Unfortunately, the answer is NO. You can have Medicare but not a Medicare Advantage plan. There are very important differences which you should completely understand. If you'd like to understand why and how it works, we're happy to explain it. We would encourage you to take the next step which is to call our offices (the number is located at the top of this website) in order to book a consultation or you can fill out a contact form, here.
Learn more about your situation at medicare.gov
Medicare - aka Original Medicare is federal health insurance for people 65 or older, some younger people with disabilities, people with End-Stage Renal Disease. It has multiple parts, A, B, C, D and E. It's generally considered that Medicare will cover approximately 80% of the cost of your Medicare approved healthcare costs. This leaves 20% for YOU to cover. Unlike Medicare Advantage and to a large extent Medicare Supplement Plans, there is NO MAXIMUM OUT OF POCKET AMOUNT for the 20% you are responsible to pay with Original Medicare. Having Original Medicare alone leaves you exposed to unlimted out of pocket costs.
Medicare Supplement Plans - aka Medigap, aka Part E, is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:
Some Medigap policies also cover some services that Original Medicare doesn't cover, like medical care when you travel outside the U.S., vision, hearing and dental. If you have Original Medicare and you buy a Medigap policy, here's what happens:
Medicare Supplement Insurace generally does NOT include Prescription Drug Coverage so you'll need a stand alone drug plan if you need/want prescription drug coverage.
Medicare Advantage Plans are another way to get your Medicare Part A and Part B and Part D coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Many Medicare Advantage Plans include drug coverage (Part D) and there are plans that don't include drug coverage. This is useful if you already have creditable drug coverage and you want to keep it. In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, sometimes at a higher costs. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.
The most common types of Medicare Advantage Plans are:
Contact me to see which plan is right for you.
Learn more at Medicare.gov
You don't have be receiving social security benefits to get Medicare. To get Medicare, you have to meet eligability requirements and sign up. Contact me and I'll walk you through it from A-Z.
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
Learn more at Medicare.gov
Medicare Part D and some parts of Part B deal with Prescription Drugs.
All Medicare Part D (or MAPD) plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes, ” like drugs to treat cancer or HIV/AIDS". Not every drug is covered. A plan’s list of covered drugs is called a “formulary,” and each plan has its own formulary. Plans place drugs into different levels, called “tiers,” on their formularies. Drugs in each tier have a different cost and may or may not be subject to a deductible. A drug in a lower tier will generally cost you less than a drug in a higher tier. Contact me using either the phone number at the top of the page or via the contact form to see if the drugs you take are covered on your current plan or may be covered on a different plan.
One of my services is to research which plans in your area cover the drugs you take. This valuable CONFIDENTIAL service will help you minimize the cost of your drugs. All I'll need to know is the name of the drug, the dosage (how many miligrams) and the number of doses you take per day. I'll even be able to estimate how much you'll pay per month. Use the form to contact me and I'll do the research and let you know.
Learn more at Medicare.gov
Sometimes, yes and sometimes no. It depends on the plan and its features and benefits. Some insurance carriers offer a national network of providers, others are local or regional. Contact me and I'll help answer your question.
If you are signing up for Medicare for the fist time, it will take around three weeks to get your red, white and blue medicare card. This card contains your Medicare ID and the month and year of your Part A and/or Part B effective dates. Once you have that card, you can begin selecting a health plan. This is the BEST TIME TO CONTACT ME. I will simplify the complex world of Medicare for you. I'll educate you on your coverage options and you will make the final decision on which plan and what options you want. I will help you sign up. I make it SIMPLE!.
Medicare limits when you can join. There are different parts of Medicare and you have options depending on your situation, if your working, already have private or group health coverage, considering retiring or already retired. The first step is to visit SSA.GOV and click on the Medicare box to learn more. If you want to make it simple for yourself, just complete the contact form and I'll walk you through it from A-Z.
Generally, you can join a plan when you first become eligible for Medicare. This is anytime beginning three months before the month you turn 65 and ends three months after the month you turned 65.
Learn more at Medicare.gov
Use the contact form to let me know you have questions or want to sign up.
Learn more about Part B late enrollment penalties at Medicare.gov
Also called Original Medicare is federal health insurance for people 65 or older, some younger people with disabilities, people with End-Stage Renal Disease. Medicare is NOT health insurance and it is not FREE.
Medicare Supplemental Insurance (Medigap): Is extra insurance you can buy from a private insurance company that helps pay your share of the costs under Original Medicare. Recalling from above that Medicare (Original Medicare) will cover only up to 80% of the cost of your healthcare, you are responsible for paying the other 20%. Medicare Supplement plans cover that 20% "Gap". Note that the 20% can be a very large amount. For example, let's say you have an extended stay in the hospital and your bill for that stay was $150,000. Under Medicare (Original Medicare) your Part A will cover up to 80% of that bill which is $ 120,000. You would be responsible for the 20% difference or $ 30,000. WIth Medicare (Original Medicare), you are financially exposed for that 20% with NO CAP. Your financial exposure is unlimited.
If you had a Medicare Supplement (Medigap) "safety net", the insurance company will pay this $30,000 leaving you with little to no financial responsibility. The catch is that there is a monthly premium that you must pay for a Medicare Supplement (Medigap) "safety net'. The monthly premium varies among insurance companies and according to the Plan letter.
Supplemental policies are standardized, and in most states named by letters, like Plan G, Plan N or Plan K. The benefits in each lettered plan are the same, no matter which insurance company sells it.
For a review of your situation, contact me.
Learn more here.
ABOUT HOWELL SILVERMAN INSURANCE:
We are in the business of helping people with their personal and business insurance needs.
We specialize in MEDICARE, Medicare Supplement Insurance (Medigap), Medicare Advantage & Prescription Drug Coverage Plans.
If you're just turning 65, are already on a Medicare, Medigap, Medicare Supplement Plan or Medicare Advantage Plan, or a Prescription Drug Coverage Plan, or you simply want to know if you can save money, or learn about the extra benefits you may be entitled to, give us a call for a no obligation education discussion.
We help consumers save money, we help businesses reduce risk and we help families protect and preserve their financial future.
We offer all forms of insurance with personal service.
We've got your covered.
We proudly work with many Medicare Insurance plan providers as well as the following life, health and commercial carriers:
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