"Saving you money & time"
Mike Craft Medicare
Senior healthcare advisor
People who are new to Medicare often have a hard time sorting things out in the beginning. There are all these parts and plans with similar letters, which makes it hard to figure out what is what. You are bombarded with literature that is not only un- helpful, but also extremely overwhelming! The time it takes to stay up-to-date and navigate your way through the ever changing Medicare Programs, that includes using multiple web-sites, and marketing calls from different companies is very daunting!
That is what I will do for you at NO COST- Save YOU $ and Time!
IMPORTANT!: Original MEDICARE does NOT cover many healthcare benefits and services that you may need…
Medicare Questions You May Have:
1.) How do I know which Medicare Advantage Plan is best for me and why?
2.) What is the cost of the plan, and is there a monthly premium?
3.) What do I pay to see my doctor, specialist, and lab work?
4.) What if I have to go the hospital, what will I pay?
5.) How much are my prescription drugs?
6.) What is meant by the GAP, and is there a plan that will cover me through it?
7.) What is a Medicare Supplement?
8.) How do I enroll in a Medicare Advantage or Medicare Supplement Plan?
9.) How do I find plan with NO monthly premium cost?
Click the down arrow next to the question to see the answer
In general, Part A covers:
• Hospital care
• Skilled nursing facility care
• Nursing home care (as long as custodial care isn’t the only care you need)
Part B covers 2 types of services
• Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
• Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.
Part B covers things like:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health
- Partial hospitalization
- Getting a second opinion before surgery
Nearly one in three seniors today is choosing to bundle hospital, medical and drug insurance coverage into a single package — and premium — by opting to go with Medicare Part C coverage, better known as a Medicare Advantage Plan.
One good reason why: When compared to the combined costs of purchasing Parts A, B and D insurance, as well as a Medigap policy under Original Medicare, the condensed costs of an Advantage plan appeal to the bottom lines of a growing number of seniors.
Medicare Advantage plans are sometimes referred to as Medicare Part C. They are Medicare-approved private health insurance plans for individuals enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premium.
Medicare Advantage plans provide all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. They generally offer additional benefits, such as vision, dental, and hearing, and many include prescription drug coverage. These plans often have networks, which mean you may have to see certain doctors and go to certain hospitals in the plan’s network to get care.
Medicare Advantage plans may potentially save you money because out-of-pocket costs in these plans can be lower than with Original Medicare, Part A and Part B, in some cases. Pricing will vary by plan provider, so it’s worthwhile to compare all plans in your area. Your costs will vary by the services you use and the type of plan you purchase. Each Medicare Advantage plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or can use only doctors, facilities, or suppliers in the network).
Plan options can include:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-for-Service (PFFS)
- Special Needs Plans (SNPs)
- HMO Point-of-Service (HMOPOS)
- Medical Savings Account (MSA)
As a Medicare beneficiary, you don’t automatically get Medicare Part D prescription drug coverage. This Medicare Part D coverage is optional, but can be valuable if you take medications. If you don’t sign up for Medicare Part D Coverage when you’re first eligible, you might have to pay a late-enrollment penalty if you decide to enroll later.
Many people are automatically enrolled in Original Medicare, Part A and Part B, when they reach 65 years of age. But you may not realize that Original Medicare doesn’t cover most of your medications (except those you may receive as a hospital inpatient or, in some cases, outpatient). Medicare Part B covers certain prescription drugs that you get in an outpatient setting, like a doctor’s office. However, these tend to be the kind of medications that you need a doctor to give you, like infusion drugs.
If you want help with most other medication costs, you’ll need to sign up for Medicare Part D coverage.
- HMO Point-of-Service (HMOPOS)
- Medical Savings Account (MSA)
You can get Medicare Part D prescription drug coverage in two different ways, depending on whether you’re enrolled in Original Medicare or Medicare Advantage. Medicare Advantage, also known as Medicare Part C, is an alternative way to get your Original Medicare benefits through a Medicare health plan, and many plans may also cover benefits beyond the federal program, including prescription drug benefits.
Medicare Part D coverage is available:
• Through a stand-alone Medicare Part D Prescription Drug Plan—you can add this benefit to your Original Medicare coverage. You can enroll in any Part D Prescription Drug Plan that serves the area where you live.
• Through a Medicare Advantage Prescription Drug plan—you can get a Medicare Advantage (Part C) plan that includes prescription drug coverage, so that you get all your Medicare benefits under one plan.
A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.
Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.