Caring for aging parents comes with plenty of challenges on its own. The last thing you want to worry about is your parents’ health insurance needs. Finding the right plan, though, isn’t always as simple as it sounds. Whether your parents are facing medical complications, transitioning to a nursing home, or simply needing help navigating technology to enroll, there are several factors you should consider before they stick with basic Medicare.
Medicare Parts A and B, also known as Original Medicare, offer hospital coverage and outpatient coverage respectively. You can learn more about what Part A and Part B cover exactly by reading this article.
With Original Medicare, you pay for services as you get them. While Medicare will cover a lot of costs, you could still be responsible for deductibles, copayments, and coinsurance. On its own, Original Medicare will not cover supplemental healthcare (such as hearing, vision, or dental care) or prescription drugs.
Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare. This plan bundles your Medicare coverage, including Parts A and B and usually Part D prescription drug coverage. Medicare Advantage can also cover things that Original Medicare does not, like vision, dental, and hearing insurance.
While Medicare Advantage has several benefits over Original Medicare, there are also a few other considerations that need to be made before choosing one Medicare option over another. If your parent has specific doctors or medical needs, you will need to check to make sure those healthcare providers are in-network and whether or not they will need a referral to see certain specialists.
If a Medicare Advantage plan covers all of your parents’ providers and services, however, then it can be a great option for anyone looking for a “one-stop shop” option for their health insurance needs.
Medicare Part D provides coverage for prescription drug costs. This plan is offered by private insurance carriers and is available for purchase as a separate stand alone plan for those with Original Medicare or can also be included as part of a Medicare Advantage plan.
Policies vary by cost and which medications they cover, but even the least expensive prescription drug plans cover most of the generic and brand name drugs generally needed by people on Medicare.
Even if your parents are not currently taking any expensive medications, it is still wise to be enrolled in at least an inexpensive drug plan as there are high financial penalties for adding it later.
A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs that Original Medicare does not cover. This may include copayments, coinsurance, and deductibles.
Not everything falls under Medigap, however. A supplement plan may not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
With a supplement plan, healthcare costs will first be covered by Original Medicare and any leftover may be covered by the Medigap plan.
Finding the right Medicare plan for your parents begins by reviewing their situation and estimating their future healthcare needs.
Trusting a professional is another way to make sure you find the best options for their needs. By consulting a Medicare advisor, you get:
Want to make sure your parents have the best Medicare coverage for their healthcare needs? Our local advisors have decades of experience supporting Medicare beneficiaries in finding the right coverage.
If you’re over 65, we’ve entered the season when your mailbox begins to fill up with advertisements from Medicare Plan carriers wanting to show you the many wonderful benefits they have to offer for the upcoming year. While this can be overwhelming, if not annoying, it does provide you reminders of a couple things:
Many Medicare beneficiaries have been on the same Medicare Advantage Plan for years, and that’s great! If you are fully satisfied with what your carrier has to offer and the network of physicians that accept your plan, then it’s one less thing for you to worry about.
But whatever your situation, would it be such a bad idea to take a little time and compare what your plan is offering versus the other options available to you? Probably not.
The Medicare ANNUAL ENROLLMENT PERIOD starts on October 15th and ends on December 7th. Within these seven weeks, all Medicare Advantage Plan members are free to decide if they want to keep the plan they have, or choose a new one, to start the upcoming year.
Medicare Advantage Plan carriers are required to have their new plan benefits published by October 1st. That gives seniors just over two months to complete a plan review.
It is a fairly simple process that takes about 30 minutes of your time. Here are the steps:
A plan review will either leave you confident that you are on the correct plan or it will reveal a plan that is more suitable for you. You really can’t lose!
If you would like to sit down with a local, experienced, and caring Medicare advisor, our team would be happy to schedule a FREE PLAN REVIEW with you.
