MEDICARE: A BRIEF SUMMARY
A federal program that provides individuals 65 years or older healthcare coverage for a small cost. This public health care coverage program started in 1965 under the Social Security Administration (SSA) and is presently controlled by the Centers for Medicare and Medicaid Services (CMS). This also covers those granted social security disability, and have received disability payments for at least 24 months. Medicare also applies to people with end-stage renal disease and ALS (Lou Gehrig’s Disease).
Medicare is broken into four main parts:
Part A (Hospital Coverage)
Part B (Medical Coverage)
Part C (Medical Advantage)
Part D (Prescription Drug Coverage)
Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, and home health care.
Part B (Medical Insurance) covers, including doctor and other health care providers’ services and outpatient care. Part B also covers durable medical equipment, home health care, and some preventive services.
Part C (or Medicare Advantage) is another way that you can get coverage, offered by Private insurance companies that Medicare contracts with to combine Parts A, B, and D together. This provides members with a Managed Care option which usually includes prescription drug coverage (Part D). Most of these also include dental, vision, hearing and some transportation and much more. Depending on what area you live in, companies can have different plans to choose from.
Medicare Advantage, Part D, and Medigap are all offered by private insurance companies. This is where our experienced advisors come in. We can take all the guesswork out for you, and help you to feel confident in the decision you make to choose a plan.
What Are Medicare Supplements?
Supplement insurance helps protect you from unexpected out-of-pocket health care costs, while also giving you the freedom to choose your own doctors and enjoy permanent coverage that you can keep even if your health changes.
Benefits of Choosing a Medicare Supplement
- Allows you to keep your doctor and visit any hospital – no networks, no referrals needed
- Provides permanent coverage even if you develop health problems
- Covers most of your out of pocket costs that Medicare does not cover including deductibles and co-insurance
What You Should Know About the Part D Penalty
Part D Penalty is calculated by multiplying 1% of the National base Part D premium times the # of months you went without drug coverage. These penalties are paid according to how long you have been without a plan and you pay this penalty plus the drug premium for the duration of your policies. This means FOREVER! Remember that even if you are of great health you still need a Drug plan to avoid paying a penalty. If you have maintained drug coverage through an employer, the penalty does not apply.
For most people, transitioning to Medicare for the first time can seem like a very complicated process. You may wonder:
- Will my current prescriptions be covered?
- Will I be able to continue seeing my current doctors?
- How can my spouse continue to receive their health coverage once I’m on Medicare?
These and many other questions can be answered by your experienced insurance advisor at Insurance Advisors of TN.
Why call an 800 number for something as important as your health benefits! 800 Numbers are like revolving doors, you will always get a different representative. When you reach out to us, you’ll have a personal relationship with someone that cares.
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Need help with your Medicare options? Schedule an appointment or call 423-485-3078 to talk with our specialist today!
Insurances we carry: Aetna, BlueCross BlueShield of TN, Cigna, Humana, Mutual of Omaha, United Healthcare, WellCare, Bright Health, Oscar, & Molina.
*We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov to get information on all of your options.
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