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

Obamacare Medicare Supplement Health Insurance Agent

Congratulations, you switch 65 and are qualified to apply for Medicare. Your monthly advantages from the Federal Government include social security along with deductions for Part A and B of Medicare. Below we will give you a brief synopsis and guide you through the first steps of understanding the Medicare options available to you. Under no circumstances is this a comprehensive review. In order to know the benefits you will receive under Medicare, see the comprehensive brochure for seniors "Choosing a Medigap Policy: Helpful tips for Health Insurance for People with Medicare".

Original Medicare parts A & B

We all know it, there are 3 parts to Medicare-Part A, B and D. Managed with the Federal Government, Part A (hospital insurance) covers inpatient hospital costs helping cover skilled convalescent homes, hospice and some home health care costs. Medicare Medicare part b covers physicians and services, outpatient care and several preventative services to aid maintain your health when you're ill. The premium for Part A is $443.00 per month and unless you are disabled or have survivor benefits from a spouse who had previously been covered by Social Security, these cost is the same for everyone and area of the benefit. Part B premium starts at $96.40 (might cost more depending on your annual income) and it is withdrawn directly from your social security check. It is possible 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. There are gaps in the government plan and payments you will end up directly responsible to cover. Selecting a supplemental plan coming from a private insurer can cover portion of these gaps.

Medicare Medication Coverage (Part D)

Section D, put into law effective January 1, 2006, was enacted underneath the Bush administration and it is funded with taxpayer dollars. If you had a Medicare plan before January 2006, you could have a Medicare Supplement policy which includes drug coverage. If you're new to Medicare, you may select a separate insurance policy for drugs. There are two solutions to buy a Drug plan-as section of a Medicare Advantage Plan or 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 before selecting the plan is helpful. For approved drug plans browse the department of insurance site where you live.

Obamacare Medicare Supplement Health Insurance Agent

Medicare Advantage Part C Plans

Within the description of Medicare is Part C, which you might assume is the one other benefit you receive --it's not. Part C is coverage it is possible 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. Selecting a MA plan means you may decline coverage through traditional Medicare. The insurer has rigorous foibles to follow and can be suspended for misleading material or infractions. A completely independent agent must be certified separately to offer Medicare Advantage Plans because they are perceived to be an extension in the Federal Government. These plans could 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 since supplemental benefits will be included in the Part C, MA plan.

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

Health related conditions you choose

Your real choice which has a MA versus a traditional Medicare Supplemental program's to make sure you get the doctors and hospitals you need. Most MA plans are regional along with the insurance company may not provide a MA plan within your zip code but may provide a Medicare Supplement plan in your town. MA plans designate a medical facility and the doctor you must 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'll best be served having a PPO/Medicare Supplement plan. Many doctors is going to take Medicare patients but aren't on the list to take Medicare Advantage patients. Do your research 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 even a Medicare Advantage plan although you may have health problems (preexisting conditions) the very first month that you are permitted be covered under Medicare Medicare part b age 65 or older. However, this guaranteed issue right is useful for only 6 months after you are eligible. After that the insurance company can underwrite your health background and you can be refused, excluded for preexisting conditions or surcharged. Should you be covered under a group health insurance program at your work you're now eligible for Part B, it is possible to wait until your group plan is over before you go with a supplement or MA plan, guaranteed issued. You have to provide proof of enrollment of Medicare Medicare part a and B as a way to purchase a supplement. (There are a few other exceptions for guaranteed issue.) Regardless, if you plan on choosing a supplemental intend to fill in the gaps of Medicare otherwise you wish to take a benefit plan, you are advisable to choose the coverage if you are first eligible or when group benefits end using your employer.

Medicare Supplement Plans (Medigap Policies)

Medicare Supplement policies are available to fill in the gaps of traditional Parts A & B. Diets are standardized and called Plans A through L and has to offer the same benefits, regardless of what company sells the blueprint. Not all companies sell A - L. Premiums and contracted doctors and hospitals are usually the major differences in these plans. Plans F & J provide the riches coverages for Medigap plans and in addition cover foreign travel emergencies that could be important if you travel away from US. The Department of Insurance in your area can provide a list of firms that provide Medicare Supplemental plans. These supplemental plans usually are less than $180 per month with regards to the company you select and most doctors that accept Medicare need the supplemental plan benefits you decide on as long as the plan just isn't an HMO or MA plan. Again, consult with your physicians billing department to make sure your plan will likely be accepted before one last selection.


There are benefits not protected by Medicare. These include: Lasting Care, Vision, Dental, 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 Medicare Supplement plans. Marketing material from A.A.R.P. and also other senior organization might be confusing. Understanding the differences can save you time and money. Choosing an impartial agent who is contracted to trade both Medicare Supplement and Medicare Advantage Plans would be to your advantage. Call or contact our agency for additional information and for your free help guide "Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare".

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