Our agents are fully licensed and are knowledgeable on all local Medicare Advantage plans. You could also contact a call center and speak to someone in an entirely different part of the country that may know little about your specific plan or the other available options in the area. But why do that?We can meet with you at our local office, at your home, over the phone, or online. In whatever setting you choose, rest assured that you will be guided by a local agent that can be of service to you year-round and for years to come! Please reach out to us when you’re ready. But remember, the deadline for making a change for next year is December 7th.
Every year there are changes made to Medicare Advantage plans. Sometimes these changes will help you, but other times these changes may mean that something you need is no longer covered by your Medicare plan. That’s why it is so important to take note when your Annual Notice of Change arrives in the mail.
In many cases, you only have one time a year to make changes to your Medicare plan, so you don’t want to waste the opportunity and be stuck with a plan that is no longer right for you.
If you have questions about your Annual Notice of Change, we have answers. Whether your Medicare plan is still right for you or you need to make a switch, we’re here to help you understand your letter and make the best decision for your healthcare needs.
The Annual Notice of Change (ANOC) is a document that you will receive in the mail, usually before the end of September, listing any changes in your Medicare plan coverage, service area, or costs that will change beginning in January. This notice will help you decide if your plan still meets your needs.
Yes – your ANOC letter will come in the mail from your Medicare Advantage plan provider each year before the Annual Enrollment Period. AEP is your opportunity each year to make changes to your plan. It runs from October 15th to December 7th.
Medicare is always changing and an ANOC is your way of seeing what changes will be made to your current plan in the next year so that you can make an informed decision about your healthcare needs.
The changes listed in your ANOC are for the next year. Any changes to costs, coverage, or service area become effective in January. You have until the end of the Annual Election Period, December 7th, to review your coverage and change your Medicare plan.
It is important that you thoroughly review your ANOC for any changes to your Medicare plan. Consider your healthcare needs and make sure that your plan is still the best fit for you. You will want to pay close attention to any changes in costs and coverage.
If your plan will become too expensive or no longer cover all of your prescription drugs or healthcare providers, then it may be time to switch to a new plan. Even small changes can make a big difference if you have to start paying out of pocket for a medication or health service that was previously covered.
If you are unsure about what all of the changes really mean for you, then you can meet with a Medicare advisor to review your ANOC letter together. They can explain the changes and give you all the information you need to make a decision one way or the other.
No – the Annual Enrollment Period is your opportunity to find the Medicare plan that best fits your needs. If the changes being made to your current plan don’t help you, then you can find a better plan.
If you are ready to make a change, contact your Medicare agent, or find a local Medicare advisor, so that you can be sure you are switching to the best health coverage for your needs.
An agent will help you review all of the changes in your ANOC, compare your current plan with your healthcare needs, narrow down your search for a new plan, and can even help you enroll in Medicare plans. They will take the burden off your shoulders so you can go back to enjoying your life.
Concerned your Medicare coverage is no longer right for you? Schedule a meeting to review your benefits with a licensed Medicare advisor to ensure you have the Medicare plan that is right for you. Medicare Annual Enrollment Period ends December 7th, so it's important you review your plan and make any changes before then.
As we age, our health needs change, and older adults, especially, face many challenges when it comes to taking care of their health. Among the most challenging is navigating the government-sponsored healthcare coverage program for seniors. The golden years of retirement can be overshadowed by the bombardment of telephone calls and excess junk mail all about Medicare. It’s no wonder so many older adults get confused when it comes to making the right choices for their healthcare coverage and therefore rely on outside help.
About 19% of Americans act as caretakers for a spouse, parent, grandparent, or community member; and the majority of individuals being cared for rely on Medicare or Medicaid. Even adult children whose parents and grandparents are still independent often end up helping their loved one navigate the healthcare system.
One of the first steps to being able to help your parent, grandparent, or other loved one enroll in Medicare is to understand the process. Keep reading to learn more about the different parts of Medicare, how Medicare enrollment works, and how to find the Medicare plan that best fits your loved one’s needs.
Medicare is a complex system that can be difficult to fully understand, especially when there is a wealth of information available. We’ll start simple by defining Medicare and all its basic parts.
