Medicare Basics
Many people qualify for a Special Election Period (SEP) which allows them to change plans anytime during the year. Call us today to see if you qualify!
What are the parts of Medicare?
PART A (HOSPITAL)
Helps cover the following (including, but not limited to):
- Inpatient hospital care
- Semi-private room
- Meals
- Drugs, supplies, equipment
- Lab and x-ray
- Operating room/recovery services
- Blood transfusions (hospital or skilled nursing facility
- In and out rehabilitation services after a qualified inpatient stay
- Some in-home skilled nursing care (restrictions apply)
- Hospice
Part B (Medical)
Helps cover the following (including, but not limited to):
- Doctor visits in and out of hospital
- Preventative services
- Flu shots
- Mammograms
- Annual physical
- Many more!
- Lab tests (Blood work)
- MRI, CT scans, X-rays, & other diagnostic tests
- Outpatient Physical, Occupational, & Speech/language therapy
- Diabetes screening, education, & supplies
- Mental Health Care
- Durable Medical Equipment (example: wheelchair, crutches, prosthetics)
- Ambulatory Surgical Center Services
- Ambulance (ground or air), Emergency Room, & Urgent Care
Both parts A and B of Medicare have restrictions & limitations on covered services provided. Although these services are “covered”, you are responsible for any deductibles, co-pays, & co-insurances left behind by Medicare. This is why you should have a Medicare Supplement or Advantage plan. Call us today!
Part D (Prescription drug coverage)
- Provided by private insurance companies overseen by Medicare
- Helps cover cost of prescription drugs
- Generic
- Brand
- Specialty
- Vaccines & Shots
- Can be a separate plan
- Example: Medicare Supplement plan and a Prescription Drug Plan
- Can be included in a Medicare Advantage plan
- Example: Medicare Advantage plan that covers both medical and prescription drugs all in one plan.
- Premiums, Co-pays, & Deductibles can be subsidized for eligible beneficiaries.
- Prescription brands covered, co-pays, co-insurance, premiums, deductibles, and pharmacy networks are different between plans.
PART C (Medicare Advantage)
Combines Medicare Parts A & B. Most plans also include Part D and extra benefits into one plan often with no additional premium.
- Plans often have no to low premiums
- Most plans offer some or all of the extra benefits
- Dental
- Eye glasses & Hearing Aids
- Free over the counter supplies
- Gym membership
- Wellness programs
- Transportation
- 24 hours nurse hotline
- Food allowance
- Part B premium reduction
- Have network of providers
- Coordinated Care
Your Medicare options
There are 7 coverage combinations that a Medicare beneficiary with Parts A & B can elect to be covered for their health care needs. See Below.
- Original Medicare (Part A and/or Part B) alone
- Original Medicare (Part A and/or Part B)
PLUS a stand alone prescription drug plan (Part D)
- Original Medicare (Part A and/or Part B)
PLUS a standalone prescription drug plan (Part D)
PLUS a Medicare Supplement (Medigap) plan
- Original Medicare (Part A and/or Part B)
PLUS a Medicare Supplement (Medigap) plan
- Medicare Advantage plan (Part C) with prescription drug coverage (Part D)
- Medicare Advantage plan (Part C) without prescription drug coverage (Part D)
- Medicare Advantage Private Fee-for-Service plan without drug coverage (Part C) OR a Medicare Savings Account (MSA) plan
PLUS a standalone prescription drug plan (Part D)
We help our eligible clients enroll into additional extra help programs to help subsidize their premiums, co-pays & deductibles....Find out if you qualify. Call us today!
6822 Lake Shore Rd N, Suite 1,
Verona Beach NY 13162
CALL NOW
For an in-home or phone appointment call:
1- 800-916-5703
Contact Us Today
One of our Licensed Representatives looks forward to speaking with you. We never charge for our services and there is no obligation to enroll into a plan.
