Medicare Advantage Plans
Medicare is for people 65 or older. You may also be eligible to get Medicare earlier if you have special conditions like disability, certain chronic diseases like; End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig's disease). Medicare is divided in four parts.
Understanding Medicare Parts
- Medicare Part A
Covers mostly hospital inpatient stays, skilled nursing, hospice and some home health care services. - Medicare Part B
Covers outpatient services like; doctors and specialists visits, lab, radiology, durable medical equipments, outpatient surgeries and outpatient ER visits - Medicare Part C (also known as Medicare Advantage)
Combines Part A and Part B, OR Combines Part A, Part B and Part D - Medicare Part D
Covers only prescription drugs.
What Are Medicare Advantage Plans?
Medicare Advantage plans are offered by private insurance companies who are contracted by Medicare to provide all services covered by traditional Medicare, and follow the rules set by Medicare. These companies also offer additional services like; dental, vision, hearing aids, transportation, OTC products and gym membership.
These additional services are not covered under traditional Medicare, which makes Medicare Advantage plans very attractive. Medicare Advantage plans covers Part A and Part B. Some Medicare Advantage plans do not include prescriptions coverage, but most plans do, and are all included in one plan. Plans that include prescription coverage are called: Medicare Advantage Prescription Drug Plan or "MAPD".
Medicare and Medicaid Combined
Some individuals with limited income may qualify for Medicaid, combining both Medicare and Medicaid coverages. In the state of California, Medicaid is also referred to as "Medi-Cal". Individuals who qualify for both Medicare and Medicaid are also called "Duals" or "Medi-Medi". Depending on the state's medicaid qualification thresholds, the benefits can either be full or partial. After the Medicaid qualification, Medicare becomes the primary insurance, and Medicaid becomes the secondary. Secondary insurance helps pick up any copays and coinsurance for some part B and part D services.
What Are Medicare Supplement Plans?
Medicare Supplement plans AKA "Medigap" are also offered by private insurance companies, these companies are contracted by Medicare to provide all services covered by traditional Medicare and follow the rules set by Medicare. Seniors who can afford paying a monthly premium, can enroll in Medicare Supplement plans if they have Medicare Part A and Part B benefits.
How To Enroll In Medicare
When you become Medicare eligible, usually a few months before turning 65, you will receive your Medicare card from Social Security Department. Check with your local Social Security office if you experience any delays or difficulties obtaining your Medicare card.
Your new Medicare card will have your name, and a number that is unique to you instead of your Social Security Number to protect your identity. The card will also show the effective dates for both Part A and Part B. If you have only Part A, it will only show Part A effective date. After receiving your card with both Part A and Part B benefits, then you'll be ready to join a Medicare Advantage Plan, or a Medicare Supplement Plan.
Understanding Medicare and Enrollment Help
Understanding all these Medicare parts and enrollment rules can be confusing and complex, which is why our agents at Limeret insurance services will step in and help you figure all this at no cost. We always look forward to working with seniors living in these states; California, Arizona, Texas, Pennsylvania, Ohio, Michigan, North Carolina and Florida.