Medicare is the U.S. government’s largest health insurance program that provides affordable healthcare coverage to eligible adults. With Medicare, there are a few different options for how to get coverage.
Medicare Parts A and B, or Original Medicare, offer hospital coverage and outpatient coverage respectively. Part A pays for room and board at the hospital and some other healthcare facilities. Part B includes almost everything that Part A doesn’t cover, like doctor visits, medical equipment, lab work, surgeries, therapy, and more.
With Original Medicare, the recipient pays for services as they get them. While Medicare will cover a lot of costs, your loved one could still be responsible for deductibles, copayments, and coinsurance. However, they may also be eligible for Medigap, supplemental insurance, to help cover those costs. If your loved one needs prescription drug coverage, they can also apply for Medicare Part D.
Medicare Part D provides coverage for prescription drug costs. This plan is offered by private insurance carriers and is available for purchase as a separate stand-alone plan for those with Original Medicare or can also be included as part of a Medicare Advantage plan.
Medicare Part C, or Medicare Advantage, is an optional, low-cost alternative to Original Medicare offered by private, Medicare-approved insurance companies. These “all-in-one” plans bundle Medicare coverage, including Parts A and B and usually Part D prescription drug coverage as well. Medicare Advantage can also cover things that Original Medicare does not, like vision, dental, and hearing insurance.
A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs that Original Medicare does not cover. This may include copayments, coinsurance, and deductibles. Not everything falls under Medigap, however. A supplement plan may not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing. Medicare Supplement plans are offered by private insurance carriers.
There are multiple Medicare enrollment periods that your parent or loved one may be eligible for. Individuals become eligible for Medicare when they turn 65. Younger adults who are disabled or have End-Stage Renal Disease may also be eligible for Medicare.
It is important to do your research and know the date cutoff for their enrollment period in order to make sure they are enrolled without any penalties.
Initial Enrollment Period: IEP begins three months before your 65th birthday and ends three months after the month that you turn 65. In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you will have to pay a late enrollment fee for as long as you have Part B and could have a gap in your health coverage.
Annual Enrollment Period: AEP begins October 15 and ends December 7 each year. During this time, beneficiaries are able to make changes to their existing Medicare plans.
Open Enrollment Period: OEP allows beneficiaries to make a one-time change to their Medicare Advantage Plan from January 1 through March 31. During this time, you can also sign up for Medicare if you missed your window, but fees and gaps in coverage may apply.
Special Enrollment Periods: SEPs are available under certain circumstances throughout the year, such as moving out of your existing plan’s service area or retiring from a job that previously provided your benefits. Generally, there are no late fees associated with signing up for Medicare during an SEP, but the eligibility requirements vary.
There are pros and cons to each Medicare plan, but the most important thing is to find the plan that best fits your parent or loved one’s needs. Determining this will depend on a few factors unique to their circumstance, such as where they live and what kind of care they expect to need.
Here are a few other things to consider:
Cost: How high will the beneficiary’s out-of-pocket expenses be? This could include monthly premiums, deductibles, copayments, or coinsurance.
Benefits: Does the plan cover any additional healthcare services they need? For example, prescription drugs, vision, dental, or hearing insurance.
Convenience: Are the in-network providers conveniently located? Are their preferred healthcare providers in-network?
Needs: Have they required healthcare in the past few years? Do they anticipate an increased need for care? Do they often see specialists for a health condition?
All of these factors impact which plan is right for your loved one. And often two plans can seem very similar, yet the smallest difference can dramatically change their fit.
To make sure you get it right the first time, your best option may be to discuss your parent or loved one’s situation with a Medicare advisor. A professional can help you weed through the excess information and find the exact plan that will best serve your loved one.
If you're helping a loved one or parent enroll in Medicare our experienced Medicare Advisors are here to support you if you have a question. You can also explore more of our Medicare Resources to educate yourself on all things Medicare.
For the average individual, Medicare can be confusing, overwhelming, and difficult to understand. Once you throw in the word "advantage," the game changes, but it remains equally confusing, overwhelming, and difficult to understand!
