Medicare Can Be Confusing — We’re Here to Answer your Questions

Navigating your Options

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get your Medicare coverage—Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people need to get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). We can help you understand your options and assist as you decide what coverage best meets your needs.

Medicare Advantage

Medicare Advantage is also referred to as Medicare Part C. Medicare Advantage plans are administered by private insurance companies contracted with Medicare. They cover everything that Original Medicare does and may include extra benefits as well, like prescription drugs, dental, vision, hearing and fitness memberships. Not all of these plans cover the same extra benefits. These plans typically have lower out-of-pocket costs than Original Medicare and have an annual cap on out-of-pocket costs, which Original Medicare does not have. Medicare Advantage plans have provider networks and covered drug lists. Before enrolling into a plan, research the benefits and be sure that your doctors and medications are covered.

Medicare Supplement

Medicare supplement insurance, or Medigap, is an additional health insurance policy you can buy from a private insurer to help pay some of the costs not covered by Original Medicare, including deductibles, coinsurance and health care if you travel outside the U.S. Medigap plans don’t cover long-term care, prescription drugs, dental, vision, hearing aids or private nursing care. There are 10 types of Medigap plans available in most states. Plan F and Plan G are the 2 most comprehensive and the most popular. Premiums depend on gender, ZIP code and tobacco use and for Plan F can range from around $120 per month to over $400. You must have Original Medicare to purchase a Medigap policy. Medigap is not compatible with Medicare Advantage — you would purchase one or the other.

Prescription Drug Coverage

Medicare Part D helps cover the cost of prescription drugs. Plans are offered by private insurers and require a monthly premium that averages about $35 a month. Higher income beneficiaries pay more. As with Medicare Part B, there typically is a late enrollment penalty added to the premium if you don’t sign up when you are first eligible.

Before enrolling into a plan, make sure your medications are covered in the drug formulary. A drug formulary is a list of drugs covered by a Part D plan. Most Part D plans separate the medications they cover into four or five drug formulary tiers. The cost of the medication will depend on the drug tier that is associated with the medication.

Frequently Asked Questions

No, we do not charge a fee to the client for our services.

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A Medicare Supplement policy, sometimes called “Medigap,” is a private insurance policy that can help pay for some of the health care costs that Original Medicare doesn’t cover. Medicare Advantage Plans are network-based plans offered by private insurance companies that have a contract with Medicare and provide additional benefits beyond Original Medicare like vision, hearing and dental benefits.

You must have Original Medicare Part A and Part B, live in the plan service area and not have End-stage renal disease requiring dialysis.

No, Medicare covers medical expenses related to illness or rehabilitation. Skilled Nursing is covered by Medicare for up to 100 days if you qualify for a skilled medical need. Long-term care services involve someone needing assistance with activities of daily living such as bathing, dressing, grooming and eating.

People rely on a variety of payment sources which include personal funds, private financing options like long-term care insurance or government programs like Medicaid.

There are no age requirements to purchase long-term care insurance. However, because of health changes that take place most often after people reach their 50s, we advocate that long-term care planning start in your 50s.

The need for life insurance persists long after the kids have graduated college or the house has been paid off. As long as premiums are paid, permanent life insurance provides a lifetime of protection. Also, a permanent life insurance policy will accumulate cash value on a tax-deferred basis and the death benefit is tax free to the beneficiary. Once approved, your policy cannot be cancelled by the insurer and the insurance will remain in-force regardless of your health status.

A final expense insurance policy is used to pay for funeral services and a burial when the named insured dies. Although the policy is called “final expense insurance,” it is no different from a traditional life insurance policy with a small monetary value.

When you buy an immediate annuity, you choose the number of years that your guaranteed income stream will last. A lifetime income annuity provides guaranteed income for as long as you are alive.

It’s a way to diversify your portfolio and make sure that your basic retirement expenses will be covered. For most retirees, the overriding concern is for a secure income stream for the future. The annuity pays principle and interest for your entire life. In this way, the lifetime income annuity operates much like a pension plan from a former employer.