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Medicare Part A covers your hospital expenses. This includes hospital stays, skilled nursing care, hospice, and home health-care services. You may have to pay various deductibles, coinsurance, and copayments. You earn Part A by paying taxes toward Medicare while working for 10 years (or 40 quarters). If you did not earn Part A, you will pay a premium.
Medicare Part B covers services that treat illnesses or conditions such as doctor’s office visits, lab work, x-rays, and outpatient surgeries. It also covers preventive services like cancer screenings and flu shots. Part B also covers medically necessary durable medical equipment such as wheelchairs and walkers to treat a disease or cond
Medicare Part B covers services that treat illnesses or conditions such as doctor’s office visits, lab work, x-rays, and outpatient surgeries. It also covers preventive services like cancer screenings and flu shots. Part B also covers medically necessary durable medical equipment such as wheelchairs and walkers to treat a disease or condition. Most people pay a premium for Part B. Even if you are enrolled in a Medicare Advantage plan that provides your Part A and Part B benefits, you will still pay your Part B premium.
Original Medicare doesn’t cover prescription drugs. Although Medicare Part D coverage is optional, it can be valuable if you take medications. You will pay a late-enrollment penalty if you don’t sign up for Medicare Part D Coverage when you are first eligible. You can get Medicare Part D prescription drug coverage either through an indep
Original Medicare doesn’t cover prescription drugs. Although Medicare Part D coverage is optional, it can be valuable if you take medications. You will pay a late-enrollment penalty if you don’t sign up for Medicare Part D Coverage when you are first eligible. You can get Medicare Part D prescription drug coverage either through an independent Prescription Drug Plan (PDP), or through a Medicare Advantage Plan that includes prescription drug coverage.
A Medicare Supplement Insurance Plans is used with original Medicare. Any caregiver that accepts Medicare will take a Supplement because they only need to bill Medicare. Medicare pays their part (generally 80% of Medicare covered benefits) and sends the remainder of the bill to the Supplement which pays their part (generally 20%). It is important to note that Supplements do NOT include Prescription Drug Coverage (Part D, PDP) and for those that do not get a PDP when first eligible there will be a penalty when they do get a PDP. (there are exceptions to this) A Medicare Supplement does not change year to year (although the cost does generally go up the coverage does not change).
Our team of ex Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These "bundled" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare drug coverage (Part D).
Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.
A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.
Please reach us at parker@vailins.com if you cannot find an answer to your question.
There are a lot of moving parts to Medicare. That’s why our licensed agents provide a thorough needs assessment and presentation. They will take as much time as you need to ensure you understand your rights and benefits. Below are the basics of what
Original Medicare covers:
Part A: helps cover hospital bills
Part B: helps cover outpatient procedures and doctor’s visits by paying 80%
of services approved by Medicare
Understanding your options is essential before you pick a plan. Our licensed agents are ready and waiting to assist you. Until then, we have provided some basic differences between plans.
Medicare Advantage
Medicare Advantage plans are an alternative way to get Original Medicare (Part A and B) coverage. Offered by Medicare-approved private companies, these plans are typically network based and may include benefits not included with Original Medicare.
Medicare Supplement Insurance (Medigap)
Typically, these plans help cover the Member’s out-of-pocket costs after Original Medicare (Parts A and B) pays. There are many plan options to choose from and cost varies between carriers and plans. Plans are standardized and identified by letters of the alphabet.
Prescription Drug Plans (Part D)
Though Medicare prescription drug coverage is optional, if individuals go without creditable prescription drug coverage, they may be subject to a late enrollment penalty. Prescription drug plans are offered by Medicare-approved private companies and can vary in cost and specific medications covered. Co-pays will depend on the drug tier.
Medicare Advantage Special Needs Plans
People who are eligible for Medicare AND Medicaid may qualify for these plans which pick up cost-sharing such as co-pays and deductibles. Eligibility is determined by State and/or Federal government program requirements. Our agents will work with you to see if you qualify.
Chronic Illness
People with Chronic conditions such as Diabetes, COPD or Chronic Heart Failure may be eligible for additional benefits that are specific to issues that occur with different types of chronic conditions. Ask our agents for more information.
Prescription Drug costs are not covered by Original Medicare (Parts A and B). Prescription Drug plans can be purchased as stand-alone plans or included as part of a Medicare Advantage plan. Our agents can help you choose a plan that fits your needs.
Most people want to go to a specific doctor or provider, and we understand how important that is to you. Luckily, there are many plans to choose from and our agents will help you find a plan that is accepted by your preferred doctor.
Phone: (520)981-0074 Email: parker@vailins.com
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