If you're currently trying to figure all this out and wondering to yourself "What's Medicare Advantage?" "How does it work?" and "How does it differ from Medicare itself?" then you're definitely not alone.
But, here's the good news: while it can seem like a lot of information and appear difficult to understand, it's not difficult to find the answers you want and the help you need. In fact, we've gone ahead a laid out a few answers to common questions for you!
Medicare Advantage became a common term after the 2004 Medicare Modernization Act, but it’s been around since the 1980s.
While Medicare has many parts – A for Hospital Insurance, B for Medical Insurance, and D for Prescription Drug Coverage – the “advantage” to Medicare Advantage Plans is that they offer bundled plans that combine parts A, B, and even D for maximum coverage and ease. These plans are typically offered by a private company that contracts with Medicare and they offer several options, depending on your needs.
Medicare Advantage is really Medicare “Part C” (get it? A, B, C, D…), but it’s been called many things – like Medicare Plus Choice, MAPD, and Medicare Replacement. All of these terms are synonymous – they mean the same thing!
Medicare Replacement can have negative connotations, but there’s nothing to be concerned about. When the term Medicare Replacement is used, it’s simply a clear way of describing what happens when you choose to allow a private insurance company to administer your Medicare entitlement program.
Don’t worry, though, you’re not giving up your Medicare, you’re simply letting your carrier be fully responsible for providing benefits, paying claims, and enriching your plan through additional features and services.
When it comes to Medicare Advantage plans, the key thing to remember is that they are basically an all-in-one alternative to Medicare itself. Individuals who are on a Medicare Advantage Plan still have Medicare, but many plans offer additional coverage – like dental, vision, hearing, health and wellness programs, and more!
Medicare Advantage plans can vary. While they all provide Medicare services, they vary in the particulars.
Some offer, as stated before, additional benefits like dental and vision.
The way this works is relatively simple. First, Medicare will pay a fixed amount each month to your carrier for your coverage. In order to receive these funds, Medicare Advantage plans must follow certain protocols laid out by Medicare. After that, Medicare Advantage plans do have some variances like out-of-pocket costs and whether or not you’ll need a referral in order to see a specialist. These rules can change each year.
Medicare Advantage plans are a simple way for you to gain more out of your Medicare and a lot of people are taking “advantage” of them!
In fact, because of a growing number of carriers and robust offering plans, Medicare Advantage plans are enjoying their highest rate of participation in over 30 years – and that number continues to grow. These plans have demonstrated a higher average quality of health outcomes in participants and have been strongly supported by the Medicare Trust Fund and others who legislate our healthcare nationally.
This is great news for you. As these plans grow and increase, the benefits will as well.
Choosing the right Medicare Advantage plan depends on you! If it doesn’t meet your needs and expectations (or the needs and expectations of your spouse/loved one) then it’s not the plan you need.
Because there’s so much variance with Medical Advantage plans, it’s often helpful to find a local advisor/agent who can explain exactly what a Medicare Advantage plan provides, how you will benefit from it, and what you can expect going forward. Plus, these agents will cost you nothing!
Agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities.
They can even provide ongoing care, no matter what you might encounter with your plan.
Common needs are:
To put it plainly, Medicare Advantage is exactly as it sounds. It’s Medicare with additional benefits.
Whether or not those benefits take the form of a Part D Drug plan, dental insurance, vision care, etc., or they include initiatives like gym memberships, wellness rewards, over the counter allowances for the purchase of health-related items, and meals for those recently home from a hospital visit, Medicare Advantage is a simple way to get more out of Medicare.
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!
If you’re new to Medicare and considering Medicare Advantage Plans, then you might be wondering what exactly is covered by Medicare Advantage Plans and what makes one option better than another.
Medicare (Original Medicare) has many parts - A for Hospital Insurance, B for Medical Insurance, and D for Prescription Drug Coverage. Medicare Advantage Plans are considered "Part C".
