Medicare Information
Medicare can be a complex system to navigate. Often when starting on Medicare, seniors can get overwhelmed. It is important to learn your Medicare options before you enroll in order to make an informed decision. We can help you understand the nuances of the Medicare systems.
Medicare Breakdown
- Medicare is very protective of its seniors.
- Outside providers that offer supplemental services to Medicare vigorously market their products.
- When comparing similar products, there is very little difference between them.
- There is a short enrollment period for Medicare (October- December).
Original Medicare Part A and B
Medicare Part A:
- The coverage provides for hospital claims (Blue Cross).
- Folks approaching 65 will be notified and automatically enrolled
Medicare Part B:
- This program provides physician services ( Blue Shield).
- Folks must enroll and pay for this coverage.
- Enrolling in Part B is mandatory. It doesn’t mean your have to pay for the coverage at that time. There is a very large penalty for not enrolling.
- There is a monthly premium, a deductible and co-insurance of 20%
Medicare Part D Prescription Coverage for Medicare Part A and B
Doughnut Hole: When your co-pay for pharmacy benefits reach $2,700 you are in the doughnut hole. You must pay full price until you have paid $1,650.00 out of your own pocket. Out of the doughnut hole you now pay the greater of $2.40 or $6.00 per prescription.
Medicare part C: Original Medicare is replaced by a managed care option.
Basically you have to choose Original Medicare or the managed care options called Medicare Advantage.
This takes original Medicare products and allows a third party health carrier to administer the benefits.
- Often this plan provides more benefits and less out of pocket than original Medicare.
- Annual physicals, vision, gyms are paid though national or regional carriers.
- Pharmacy is included.
- It is one stop shopping for a price.
Medicaid
- This is healthcare for folks who are disabled and or poor.
- Taxes pay for this coverage
Long -term Care Insurance (LTCI) Insurance that pays for custodial care is NOT covered by Medicare!
