Medicare

Medicare time is upon me and as a licensed insurance agent I can write the policies myself.

Although Medicare is part of my continuing education for my life and health certifications from the Department of Insurance, the brief material on Medicare was not enough for me to make an educated selection. I therefore joined up with an insurer who offers the supplements and I am now knee deep in materials.

Many people reach the qualifying age of 65 since I am approaching that age I ask folks what Medicare plans they have selected.

To my surprise, many don’t know what exact Medicare options they have selected. That being said, it makes me wonder why so many people don’t understand what they have.

Either they are not taking adequate time to learn Medicare or whoever they are asking for help from are not explaining the options very well. Whatever the case may be, understanding the basics and what is available is time well spent.

Medicare has gone through many changes. There are the government basic plans offered direct through the government and then the supplemental plans called Medi-Gap and Medi-Advantage. These fill in the holes not offered by Plans A and B. Different plans and options can address individual situations.

To begin with, all plans are designated by alphabetical letters.

Medicare part A and part B are the government offered coverages and everyone starts with these.

Generally speaking, A is for hospitalization needs and generally covers inpatient hospital stays, skilled nursing care, hospice care, and limited home health-care services.

B is for Doctor needs and helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services. A is free for the most part but can have some payments required such as deductibles. B is not free but dependent on one’s income and like A, can also have required out of pocket expenses.

Then rest of the parts of Medicare you must procure through private insurers.

These insurers, of which there are many, must adhere to certain guidelines set by the government.

These insurers sell plans called “supplemental” plans commonly referred to as Medi-Gap plans. These gap plans cover things that Plans A and B do not. There is also is the hybrid Medicare part C, called Medi-Advantage, which stands alone on how it works.

In simple terms, once you get plans A and B, you either get a supplement plan(s), or Medi-Advantage part C, but not both.

Which plans and options one can choose is also dependent on where one lives.
If it sounds confusing, that’s what I thought. And truth be told, it’s probably why the many folks I talked to didn’t know exactly what it is they bought.

And although the government stipulated plan benefits must be identical no matter what insurer you buy it from, the authorities did not stipulate they all have to offer them to you at the same price. In other words, you could pay more for the exact same plan depending on the insurer you buy it from.

Depending upon how many ills one might have, how often you go to a doctor, how many prescriptions you may have, if you want to keep your current medical providers or not and balancing your monthly premium desires with your out of pocket expenses expectations, this will all lead you in the direction of selecting the best plan for your situation.

To select the best and most affordable plan for your situation it will likely require some hours spent in front of the computer although special circumstances will mean automatic enrollment and age exceptions for some, in general, there is an enrollment period that starts 3 months prior to your 65th birthday and ends 3 months after the month of that birthday.

Missing this enrollment period can lead to problems for some so don’t overlook it.

You likely won’t have to be reminded as your mailbox will likely start to fill with offer after offer from Medicare providers as you approach your 65th birthday. As always watch for scams and double check everything before you buy as changing plans later can have restrictions. Newbies can start by visiting www.medicare.gov.

Finding a Medicare specialist insurance agent will also help in your final selections,
This article offers the opinions of Marc Cuniberti only and does not necessarily represent those of any news media, its staff, members or underwriters. Content or statements are not guaranteed. Mr. Cuniberti holds California Insurance License #0L34249.