The benefit of choosing a Medicare Advantage Plan is that they offer bundled plans that combine parts A, B, and even D for maximum coverage and ease. These plans are typically offered by a private company that contracts with Medicare and they offer several options, depending on your needs.
The short answer to the question "What do Medicare Advantage Plans cover?" is this: Everything covered under Medicare is covered by Medicare Advantage Plans. Medicare Advantage Plans can only offer more coverage – not less!
The long answer to the question is detailed below...
Part A plans are critical to your healthcare needs and, thankfully, are required coverage on all Medicare and Medicare Advantage Plans.
Part A plans are considered "hospital insurance." In other words, this part of Medicare makes sure that you have inpatient hospital coverage – and it’s included in any Medicare Advantage Plan.
While there are some limitations included with Part A, you’re covered when it comes to the following needs:
This includes care received at acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals, inpatient care as part of a qualifying clinical research study, and mental health care facilities.
The reason you might consider choosing a Medicare Advantage Plan rather than Medicare alone is that you might gain additional benefits along with your inpatient hospital coverage.
This coverage will vary based on your Medicare Advantage Plan, but only for the better. You will always receive the same coverage that Original Medicare offers for Part B, but you will see some variance in plans when it comes to additional Part B benefits.
The most helpful way to consider Part B coverage is to see it as two parts: One being necessary medical coverage and the other being preventative medical coverage.
Medically necessary coverage is anything (services or supplies) needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine – like stitches!
Preventative medical coverage is anything used to prevent illness (like a flu shot) or detect it at an early stage, when treatment is most likely to work best.
Medicare Part D coverage is an optional benefit to everyone who has Medicare. Part D coverage is coverage for prescription and even over the counter drugs – depending on your plan. Your medications and even certain vaccines will fall under Part D coverage.
Medicare Advantage Plans often offer Parts A, B, & D in a perfectly bundled package – which is one of the biggest benefits to choosing a Medicare Advantage plan.
As you consider your Medicare Advantage Plans, it’s important to study what is included in them. Not all are created equal and Part D coverage is a key differentiator!
Not only will you want to make sure your plan includes Part D coverage, but you’ll want to understand what is included within that coverage and whether it’s the best plan for you.
In addition to Original Medicare coverage and (oftentimes) Part D coverage, Medicare Advantage Plans often include additional benefits.
Most common benefits include dental, vision, and hearing care, but this list is expanding.
Wellness programs are a common addition to Medicare Advantage Plans. This would include gym memberships, weight loss programs, and more.
Other benefits can include transportation to doctor appointments, adult daycare, over the counter drugs, etc.
Whether you’re looking for a plan with a Part D Drug plan, dental insurance, vision care, etc., or not, Medicare Advantage Plans are a simple way to get more out of Medicare. You can only get more coverage when you choose a Medicare Advantage Plan.
Choosing the right Medicare Advantage plan depends on you! If it doesn't provide the coverage you need and expect (or the needs and expectations of your spouse/loved one) then it's not the plan you need.
One important option to consider is to simply get help. Because there's so much variance with Medical Advantage plans, it's often helpful to find a local advisor/agent who can explain exactly what a Medicare Advantage plan provides, how you will benefit from it, and what you can expect going forward. Plus, these agents will cost you nothing!
Plan Advisors Medicare agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities.
They can even provide ongoing advice, no matter what you might encounter with your plan.
Common needs are:
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!
If you’re new to Medicare and considering Medicare Supplement Plans, then you might be wondering what exactly is covered by Medicare Supplement Plans and what might make one option better than another.
Medicare Supplement Plans combine with original Medicare plans to "fill in the gaps" of traditional Medicare coverage. While similar to Medicare Advantage Plans in many ways, Medicare Supplement Plans, are different in that Medicare is not included in the plan, the plan merely works in addition to Medicare.
You will pay a monthly premium for any Medicare Supplement plan – in addition to the monthly premium you pay towards your Medicare plan.
