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★ Health Insurance ★
Medicare Advantage, Supplement,
Prescription Drug, Dental
Here's a brief overview
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★ Medicare ★
About Medicare
Visit these links to learn more about Medicare
What is Medicare?
Medicare.gov
More Links


Is it mandatory to go on Medicare when you turn 65?
Those who receive Social Security benefits are automatically enrolled in Medicare when they turn 65. ... Either you enroll in Medicare Part A, or you forfeit your Social Security benefits. Most individuals are unwilling to forfeit their Social Security benefits, and thus accept the enrollment into Medicare.


Do you get Medicare automatically when you turn 65?
Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don't need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65.


Is there a penalty for not signing up for Medicare?
You may have to pay the late-enrollment penalty for as long as you have Medicare Part B. The penalty amount could go up 10% for every 12-month period when you were eligible for Part B but didn't enroll. For example, if you waited for three years to sign up, your penalty could be 30% of the premium.


Can I reject Medicare Part B — which has a premium?
Those who receive Social Security benefits are automatically enrolled in Medicare when they turn 65. There is no way to opt out of Medicare once you are 65 if you receive Social Security. Either you enroll in Medicare Part A, or you forfeit your Social Security benefits. Most individuals are unwilling to forfeit their Social Security benefits, and thus accept the enrollment into Medicare. Note that you're only required to accept Medicare Part A—which is premium-free if you're receiving Social Security benefits—in order to retain your Social Security benefits. You are allowed to reject Medicare Part B—which has a premium—if you choose to do so, although you could be subject to a late enrollment penalty if you choose to enroll in Part B at a later date.


The Original Medicare has two parts....
Part A (for hospitals) and
Part B (for doctor visits)
Here's a brief explanation of Part A and Part B.

Original Medicare Part A - Hospital Insurance
Hospital stays
Skilled nursing facility
Hospice care
Some home health care
Once you turn 65, you’re automatically enrolled in Medicare Part A. Most people don’t have to pay a premium for Part A because they, or their spouse, paid Medicare taxes while working.


Original Medicare Part B - Medical Insurance
Medical service (doctor visits)
Outpatient care
Medical items
Medicare pays: 80% of approved charges
Beneficiary Pays: about 20% of approved charges
Part B is optional because you have to pay a monthly premium and satisfy a deductible before Medicare will pay benefits.


After enrolling in the Medicare program, beneficiaries must decide how they want to receive their Original Medicare, Part A and Part B, benefits and whether they need additional coverage. This means that they will have to decide if a Medicare Advantage plan is right for them, or if they should stick with Original Medicare coverage and sign up for a Medicare Supplement plan for added benefits. Each of these Medicare plan options come with different benefits, costs, and rules; hence, it is important to weigh both options carefully before choosing.

What is Medicare Advantage?
Also called Medicare Part C, Medicare Advantage plans provide coverage through private insurance companies approved by Medicare. These companies provide all the benefits of Part A and Part B, with the exception of hospice care (that remains covered by Medicare Part A). These plans sometimes also include additional benefits, such as vision, dental, and/or prescription drug coverage. Note that people with end-stage renal disease (ESRD) generally do not qualify for Medicare Advantage plans. When you join a Medicare Advantage plan, you must continue paying your Part B premium.

What is Medicare Supplement?
Also known as Medigap, Medicare Supplement plans are offered by private insurance companies and can take care of certain health care costs not covered by Original Medicare, like deductibles, premiums, and copayments. There are 10 standardized plans in 47 states, while Massachusetts, Minnesota, and Wisconsin each have their own plan offerings. Plans are categorized by letter—A, B, C, D, F, G, K, L, M, and N—and plans of the same letter offer the same benefits. However, insurance companies can offer plans at different prices; therefore, you may have different out-of-pocket costs, even if the standardized plan benefits are the same. These plans do not provide prescription drug coverage. This means that you will have to enroll in a stand-alone Medicare Prescription Drug Plan for medication coverage.

While Medicare Supplement plans help with deductibles and other expenses not paid by Original Medicare, they do not cover services if Original Medicare does not cover them. For example, they do not cover long-term care, dental care, or eye glasses.

How do I choose?
When deciding on a plan, it’s essential to compare the benefits and costs in relation to your specific health care needs. With Medicare Advantage plans, you must continue to pay your Part B monthly premium, in addition to the monthly premium for your plan. However, although Medicare Supplement plan benefits are standardized, costs can vary between plans with the same benefits and are generally more expensive.

When comparing the benefits and costs of plans in your area, be sure to take these key factors into consideration:

Deductibles
Monthly premiums
Anticipated costs of health care and hospital services you use often
Restrictions on doctors, hospitals, and pharmacies
Expected costs of prescription drugs that you require regularly
Maximum out of pocket amounts


Can’t I have both?
No, Medicare Advantage plans do not work with Medicare Supplement plans. This means that you cannot use your Medigap plan to take care of the copayments, premiums, or deductible from your Part C Medicare Advantage plan.

What if I choose Medicare Advantage?
If you decide to enroll in a Medicare Advantage plan after being in Original Medicare (Part A and Part B) for some time, you may want to cancel your Medigap plan since it cannot be used to pay for Medicare Advantage costs. If you do drop your Medigap plan in this scenario, you have a guaranteed right to purchase another Medigap policy if you decided to disenroll from the Medicare Advantage plan while you are still in a “trial period.” In most cases, a trial period lasts for twelve months after a person enrolls in a Medicare Advantage plan for the first time.

★ Medicare Advantage ★
Medicare Advantage
Medicare Advantage 'combines' the original Medicare Part A and Part B

Covers original Medicare Part A - Hospital Insurance

Covers original Medicare Part B - Medical Insurance

Combines Part A and Part B in one plan

Often also include Part D (prescription drug coverage)

These plans are part of the government’s Medicare program, but are offered and managed through private insurers and may offer plan extras not found in Original Medicare. You must be enrolled in Medicare Parts A and B to join.

Medicare Advantage health care plans provide comprehensive benefits, including coverage for medications and all medically necessary services. These plans use a designated network of doctors and hospitals who work together to provide the care you need in the most cost-effective way.

Low monthly premiums

Combines all Medicare benefits into one

★ Medicare Supplement ★
Medicare Supplement Insurance Plan
The original Medicare Part B only pays about 80% of the cost.

YOU have to pay the other 20%.

A Medicare Supplement insurance plan is designed to pay that other 20% cost for you.

Medicare Supplement insurance is private health insurance offered by insurance companies to help you pay about 20% of the Part B medical expenses that Original Medicare doesn't cover. Medicare Supplement insurance plans, also known as Medigap plans, are standardized by the government, which means that all plans have exactly the same basic benefits, regardless of which insurance company you choose.

★ Prescription Drug Plans ★
Medicare Part D Prescription Drug Plans
In 2006, Prescription Drug plans (Part D) became available. These prescription drugs plans for eligible citizens help lower the cost of prescription drugs that can prevent complications of diseases and help keep you healthy.

Part D plans are part of the government’s Medicare program, but they are offered and managed through approved private insurers.

If you have Medicare Part A and Part B, you can enroll in a separate Part D prescription drug plan, or you may choose to join a Medicare Advantage plan (Part C) that includes drug coverage.

Protection against high prescription drug costs

Low premiums

Choices of cost and benefit levels

Easy to use

Works with Medicare Part A and Part B, or may be included in a Medicare Advantage (Part C) plan.

★ Dental ★
Prescription Drug
$0 preventive care. No copays or deductibles for cleanings, routine x-rays, and more with in-network dentists.

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