Covers in-patient hospital stays, care in a skilled nursing facility, hospice care, and some home health care
Covers certain doctors’ services, outpatient care, medical supplies, and preventative services
Covers government-provided Medicare and often prescription drugs, dental, routine vision and fitness
Provides optional benefits for prescription drugs
Covers out-of-pocket costs not covered by government-provided Medicare
Medicare can be confusing. Between doctors, prescriptions, and co-payments, you probably have questions. Insurance Warehouse in Monticello, Georgia is a proven Medicare insurance provider that can help you navigate Medicare and find a plan that best meets your needs.
Our comprehensive insurance agency can take care of your healthcare concerns so that you can spend more time living your life now.
Medicare is a US federal health insurance program that was primarily created to provide health insurance to Americans over 65 years old. Medicare is also provided for some individuals younger than 65, who have permanent disabilities. It is also called “Original Medicare”. Medicare consists of two main parts: Part A and Part B. In order to qualify to receive Medicare coverage, one must be a legal citizen of the US for at least 5 consecutive years up until they apply for Medicare. One must meet one of three requirements to be eligible for Medicare:
Part A. Original Medicare Part A covers inpatient hospital care and inpatient services at skilled nursing facilities. The coverage and costs for Part A are determined on a benefit period that is usually annual. Each benefit period requires a new deductible.
Types of coverage include:
Part B. Part B covers outpatient medical coverage like doctor visits or clinic services.
Medicare-covered individuals are often surprised when they lean of medical services that aren’t covered by Original Medicare.
Some services not covered by Original Medicare can include:
More coverage is provided by optional “Medicare Advantage” plans:
Part C. Medicare Advantage plans (Part C) combine both Part A and Part B, but also can include additional coverage and benefits not provided with Original Medicare. Coverage is typically limited to a network of providers.
Typical full coverage:
Typical partial coverage:
Part D. Medicare Prescription Drug Plans (Part D) assists in paying for medications that are not covered by Original Medicare. The option is available to get a standalone Part D plan or a Part C plan that includes the drug coverage that Part D would provide.
Medigap. Medicare Supplement Insurance (Medigap) assists in paying some or all costs not paid by Original Medicare, including deductibles, copays and coinsurance. There are currently ten federally-standardized Medicare supplement insurance plans, lettered A through N, with varying coverages and benefits. The most comprehensive Medigap alternative plan provided at this time is Plan G, which covers all deductibles, copayments and coinsurance.
Individuals have the choice of adding additional coverage to Original Medicare, or to choose a standalone Medicare Advantage plan. Part C and Part D can both be added individually, or combined with Original Medicare (Parts A and B). Medicare Advantage (Part C) can also include prescription drug coverage, so that only a standalone Part C plan is needed. Not only does each different part assist to pay different healthcare costs, but each plan is funded differently. A variety of ways are available to tailor your coverage for your individual needs.
Medicare, as well as other Medicare Heath Plans, charge premiums. Premiums are fixed monthly payments for Medicare coverage. In addition to premiums, insured individuals also share the cost for the health care services that they receive. These additional payments include:
The Initial Enrollment Period (IEP) is typically 7 months. It begins three months before the individual’s birthday and ends 3 months after the birthday. If an individual’s birthday falls on the first day of the month, his IEP will begin and end one month earlier. If an individual is covered due to a qualifying disability, his IEP will be based on the 25th month after receiving benefits. Typically Original Medicare coverage begins on the first day of the month when the individual turns 65. If the birthday falls on falls on the first day of the month, Original Medicare coverage will begin on the first day of the prior month.
A qualified individual may enroll in a Medicare supplement plan at any time. However, the individual may be denied coverage or incur increased charges based on his health history if he enrolls outside the Medicare Supplement Open Enrollment Period of October 15 through December 7. The General Medicare Open Enrollment Period (as well as the Medicare Advantage Open Enrollment Period) runs from January 1 through March 31, during which enrollees are allowed to change to any different plan.
The primary factor when determining the best Medicare coverage is the individual’s expected needs:
Health. One’s health should be considered. This can be determined by considering how often doctor visits are needed, what health problems are present, and what medications are currently prescribed.
Budget. One’s budget is also a factor when determining the best coverage. Considerations include what the individual is able to pay in monthly premiums, whether or not copays and coinsurance fees will be affordable, and whether or not high out-of-pocket risks will be acceptable.
Individual Preferences. One’s preferences should also be considered. These preferences include the doctors, hospitals or pharmacies the individual prefers, whether or not coverage is accessible while the individual is traveling often, or other coverages the individual already has.
Schedule a one-on-one review of your benefits with a local professional insurance agent today.
Brad has been providing insurance services as an independent insurance agent since 2013, after having been in the industry since 2000.
Tailored and comprehensive. We can combine products provided by the most respected insurance providers into a custom package that meets your needs.
When you request a quote, our professional insurance agency will use our experience and the best resources to find all available discounts that apply to you.