The benefit to choosing a Medicare Supplement Plan is that they offer additional coverage to Medicare plans and there are several different plans available. This way, there is more available to you to choose and you can find a plan that’s a little more specific to your needs.
But how do you know which plan is right for you?
It’s not easy to choose between plans – especially when there are many options available.
Medicare Supplement Plans are typically labeled A-D, F, G, K, L, M, and N.
Pricing can feel like the obvious decision-maker, but oftentimes, with Medicare Supplement Plans, the pricing is pretty standardized between carriers. The only difference in pricing would be between the different plans themselves (like Plan F vs. Plan N).
The biggest thing to consider is that, if you choose a supplement plan based simply on pricing, you run the risk of not having the coverage you need.
What you have to consider in this case is what’s important to you – what coverage do you see yourself requiring the most?
Medicare Supplement Plans can include the following coverage:
When you’re choosing between plans, consider what you need coverage for the most and which options you might want to consider going without.
For example, maybe know in advance that you’ll need Part B coinsurance or copayment and Blood, but you don’t see any need for skilled nursing facility care coinsurance. Then, you might choose Medicare Supplement plans A or B.
In order to differentiate themselves from the pack, many carriers are choosing to add ancillary benefits to their Medicare Supplement Plans.
These benefits can include discounted dental and vision plans, as well as, special fitness programs and more.
This serves to allow carriers to provide their client’s with a clear differentiator – something that allows their supplement plan to stand out against the competition.
The important thing to remember in this, is that no matter what carrier you choose, your A-D, F, G, K, L, M, and N Medicare Supplement Plans will all offer the same benefits and come at the same or similar premiums.
One carrier might offer an additional benefit, but you will not lose coverage on any of the plans that you choose from one carrier to another.
Medicare Supplement Plans are a simple way to get more of what you need. They literally supplement Medicare, so that you can get the exact coverage you need.
These types are plans are typically a better option for those who don’t need all the bells and whistles that come with Medicare Advantage Plans, but still need more coverage than what’s provided through Original Medicare.
Choosing the right Medicare Supplement plan really depends on you! If it doesn't provide the coverage you need and expect then it's not plan you need.
One important option to consider is to simply get help. Because there's so much to consider with Medicare Supplement Plans, it's often helpful to find a local advisor/agent who can explain exactly what each Medicare Supplement Plan provides, how you will benefit from it, and what you can expect going forward. Plus, these agents will cost you nothing!
Agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities.
They can even provide ongoing advice, no matter what you might encounter with your plan.
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!
Are you new to Medicare and wondering about eligibility?
Medicare can be confusing, overwhelming, and difficult to understand – for anyone.
If you're currently trying to figure all this out and wondering the best ways to go about a Medicare eligibility check for different Medicare plans, don’t worry.
While it can seem like a lot of information and appear difficult to understand, it's not difficult to find the answers you want and the help you need.
In fact, we've gone ahead a laid out a few answers to common questions for you! We’ll walk you through it step by step...
Medicare is a federal health insurance program.
It has many parts:
A – Medicare for Hospital Insurance. This covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
B – Medicare for Medical Insurance. This covers certain doctors’ services, outpatient care, and preventative services.
D – Medicare for Prescription Drug Coverage. Part D is often offered by insurance companies and other private companies approved by Medicare and adds prescription drug coverage to Original Medicare and other Medicare-related plans.
These parts can be, and often are, supplemented through Medicare Advantage Plans or Part C.
If you’re wondering if you are eligible for Medicare coverage or who exactly is, then you’re not alone.
In general, Medicare is available for people at or over the age of 65. In addition, some individuals under the age of 65 can qualify based on disabilities or if they have been diagnosed with End Stage Renal Disease (like permanent kidney failure which requires dialysis or a transplant).
Some individuals qualify for Medicare premium free.
You can get Part A Medicare, premium-free, if you meet one of the follow requirements:
You are eligible to receive Social Security or Railroad benefits
You (or your spouse) had Medicare-covered government employment
You are under the age of 65, but you have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months
You are a kidney dialysis or kidney transplant patient
If you do not qualify based on any of these requirements, but you are over the age of 65, then you might qualify to simply buy it.
