also called “Medicare Advantage”): • Includes all benefits and services covered under Part A and Part B provided by Medicare approved private insurance companies • May include extra benefits and services for an extra cost • Usually includes Medicare prescription drug coverage (Part D) as part of the plan Medicare Part D (Medicare prescription drug coverage): • Helps cover your prescription drug costs • Run by Medicare-approved private insurance companies • May help lower your prescription drug costs and help protect against higher costs in the future
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What are some other Medicare terms?Some other terms you might need to know include: Original Medicare: Original Medicare is sometimes called “traditional Medicare.” Original Medicare coverage is managed by the Federal Government. If you don’t choose a Medicare Advantage Plan (such as a Medicare HMO or PPO), you will have Original Medicare. Medicare Supplement Insurance (also called Medigap): Medigap helps pay some of the costs that Original Medicare does not cover, such as copayments and deductibles. You need both Part A and Part B to purchase a Medigap policy.