MEDICARE BENEFITS

You have important decisions to make about Medicare. And we want to help you make the choices that are right for you.

 

As your local advisor, our job is to help you understand your Medicare options, answer your questions, and help you determine which plan benefits best align with your health needs – and your budget.

 

Best of all, you’ll never pay a penny for our services.  Please call or email one our trusted Advisors to get started:

 

What’s Medicare?

 

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

 

The different parts of Medicare help cover specific services:

 

Medicare Part A (Hospital Insurance)

 

Part A covers inpatient hospital stays, qualified care in a skilled nursing facility, hospice care, and some home health care.  Doctor’s fees incurred during a hospitalization may be billed separately as a Part B claim.

 

Medicare Part B (Medical Insurance) 

 

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.  There may a late enrollment penalty if you don’t sign up for Part B when first eligible.

 

 

 

Medicare Part C (Medicare Advantage Plans)

 

A type of Medicare health plan offered by private companies that contract with Medicare. Medicare Advantage Plans in Indiana include Health Maintenance Organizations, (HMOs), Preferred Provider Organizations, (PPOs), and Special Needs Plans, (SNPs).

 

If you’re enrolled in a Medicare Advantage Plan you still pay your Part B premium, but most Medicare services are covered through the plan, not Medicare.  Medicare Advantage Plans have to cover the same health services as Part A and Part B, and most offer prescription drug coverage.  They may also provide services not covered by Medicare Parts A and B, such as routine dental and vision care.

 

When considering a Medicare Advantage Plan, it is important to determine their service area, whether your providers and hospitals are in-network, and your medications are included in their formulary, and possible restrictions, such as Prior Authorization, Quantity Limits, and Step Therapy

 

Medicare Part D (prescription drug coverage)

 

Part-D is the stand-alone prescription drug coverage offered thru private companies, and are approved by Medicare annually.  There are 24 plans currently offered in Indiana.  Part-D plans have many variables to be considered when choosing a plan: premiums, deductibles, co-pays, co-insurance, whether your medications are included in their formulary, and possible restrictions, such as Prior Authorization, Quantity Limits, and Step Therapy.  There may a late enrollment penalty if you don’t sign up for Part-D when first eligible.  You will need a Part-D Plan if you are enrolling in a Medicare Supplement, as Medicare Supplements do not cover prescription drugs.

 

Medicare Supplement Insurance (Medigap)

 

Medicare Supplement Insurance (Medigap) policies helps pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.  Medicare Supplements are sold by private companies, but the benefits are defined by Medicare.

 

You must have Medicare Part A and Part B to apply for a Medicare Supplement.  We can advise you on how to enroll in Medicare Part A & Part B.  You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.  A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies. Many companies do offer household discounts. Medigap policies are guaranteed renewable as long as you pay the premium.