For Parts B & D, there is a premium, but this can be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.
If you do not qualify based on any of these requirements, but you are over the age of 65, then you might qualify to simply buy it.
For Parts B & D, there is a premium, but this can be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.
When it comes to Medicare Advantage plans, the key thing to remember is that they are basically an all-in-one alternative to Medicare itself. Medicare Advantage plans are a simple way for you to gain more out of your Medicare.
Individuals who are on a Medicare Advantage Plan still have Medicare, but many plans offer additional coverage - like dental, vision, hearing, health and wellness programs, and more.
These plans have demonstrated a higher average quality of health outcomes in participants and have been strongly supported by the Medicare Trust Fund and others who legislate our healthcare nationally - which is great news for you. As these plans grow and increase, the benefits will as well.
If you’re still in the dark about whether you are currently eligible for Medicare, we have good news!
There are two simple ways to learn if you qualify:
Click here to complete this Medicare eligibility check! It will help you determine exactly what options you qualify for and you’ll even find a helpful premium calculator.
Another easy way to learn if you’re eligible for Medicare is to simply get help. Because there's so much to consider when it comes to Medicare eligibility, it's often helpful to find a local advisor/agent who can explain exactly what you qualify for, what plans you have to choose from, and what you can expect going forward.
Plus, these agents will cost you nothing! Agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities. They can even provide ongoing advice, no matter what you might encounter with your plan.
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!
If you’re new to Medicare Advantage plans, or maybe you’re considering switching your current plan, you might have some questions about Medicare Advantage Enrollment periods.
You’re not alone! Medicare Advantage Enrollment periods go by many names, and, you might be surprised to know, there’s more than one time of year when you can join and/or switch a plan.
A lot of this depends on what plan you currently have, your age, and what time of year it is!
Don’t worry – we’ll explain everything you need to know when it comes to Medicare Advantage Enrollment periods. Let’s get started!
Your eligibility for Initial Enrollment Period depends on you! Initial Enrollment Periods are all about dates that are specific to you.
Typically, you have a 7-month window for open enrollment. This would mean that you could enroll three months prior to your birthday month (turning 65), during your birthday month, and three months after.
Or, if you are eligible due to disability, your enrollment period would being three months prior to your 25th month of getting Social Security, three months after your 25th month of getting disability benefit, and include your 25th month of getting disability benefits.
Outside of these enrollment periods, if you are already enrolled in Part B, then you might qualify to enroll in a Medicare Prescription Drug Plan or Part C (Medicare Advantage) plan between April 1st and June 30th.
If you’re unsure about your exact enrollment periods, dates, or what you qualify for, you might want to talk to a Plan Advisor near you. It’s always helpful to get an expert’s opinion! (link to blog about Medicare coverage)
This open enrollment period is for Medicare Advantage and Medicare Prescription Drug Coverage. If you’re looking to enroll in Medicare Part C and/or D, this is the time for you!
This Annual Enrollment Period (AEP or YEP) occurs each fall, from October 15 to December 7.
During this period of time, you can choose from several options:
Yes, this Medicare Advantage Open Enrollment Period is a new addition as of 2019!
During this period, from January 1st to March 31st, you are once again able to switch things up. But, be careful. Not everything is available for change during this time.
Here’s what you can do during this period:
Additionally, if for some reason you did not sign up from Medicare A or B during your Initial Enrollment Period, you have a chance to do so now – though there may be a slight late enrollment penalty (especially for Part B – most people are eligible to receive Part A for free).
Here's what you can’t do during this period:
There's so much to consider when it comes to Medicare Advantage Enrollment. When to do it, what you are eligible for, which plans are best – this list goes on!
Because of this, it's often helpful to find a local advisor/agent who can explain exactly what you qualify for, what plans you have to choose from, when you can enroll, and what you can expect going forward.
