MEDICARE CHOICES

WHICH PLAN OPTION IS RIGHT FOR YOU DEPENDS ON YOUR NEEDS AND BUDGET.  HERE ARE THE COMMON CHOICES:

THIS IS THE BASIC COVERAGE THAT INCLUDES PART A  (HOSPITAL INSURANCE) & PART B (MEDICAL INSURANCE) WITH COSTS DEDUCTED FROM SOCIAL SECURITY BENEFITS OR BILLED BY THE GOVERNMENT IF YOU ARE NOT YET COLLECTING SOCIAL SECURITY.  WHEN YOU SIGN UP FOR MEDICARE THIS IS THE COVERAGE THAT YOU ARE PROVIDED THAT COVERS ROUGHLY 80% OF THE MEDICARE ELIGIBLE COSTS. MEDICARE IS THE FOUNDATION FOR ALL OTHER COVERAGES.

PRESCRIPTION DRUG PLANS ARE ALSO KNOWN AS PART D.  A PDP NEEDS TO BE PURCHASED WITHIN 63 DAYS OF STARTING MEDICARE TO AVOID A LATE ENROLLMENT PENALTY.  NOT HAVING "CREDITABLE COVERAGE" FOR PRESCRIPTIONS WILL LEAD TO FUTURE PERMANENT PENALTIES EVEN IF YOU ARE NOT ON ANY PRESCRIPTION DRUGS. HAVING A PRESCRIPTION DRUG PLAN TOGETHER WITH THE BASIC MEDICARE COVERAGE IS THE MINIMUM OPTION.  

PRESCRIPTION DRUG PLANS MAY BE PURCHASED BY INDIVIDUALS WHO ARE:

•         ENTITLED TO BENEFITS UNDER PART A BUT ARE NOT ENROLLED IN PART B  or
•         WHO ARE ENROLLED IN PART B BUT ARE NOT ENTITLED TO PART A  or
•         ARE ENTITLED TO PART A BENEFITS AND ARE ENROLLED IN PART B

WE REPRESENT MULTIPLE PRESCRIPTION DRUG PLANS SO WE CAN FIND YOU THE CHEAPEST PLAN IF YOU AREN'T ON ANY MEDS, OR IF YOU ARE ON MEDS, THE RIGHT FORMULARY FOR YOUR MEDICATIONS AND BUDGET.

MEDICARE SUPPLEMENTS PROVIDE A MONTHLY BUDGET WITH MINIMAL UNEXPECTED EXPENSES.  THEY ARE THE MOST FLEXIBLE OPTION FOR CARE WITHOUT GEOGRAPHIC LIMITS, BUT ARE ALSO THE MOST EXPENSIVE.  THESE PLANS CAN ONLY BE USED IN COMBINATION WITH MEDICARE PART A & B. YOU CANNOT HAVE BOTH A MEDICARE SUPPLEMENT AND A MEDICARE ADVANTAGE PLAN.  THESE ARE THE PLANS THAT YOU HEAR REFERRED TO AS A, B, C, F, G, K, L, OR N PLANS. THEY ARE ALSO KNOW AS MEDIGAP POLICIES BECAUSE THEY FILL THE 20% GAP NOT COVERED BY BASIC MEDICARE.  HOW MUCH OF THE 20% GAP THAT IS COVERED DEPENDS ON WHICH PLAN YOU CHOOSE.  THESE PLANS SHOULD BE PURCHASED WITHIN THE FIRST SIX MONTHS OF BECOMING ELIGIBLE FOR MEDICARE TO ENSURE ACCEPTANCE.   MEDICARE SUPPLEMENT COMPANIES MUST ISSUE THE PLANS, AS A GUARANTEED ISSUE RIGHT, REGARDLESS OF ANY PRE-EXISTING CONDITIONS DURING THIS INITIAL ENROLLMENT PERIOD.  SOME STATES, SUCH AS NEW YORK, HAVE ADDITIONAL GUARANTEE ISSUE PERIODS.

A SEPARATE PRESCRIPTION DRUG PLAN IS ALSO REQUIRED TO COMPLETE YOUR COVERAGE.

WE WOULD BE HAPPY TO HELP YOU FIND THE RIGHT PLANS FOR YOUR NEEDS AND BUDGET.

MEDICARE ADVANTAGE PLANS ARE OFFERED BY PRIVATE INSURANCE COMPANIES APPROVED AND CONTRACTED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.  THESE PLANS COMBINE THE COVERAGES OF BASIC MEDICARE (PARTS A & B) INTO ONE POLICY.  MEDICARE ADVANTAGE PLANS MAY ALSO INCLUDE PART D, PRESCRIPTION DRUGS.  ADDITIONAL BENEFITS SUCH AS VISION, DENTAL AND HEARING COVERAGES ARE ALSO OFTEN INCLUDED, ALL IN ONE PLAN.  

YOU MUST BE ENROLLED IN BOTH PART A AND PART B TO JOIN A MEDICARE ADVANTAGE PLAN.  YOU WILL REMAIN ENROLLED IN MEDICARE PARTS A & B,  AND CONTINUE TO PAY YOUR PART B PREMIUM, BUT YOU WILL RECEIVE YOUR BENEFITS THROUGH YOUR MEDICARE ADVANTAGE INSURANCE COMPANY INSTEAD OF THE GOVERNMENT.  THESE PLANS CAN BE HEALTH MAINTENANCE ORGANIZATIONS (HMO), POINT OF SERVICE (PSO), PREFERRED PROVIDER ORGANIZATION (PPO), SPECIAL NEEDS (SNP), PRIVATE FEE FOR SERVICE (PFFS) OR MEDICAL SAVINGS ACCOUNT (MSA) PLANS.

THESE PLANS WILL HAVE GEOGRAPHICAL LIMITATIONS AND MAY REQUIRE SERVICES BE PROVIDED ONLY BY NETWORK PROVIDERS.  THESE PLANS ARE USUALLY THE LEAST EXPENSIVE OPTION HOWEVER WHEN SERVICE IS REQUIRED THERE WILL BE COPAYS AND DEDUCTIBLES TO PAY.

WE CAN HELP YOU FIND THE RIGHT PLAN THAT ACCOMODATES YOUR PROVIDERS, MEDICATIONS, NEEDS AND BUDGET,