Medicare
Medicare is health insurance that the federal government provides for seniors 65 and older, people with certain disabilities, and people with permanent kidney failure. It’s easy to feel overwhelmed by all the information you’ll need to review before signing up for Medicare benefits. You’re likely to have many questions and need a trusted source for advice. Muneris can help. Our knowledgeable staff can make sense of your Medicare benefit and supplemental coverage options so you can make the best selection.
You need to sign up for Medicare about three months before you turn 65.
Medicare PDP Explained
Medicare Part A
(Hospital Insurance) helps cover your inpatient care in hospitals. It also helps cover skilled nursing facility, hospice, and home health care if you meet certain conditions.
You need to sign up for Medicare about three months before you turn 65. You are eligible for premium-free Part A if you are 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.
Although most people do not pay a premium for Part A; there are costs associated with your Part A coverage. Part A has a per-benefit-period deductible that changes each year. Part A only pays 80% of your Medicare-approved charges
Medicare Part B
(Medical Insurance) helps cover medically-necessary services like doctors’ services and outpatient care. It also helps cover some preventive services to help maintain your health and keep certain illnesses from getting worse. All Medicare beneficiaries must pay a Medicare Part B premium. Part B premium is indexed to annual income.
Part B premiums are deducted monthly from your Social Security, Railroad Retirement or Civil Service Retirement checks. Premium amounts change each year.
Like Part A, your Medicare Part B has additional costs as well. Medicare Part B has an annual deductible of $183, and it pays only 80% of your Medicare-approved charges.
Medicare Part C
(Medicare Advantage Plans) combines Part A, Part B, and, sometimes, Part D (prescription drug) coverage under one plan. Part C plans are managed by Medicare-approved private insurance companies and must cover medically-necessary services. However, these plans can charge different co-payments, coinsurance fees, or deductibles for the services they provide.
Medicare Part D
(Medicare Prescription Drug Coverage or PDP) helps cover prescription drugs and may help lower your costs and protect against higher costs in the future.
Anyone with Medicare Part A and/or Part B can join a Medicare Prescription Drug Plan offered in your area. If you are in a Medicare Advantage Plan, your plan may also offer drug coverage.
Medicare Advantage
What is a Medicare Advantage Plan?
- Private insurance companies approved by Medicare to provide this coverage
- Provides Medicare beneficiaries a choice in how they receive Medicare coverage
- MA plans are NOT Medicare Supplement plans
- All MA plans must offer all benefits of Original Medicare and can include Part D prescription drug coverage
- All plans have a maximum out of pocket expense limit indexed and changed each year by the government
- MA plans include emergency coverage when traveling outside the US
Why Choose Medicare Advantage Plans?
- Most plans include medical and RX coverage combined
- Most plans have lower out of pocket costs than Original Medicare
- Most plans include networks of providers such as HMOs, PPOs
- Predictable copayments and deductibles similar to an employer plan
If you are inquiring about a Medicare Advantage Plan or Part D coverage, you must contact Muneris personally. Agents and Brokers are prohibited from contacting you directly for information regarding Medicare Advantage Plans and/or Part D coverage. Thanks for your understanding regarding CMS rules.
Are you eligible for a Medicare Advantage plan?
In order to enroll in a Medicare Advantage Plan you must:
- Be enrolled in Medicare Parts A and B
- Permanently reside in the service area
- Must not have End-Stage Renal Disease (ESRD) unless you:
- Have another health plan from the same organization within the same state, or
- Were enrolled in a Medicare Advantage plan that was terminated or discontinued after 12/31/98, and this is your first election since that happened.
Medicare Supplements
Medicare supplements, often called Medigap insurance, are private insurance policies that supplement, or fill the gap between original Medicare coverage and out-of-pocket costs. These plans help pay for Part A and B deductibles, co-pays and coinsurance and extras like extended hospital stays and foreign travel emergencies. You must be enrolled in Medicare Part A and B to purchase a Medicare supplement policy.
There are 12 different standardized Medigap plans offered, lettered A through L. To follow federal and state law, every Medigap policies must have specific benefits so you can easily compare them.
Premiums for Medigap policies are based on participant enrollment age and geographic area. As with the Medicare Advantage Plans, Medigap premiums are paid in addition to the Medicare Part B deductible.
Which Medicare Supplement plans are right for me?
Medicare Supplement and drug coverages options can be confusing at times. Don’t worry, We are here to help and help you find the best available plans in your area. Our licensed agent can guide you to find a plan based on your needs.
Muneris has assisted individuals and families with their coverage needs since 1990.
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