Plus, these agents will cost you nothing! Agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities. They can even provide ongoing advice, no matter what you might encounter with your plan.
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!
If you’re eligible for Medicare, or going to be soon, and you’re currently seeking to choose a Medicare plan, then you might be a little overwhelmed! There’s a lot of information to compare, contrast, and consider. It can be intimidating to try to delve into the differences between Original Medicare and Medicare Advantage plans and find one that works for you. The pros and cons are plentiful!
The good news is, we’re here to help.
With Original Medicare, there are a few clear benefits that are worth mentioning.
One of these is that you don’t have to "choose" a plan. With Original Medicare, as long as you’re already receiving Social Security benefits, you’ll automatically receive Medicare Parts A and B as soon as you become eligible.
If you’re not currently receiving benefits from Social Security, you simply have to sign up for Medicare Part A and B. You can sign up online, or through your local Social Security office. They’ll review your records and determine your eligibility.
Other benefits of Original Medicare include:
That’s right. You can choose any doctor you like – as long as they accept Medicare assignment. But, this is a great benefit because many Medicare Advantage plans require that you choose a doctor on the plan’s network, which might not coincide with your preferences.
Unlike Medicare Advantage plans, you can receive full Medicare coverage no matter where you are in the U.S. This means you’re safe to travel and/or live wherever you’d like.
This can be a big perk for those who regularly require or prefer to visit a specialist. Original Medicare does not require a referral from a primary care doctor in order to see a specialist.
Original Medicare is oftentimes more expensive and offers fewer benefits than Medicare Advantage plans.
Additionally, Original Medicare does not include prescription medication (Medicare Part D), and it doesn’t cover long-term care, dental care, eye glasses prescriptions, hearing aids, and other non-essential but beneficial medical needs.
Medicare Advantage plans communicate benefit in the name itself. There IS generally an advantage to choosing one of these plans!
One major advantage is that you have a plethora of plan options to choose from – each with different benefits from the last. With Medicare Advantage, you’re more likely to find a plan that’s specific to your needs.
Other benefits of Medicare Advantage plans include:
One of the most significant benefits of a Medicare Advantage Plan is the coverage. With these plans, you typically gain more coverage for less money.
While all Medicare Advantage Plans, like Original Medicare, include Medicare Parts A and B, they can also include benefits that Original Medicare specifically does not cover – like Dental, Vision, and even health and wellness programs.
Surprisingly, Medicare Advantage plans oftentimes are less expensive than Medicare itself (especially considering the additional coverage they offer).
Premiums for Medicare Part A can be as low as $0. Plus, many plans include an "Out of Pocket Maximum" which means that your plan will begin covering your medical needs in FULL once you’ve reached this limit.
Most, if not all, Medicare Advantage plans include some type of prescription drug coverage. This is one of the biggest benefits to choosing a Medicare Advantage plan over Original Medicare.
Prescription drugs are something that we all need at some point or another and having an insurance plan that covers this need is key!
As stated before, there are a lot of options when it comes to Medicare Advantage plans. This can be a negative, as it takes time to sift through options and find what’s best for you.
Additionally, three of the main benefits to choosing Original Medicare are three of the main cons to choosing Medicare Advantage!
Medicare Advantage plans are often regional. In order to receive coverage, you must reside in the area that your Medicare Advantage plan services for at least six months out of the year. They also tend to require referrals from your primary care physician to receive specialist coverage and you may even have less physicians to choose from. These plans often have a list of providers in their network that you can choose from, rather than the freedom of choosing any health care provider who accepts Medicare.
There's so much to consider when it comes to choosing a Medicare plan - especially one that’s right for you.
Because of this, it's often helpful to find a local advisor/agent who can help you choose between Original Medicare and a Medicare Advantage plan. They can explain exactly what you qualify for, what plans you have to choose from, when you can enroll, and what you can expect going forward.
Plus, these agents will cost you nothing! Agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities. They can even provide ongoing advice, no matter what you might encounter with your plan.
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!
