Team West Insurance

Your Questions Answered

Quick Start your Medicare knowledge by scheduling your personalized Medicare 101 through Zoom or a phone call!Medicare does not cover everything. Original Medicare (Parts A and B) was designed to provide basic medical coverage. If you rely on Medicare alone, there is no cost to how much you could owe due to a medical event.
  1. There is a Part A (Hospital) Deductible that is owed each “benefit period.”
  2. There is a per-day fee for hospitalizations lasting more than 60 days.
  3. There is a Part B (Medical) Deductible that is owed each year plus 20% of all remaining costs incurred outside of the hospital.
These costs add up fast! Medicare does not cover routine dental, vision, or hearing. There are additional options available to you to assist with your cost of care.
 Click here to view and download your free copy of our MEDICARE CHECKLIST! 

There can be late enrollment penalties on both Part B and Part D. However, if you enroll when you are first eligible you will not be penalized.

If your coverage through your employer is deemed “creditable coverage” you can keep it. However, when you do elect to go onto Medicare you need to follow the appropriate steps to ensure you are not charged a late enrollment penalty. (Do NOT accept COBRA when you are eligible for Medicare.)

No, an insurance company and its rates must be approved by the state in which it sells Medicare plans. And the plans it sells must be approved by the federal government.

You are eligible to enroll in Medicare beginning three Months before your 65th birthday or 24 months after being deemed “disabled” by Social Security.

If you enroll as soon as you’re eligible, your coverage typically begins first day of your birthday month.

If your Modified Adjusted Gross Income is above a certain amount, you may pay more for Part B and Part D.

 

You can obtain additional coverage that meets your individual needs and helps protect your assets. Typical options include a Medicare Supplement and Prescription Drug Plan – or – Medicare Advantage Plan.

 

Medicare Supplement plans help cover medical expenses Original Medicare doesn’t. Also referred to as “Gap” or “Medi-Gap” plans. The plan names are oftentimes confused with parts of Original Medicare as they are named alphabetically as well. Example: Plan G, Plan K, etc. Medicare Supplement plans NEVER include prescription drug coverage, so you need to add that to your insurance folder to be covered appropriately.

  • Parts A and B are administered by Medicare; your supplemental coverage is administered by your insurance company.
  • Medicare Supplement plans never include prescription drug coverage.
  • Covers most potential out-of-pocket expenses.
  • Multiple plan options are available to fit a wide range of budgets and needs.
  • Plan benefits are standardized by the government (ex: Every Plan G is identical in coverage). 

Prescription drug coverage helps pay for your medications prescribed by your doctor (also known as Part D).

Prescription Drug Coverage

A prescription drug plan will help lower your out-of-pocket costs for your prescriptions. If you don’t sign up for a Prescription Drug Plan when you are first eligible, you will have a Late Enrollment Penalty (LEP) assessed every month once you are able to add one.

  • Medicare Supplement plans never include prescription drug coverage.
  • Most Medicare Advantage plans include Part D coverage.

Medicare Advantage plans combine coverage for Part A and Part B with added benefits and oftentimes include prescription drug coverage (also known as Part C).

Medicare Advantage Plans (Part C)

  • These “bundled” plans combine coverage for Part A and Part B with added benefits (also known as Part C).
  • Many Medicare Advantage Plans include prescription drug coverage (Part D) and are referred to as “MAPD.”
  • These plans are oftentimes an “all in one” alternative to Original Medicare.
  • They are offered by private companies approved by Medicare.

Medicare Advantage plans frequently offer additional coverage for things Original Medicare doesn’t cover, such as Vision, Hearing, Dental, Fitness Programs, over-the-counter items, and even meal delivery after hospitalization.

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