DE-MYSTIFYING MEDICARE
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When it comes to picking the best plan for your health and your wallet, the options can be overwhelming and confusing. When selecting Medicare, it is especially difficult because when you are near age 65, you become inundated with telephone calls and direct mail from insurance agents trying to sell you their company’s plan.
Medicare Options
If you are enrolling in Medicare for the first time, you may be wondering how you should receive your Medicare benefits. You can get your benefits through Original Medicare or Medicare Advantage.
Original Medicare
Original Medicare is the federal program that administers your Part A (hospital insurance) and/or your Part B (medical insurance) benefits. Most people are automatically enrolled in Part A when they turn 65 years of age. It is your choice to enroll in Part B, which has a monthly premium and yearly deductible.
Supplementing Your Original Medicare Coverage
Many people with Original Medicare choose to supplement their coverage with a separate Medigap (or Medicare Supplement) policy to help them cover the out-of-pocket costs that Original Medicare does not. There is an initial Medigap enrollment period when you are first eligible that will give you a guaranteed issue right to purchase any Medigap policy sold in your state without being subject to medical underwriting. Our independent brokers at Apron Agencies can help you choose Medigap plans that will best fit your needs and budget. Although Medigap policies are standardized, the costs may vary.
Prescription Drug Plans
Prescription drug coverage is not available through Part A, Part B, or Medigap policies, so you may need to consider Part D prescription drug coverage. A PDP is a stand-alone plan offered by private insurance companies that will help cover the costs of prescription drugs. (Prescription drugs are not covered by Part A or Part B or by Medigap policies.) Licensed insurance agents can help you decide if you should enroll in a Prescription Drug Plan (PDP) and can help you review and compare plans based on your particular budget and medications. Each PDP has its own formulary or list of covered drugs, so you need to review your current prescriptions to ensure they are included. Costs will vary based on pricing tiers (generic vs. brand name, mail order, etc.), so it is helpful to have an expert help you find the pan that will be right for you.
Medicare Advantage (MA) Plans
Medicare Advantage plans are offered by private insurance companies that contract with Medicare to provide your Part A and Part B benefits. Although they are required to provide the same benefits as Part A and Part B, some plans offer additional benefits for the same cost, including vision care, dental services, hearing exams, and prescription drug coverage. Most MA plans will require you to visit physicians, hospitals, suppliers, and pharmacies within the plan’s network or pay more if you go out of network. A licensed sales agent can help you make the choice that is best for you.
How our Independent Agents Can Help
An independent health insurance sales agent can help you tailored a plan to fit your needs and ensure that your plan provides you with the most comprehensive coverage.
Independent agents are different than captive agents. A captive agent is working exclusively with one carrier, and therefore, is only able to show you that company’s plans. On the other hand, independent agents are free agents, and therefore, they show you options from multiple companies, allowing you to compare plans while working with the same representative.
Independent agents will build a relationship with you. You can call and talk to the same person with any questions, and they will keep in contact. During the Annual Enrollment Period, they are available to help you look at any new (or other) options that you think would be a better fit.
Agents are required to complete certification each year to retain their active broker status, and also complete certifications with any carrier that requires additional training, making them the best person to speak with regarding Medicare coverage.
Generally, your Medicare agent will gather information about you and how you use your insurance. They will take the time to look up your doctors and prescriptions, and then run an analysis that will help determine which insurance carrier and plan will provide the most coverage for you. They will also be able to tell you what to expect for your out of pocket expenses.
At Apron Agencies, we offer you a full team of accessible agents who are here to work with you and answer all of your questions. Call to schedule an appointment today at (504) 834-9280.
