MEDICARE
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What's Medicare?

Medicare is the federal health insurance program for:

  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

The different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Medicare Part D (prescription drug coverage)

Part D adds prescription drug coverage to:

  • Original Medicare
  • Some Medicare Cost Plans
  • Some Medicare Private-Fee-for-Service Plans
  • Medicare Medical Savings Account Plans

These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

 

MEDICARE

We can help you get the medicare coverage that works best and is most affordable for you. We can sign you up for Medicare, explain all of the parts of Medicare: Part A, B, C, and D and provide you with the Medicare Supplemental Plans and Prescription Drug plans available to you in your state.  We take care of the entire application process for you.

Medicare is a federal health insurance program for people 65 and older and others with disabilities.  When you turn 65 you become eligible for Original Medicare which is Medicare Parts A and B.   Or you can choose a Medicare Advantage Plan or a Medicare Supplement Insurance Policy and Prescription Drug Plan.  There are many options and varying price plans.

Happy senior couple in autumn park

A Medicare Advantage Plan — also known as “Part C” or “MA Plan” — is offered by private companies that are approved by Medicare. If a person chooses to enroll in a Medicare Advantage Plan, they still have Medicare; their Medicare Part A coverage (Hospital Insurance) and Medicare Part B coverage (Medical Insurance) coverage is provided by the Medicare Advantage Plan — and not from Original Medicare. In addition, most Medicare Advantage Plans include prescription drug coverage (Part D).

These plans cover all Medicare services, and most of them also offer additional coverage such as vision, hearing and dental. Medicare pays a set amount for care each month to the companies that offer Medicare Advantage Plans, who must follow rules set by Medicare.

Out-of-pocket costs in a Medicare Advantage Plan (Part C) are typically lower, but this depends on many factors. For example, the costs differ if the plan charges a monthly premium, pays any monthly Medicare Part B (Medical Insurance) premium, or has a yearly deductible (or any additional deductibles). Medicare Advantage Plans have a yearly limit on out-of-pocket costs for medical services; once this limit is reached, there is no charge for covered services. Applicants need to be informed of all the possible costs, rules and limits.

Why Agents Offer Medicare Advantage

Just as Medicare Advantage Plans aren’t the best fit for every client, they aren’t always the best fit for Agents. Consider these questions:

  • Are these plans beneficial for the people in your community and the areas you serve?
  • Do you offer similar/competitive products?

There are many compelling reasons to offer Medicare Advantage Plans, such as:

  • You can help families with some of the most difficult decisions of their life
  • You can provide your clients with peace of mind, as they will know they have a health plan behind them
  • You’ll be serving the needs of your clients and community
  • You can offer a profitable product that will help your bottom line

How to Get Started with Medicare Advantage
If you decide to offer Medicare Advantage Plans, we recommend talking to someone from the Premier team of experts. They’ll provide answers to your questions, and have tools available to support your new product offering.

Medicare Advantage Plan

Part A

Medicare Part A covers hospital stays and inpatient care, including:

  • Semi-private room and meals
  • Skilled nursing services
  • Care in special units, such as intensive care
  • Drugs, meidal supplies and equipment
  • Lab tests and X-rays
  • Operating Room and recovery room services
  • Some blood transfusions
  • Rehabilitation services after a qualified inpatient stay
  • Part-time skilled care for the homebound
  • Hospice Care

What providers can you use?
You can choose any qualified provider enrolled in Medicare that is accepting patients.

Costs
Premium. There is no cost if you have made contributions to Social Security for at least 10 years.  If not you will pay a monthly premium.

Deductible. For each benefit period, you have to pay a Part A deductible before Part A starts to pay a sheare of your costs.  A benefit period begins the day you are admitted to the hsopital and ends when your’ve been out of the hospital 60 days in a row.

You pay only one deductible each benefit period, even if you had more than one hospital stay.  For 2020, the Part A deductible is $1,408.

Copay
There is no copay for hospital stays up to 60 days in one benefit period.  Copays for a longer stay may include:

  • $335 per day for days 61-90
  • $670 per day for up to 60 lifetime reserve days

Co-pays for skilled nursing facility stays are:

  • $0 for days 1-20
  • $167.50 per day for days 21-100

Lifetime reserve days may not be used to extend coverage in a skilled nursing facility.

Coinsurance.
Home hospice patients may pay a small co-insurance amount for inpatient respite care so the patient’s caregiver can have time off.

Part B
Part C
Part D
Medicare Supplemental Plans
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PRESCRIPTION COVERAGE

Medicare prescription drug coverage adds to your Medicare health coverage

Medicare prescription drug coverage (Part D) helps you pay for both brand-name and generic drugs. Medicare drug plans are offered by insurance companies and other private companies approved by Medicare.

You can get coverage 2 ways:

1. Medicare Prescription Drug Plans (sometimes called “PDPs”) add prescription drug coverage to Original Medicare, some Medicare Private Fee-for-Service (PFFS) Plans, some Medicare Cost Plans, Medicare Medical Savings Account (MSA) Plans.

2. Some Medicare Advantage Plans (like HMOs or PPOs) or other Medicare health plans offer prescription drug coverage.
You generally get all of your Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and Part D through these plans. Medicare Advantage Plans that offer prescription drug coverage are sometimes called “MA-PDs.”

Medicare Supplements

What Is Medicare Supplement Insurance?

 

It's an insurance policy that helps pay the medical expenses that Original Medicare doesn't cover, like copayments, coinsurance and deductibles. Medicare Supplement Insurance plans are standardized by the government, which means they offer the same core benefits

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