Medicare

Indemnity health insurance works much like auto insurance in that you will pay your health insurance deductible before the insurance company picks up the remainder of your bill. This deductible amount will vary based upon the specific type of health insurance policy option you chose.
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FAQ

Medicare only pays about 80% of your medical and health care costs. The remaining 20% is up to you. Adding a Medicare Supplement plan or electing for a Medicare Advantage plan, a stand-alone Part D, or combined Medicare Advantage Part D (MAPD) are all opportunities to cover your remaining costs, providing for complete coverage.

  • Co-pay – a flat fee that you pay on the spot each time you go to your doctor or fill a prescription.  Copays cover your portion of the cost of a doctor’s visit or medication.
  • Co-insurance – a portion of the medical cost you pay after your deductible has been met. Coinsurance is a way of saying that you and your insurance carrier each pay a share of eligible costs that add up to 100 percent.
  • Deductible- the amount you pay each year for most eligible medical services or medications before your health plan begins to share in the cost of covered services.

Pros:

  • Out of pocket maximums, Prescription drug coverage, Silver sneakers, Dental, Hearing, and Vision coverage. Also, lower out of pocket costs, ESRD coverage, and more.
  • Keep in mind not all Medicare Advantage plans offer the same extra benefits. Since benefits vary by plan, let’s check with the specific Medicare Advantage plan you’re considering for more details.

Cons:

  • You cannot have a Medicare Supplement plan with it. Many Medicare Advantage plans may have provider networks that limit the doctors and other providers you can use. The out of pocket maximum resets every calendar year.

If you choose to not sign up for Medicare Part D during your initial enrollment period, you will be charged a penalty.  Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($33.06 in 2021) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

For Example, if you delay signing up for Part D insurance for 2 years (24 months), your penalty would be:

  • .24 (24% penalty) × $33.06 (2021 base beneficiary premium) = $7.93
  • $7.93 rounded to the nearest $0.10 = $7.90
  • $7.90 = the monthly late enrollment penalty for 2021. Your new premium would be $33.06 + $7.90 = $40.96 per month.

* The national base beneficiary premium may change each year, so your penalty amount may also change each year.

However, there are some very affordable prescription plans that will satisfy this requirement without breaking the bank. We are happy to provide you with the available options.

  • Part A is hospital coverage,
  • Part B is medical/doctor coverage.
  • Parts A and B are also known as original Medicare.
  • Part C is a private medicare plan (Medicare Advantage) that pays for the same services that parts A and B provide.
  • Part D is prescription drug coverage.
  • With Original Medicare, a primary care doctor is not required. You can visit any doctor who accepts Medicare.
  • With a Medicare Advantage plan, your choice of doctor depends on whether you select a health maintenance organization (HMO) or preferred provider organization (PPO) plan.
  • With an HMO plan, you can choose your primary care physician from any doctor in the plan’s network. If you opt for a PPO plan, generally, choosing a primary care physician is optional. With both types of plans, you’ll usually save money by visiting a network provider.
  • It’s important to note that Medicare Advantage plans must offer emergency coverage outside of the plan’s service area, anywhere in the U.S.

Maybe. Medicare plans vary state to state and even county to county. We can run a simple check using your new zip code to determine what plans are available in your new area.

If you would like to include others in these important decisions we encourage you to do so. Our video-conferencing technology can bring people together regardless of their location.

This is the official U.S. government Medicare handbook. Learn more about your Medicare options.

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