Medicare & Health Insurance Plan

Health Insurance Plans that Work with Medicare

It is estimated that expenses related to health care make up one of the biggest portions of a retiree’s budget. Understanding which health insurance plan to choose to cover these expenses is an important decision. Below are the common types of plans that work with Medicare, as well as information about Medicare and its eligibility requirements. Please contact us for more details and see how we can help you.

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Common Types of Plans that Work with Medicare

medigap PLANS

Medigap plans can offer full coverage in areas of deductibles, co-payments and co-insurance. A National Provider Network is offered along with emergency care coverage worldwide. These plans can also be paired with stand-alone prescription drug plan options. Medigap Plans are guaranteed renewable — premiums may change each year, but benefits remain the same.

COST PLANS

Cost plans provide options in medical and hospital coverage levels, lower premiums and can be paired with stand-alone prescription drug plan options. As with all Cost Plans, benefits, premiums and cost-sharing may change from year to year. Availability may vary by the county in which a person resides.

medicare advantage PLANS

Medicare advantage plans provide convenience in providing medical, hospital and drug coverage in one plan. Some plans utilize a Preferred Provider Organization (PPO) while others are Private Fee For Service (PFFS) plans. As with all Medicare Advantage Plans, benefits, premiums and cost-sharing may change on an annual basis. Availability, benefits and premiums will vary by the county in which a person resides.

Understanding Medicare

What is Medicare?

In 1965, the federal program Medicare began. Today, Medicare is the nation’s largest health insurance program providing coverage to older Americans. In 2006, along came Medicare Part D, providing people on Medicare with a prescription drug program and additional health plan options.

What is Medicare Part A and B ?

Medicare Part A is hospital insurance that helps pay for inpatient care in hospitals, skilled nursing facilities, and hospice care after deductible and co-insurance payments.

Medicare Part B is medical insurance that helps pay for physicians’ services, lab tests, durable medical equipment, outpatient hospital treatment, and some medical services and supplies not covered by Medicare Part A.

When Am I Eligible for Medicare?

You are eligible for Medicare if you are a U.S. citizen or have been a permanent legal resident for five continuous years and:

  • You are 65 years or older and eligible to receive Social Security, or
  • You are under age 65, permanently disabled and have received Social Security disability insurance payments for at least two years, or
  • You require continuing dialysis for permanent kidney failure or need a kidney transplant

When Should I Enroll in Medicare?

Part A

Part A enrollment is usually automatic starting the first day of the month you turn 65.

Part B

Part B offers three opportunities to sign up: the Initial Enrollment Period, the Special Enrollment Period and the General Enrollment Period.

  • Initial Enrollment Period (IEP) allows you to enroll three months prior to, the month of, or three months after your 65th birthday.
  • Special Enrollment Period (SEP) relates to special circumstances surrounding previous medical coverage through an employer or with a union. Contact us for specifics and further details.
  • General Enrollment Period (GEP) occurs from January through March 31 of each year, with coverage starting July 1 of the enrollment year.