Welcome to the Medicare Shoppe!
Whether you are 65 or older – or nearing retirement – you know that there is a lot of information to process when considering Medicare options and plan designs. The Health Insurance Shoppe is your trusted partner to help you understand what Medicare is and how it works so that you can choose a program that will best meet your individual health care needs.
What is Medicare?
Medicare is a national health insurance program that helps people age 65 and up, and younger individuals with certain disabilities, pay for health care. Like most insurance programs, Medicare does not pay all your health care costs – you will be responsible for deductibles, premiums, coinsurance, or co-payments. The Medicare program does offer options to help you purchase additional coverage to cover out-of-pocket expenses – and the options that you select will affect the cost and level of coverage.
When reviewing the various Medicare plan designs, you should keep in mind that each person has unique needs and concerns when it comes to health care – whether it’s keeping costs down or having the freedom to go to any doctor they choose.
Here are some key differences among the Medicare plans that you should consider:
- How much will you be required to pay in premiums and out-of-pocket costs?
- How much choice do you have to select your own doctors or hospitals?
- Can you go directly to a specialist?
- Can you get additional benefits, such as prescription drugs?
- How far will you need to travel to get to the doctor or hospital?
- How often do you travel for business or leisure?
Understanding the different parts of Medicare
Medicare is basically broken down into two main categories, the “Original Medicare Plan” and the “Medicare Advantage Plan.” Each category is made up of four sub-categories: Part A, Part B, Part C, and Part D.
Medicare Part A (Hospital Insurance)
- Automatically acquired at age 65, regardless of income or health status, if Medicare taxes were paid
- Helps cover inpatient care in hospitals
- Helps cover skilled nursing facility, hospice, and home health care
Medicare Part B (Medical Insurance)
- Helps cover doctors’ services and outpatient care
- Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse
- Additional standard monthly premium of $80.40 for 2009 for an annual deductible of $135
- Excess cost not covered by Medicare is paid for in co-payments
- Plans that supplement Medicare Part A and B and include a prescription drug card can cost $0 in monthly premium
Medicare Advantage Plans (Part C) (HMO or PPO) (PFFS)
- A health coverage choice run by private companies approved by Medicare that supplements Medicare Part A and B and can include Part D. If plan includes Part D than enrollment follows Part D limited time enrollment.
- Must be currently enrolled in Medicare Part A and B
- Excess cost not covered by Medicare is paid for in co-payments
- Plans that supplement Medicare Part A and B and include a prescription drug card can cost $0 in monthly premium
Medicare Part D (Prescriptions)
- Medicare prescription drug coverage that must be purchased through a private insurance company
- Medicare Part A and B are required to become eligible
- Limited time enrollment (Nov. 15 - Dec. 31, annually). Penalties are reflected in premiums if eligible and proof of credible prescription drug coverage can not be provided.
Medicare Supplements (Gap Insurance) (Plans A-L)
- Covers the deductibles of Part A and Part B
- Covers the excess cost that Medicare does not cover for Part A and Part B
- Provides coverage for foreign travel
With federal regulations imposed, you must call or email info@thehealthinsuranceshoppe.com to begin conversation.
