DISCLAIMER

The content included on this website page is for informational purposes only.  It should not be considered, or substituted for, licensed professional advice or as the legal interpretation of benefits provided by Original Medicare or Medical Supplemental Plans offered by private insurance companies.

MEDICARE, SUPPLEMENTAL PLANS, & MEDICARE ADVANTAGE PLANS

WHAT IS INCLUDED IN ORIGINAL MEDICARE?

image2

INITIAL  ENROLLMENT  FOR MEDICARE BEGINS WHEN YOU

1.  Turn 65 yrs. of age.

2.  You can enroll for Original Medicare up to (3) months in advance of your 65th birthday.

3.  When you enroll in Medicare, you should choose a supplemental medical plan & prescription drug insurance, because Medicare  does not cover all the medical expenses you can incur.


Original Medicare is administered by the Federal Government.

Part A - Hospital Insurance

Part B - Medical Insurance

    ________________________________________

Part C - Medicare Advantage

Part D - Prescription Insurance

Plan F - Supplement Plan to Parts A & B

Plan G - Supplement Plan to Parts A & B


ORIGINAL MEDICARE Part A & Part B 

1.   Under Original Medicare, the government pays your health care providers directly for the health care services you receive.


2.   You can visit any hospital or see any doctor that accept Medicare.  


PREMIUMS

1.   There is no premium for Part A, if you worked 40 quarters and paid taxes to Medicare.


2.   There is a monthly premium for Part B and it is deducted from your Social Security Benefits.


3.  If you do not yet collect Social Security Benefits, you will need to pay monthly for Part B.  

     _______________________________________


Part A - Hospital Coverage

Coverage for inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care.

     _______________________________________


Part B - Health Insurance 

Offers coverage for (2) types of services;


Medically necessary services to treat illnesses or conditions, such as, doctor's office visits, lab work and x-rays.


Outpatient surgeries, and preventive services to keep you healthy, like cancer screenings, including 3-D mammograms, pneumonia and flu shots. 

_______________________________________


Part D - Prescription Drug Insurance 

Other vaccines, such as, Shingles, Diphtheria, Tetanus, Pertussis are not covered under Medicare. However, they are generally covered under a stand-alone Part D  or  a Medicare Advantage that includes Plan D. 

www.medicare.gov

MEDICARE ADVANTAGE PART C

image3

Original Medicare and Medicare Advantage Plans are NOT the same.


MEDICARE ADVANTAGE PLANS 

(PART C) are purchased from private insurance companies (HMOs & PPOs).

     ________________________________________ 


OCT.  15 - DEC. 7, 2019 

ANNUAL ENROLLMENT PERIOD 

For Part C - Advantage Plans  for 2020         

For Part D - Drug Coverage for 2020


JAN. 1 - MAR. 31, 2020

OPEN  &  DIS-ENROLLMENT PERIOD  

For Medicare Advantage Plan(s)

During this time, eligible beneficiaries may make the following changes:        


>>  Change Medicare Advantage Plans

by changing insurance companies but keeping a Medicare Advantage Plan.

                                               

>>  Switch to Original Medicare from a Medicare Advantage Plan.


>>  Switch to Medicare Advantage Plan to Original Medicare.

   __________________________________________ 


You will not be enrolled in Parts A & B of Original Medicare if you choose a Medicare Advantage Plan.


1.   'Medicare Advantage Plans are offered by Private Insurance Companies (HMOs or PPOs).


2.   Advantage Plans cover most costs, but coverage is LIMITED to Medicare Approved Charges. You may be responsible for additional out-of-pocket expenses if your doctors charge more than what is allowed by Medicare. 


3.   You can purchase an Advantage Plan that includes Prescription Drug Coverage, or one, that does not.


 

SUPPLEMENTAL PLANS PARTS: D, F, G

image4

PURCHASED FROM PRIVATE INSURANCE COMPANIES 


Part D - Prescription Drug Coverage 

Provided only by Private Insurance Companies who have contracts with the federal government.


Your prescription drug costs are based on the Tiers of Drugs under which your current medications are categorized.  


Most Advantage Plans include Plan D for prescription drugs. 


PENALTY APPLIED: If  you choose NOT to purchase Plan  D for Prescription Drug Coverage when you are eligible  a 

life-long penalty can be imposed. 

   _________________________________________


Plan F - Supplemental Medical Coverage to Parts A & B of Medicare

This plan pays 100% of any excess charges not covered by Medicare including your annual deductible. 

  __________________________________________


Plan G -  Supplement Medical Coverage to Parts A & B of Medicare. 

This plan is nearly identical to Plan F and is designed to cover “excess costs” from healthcare providers (charges exceeding Medicare approved charges). 


This plan covers 100% f Plan A excess amounts, except it does not pay the annual deductible required by Plan A.


This plan covers 100% of Plan B excess amounts.  


Excess charges occur when medical providers charge more than what Medicare allows. By law, providers can't charge more than 15% of what Medicare covers.


 TERMS TO UNDERSTAND

  1. Initial Medicare Enrollment Period
  2. Annual Enrollment Period
  3. Open Enrollment Period
  4. Original Medicare
  5. Medicare Advantage
  6. Supplemental Plan (Medigap)
  7. Private Insurance Company
  8. Medicare Approved Charges
  9. Annual Deductible
  10. Out-of-Pocket Expenses
  11. Maximum Out-of-Pocket Expenses
  12. Tiers of Prescription Drugs

AMRRC ~ RECOMMENDS

image5

Supplemental Plans should be considered and chosen with the help of a "licensed professional" and should be based on your medical history and the state in which you reside. 


AMRRC recommends that you consult AMERICAN SENIOR BENEFITS to assist you with the Original Medicare, Medicare Advantage and other Supplemental Plan information. 


Contact Kobey Liles, a licensed professional, with American Senior Benefits to assist you and explain the various plans for which you may be eligible. 


(972) 740-2658 

OR 

Email:  kliles@asbtex.com


American Seniors Benefits - Kobey Liles

NEW MEDICARE CARDS

image6

www.medicare.gov 


You should have received your "new" Medicare Card. Your new card does not included your Social Security Number.


PLEASE ENSURE YOUR HEALTHCARE PROVIDERS HAVE YOUR NEW MEDICARE NUMBER.  

    ________________________________________


MEDICARE ADVANTAGE PLAN

If you have a Medicare Advantage Supplemental Insurance Plan - 

you must keep your Medicare Advantage Plan Card. 


You should also carry your new Medicare Card with you ----- even if you are  in a Medicare Advantage Plan.

Medicare Website