We can help you navigate through the "Medicare Maze".

The “Medicare Maze” as we like to call it has a lot of moving parts that can be very intimidating, especially if you are new to it, because it is constantly changing year after year. There is a plethora of information out there that can be very misleading and our job is to make sure our clients are getting the facts and are able to make an educated decision based on those facts.
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To help you wade through the sea of information, we put together some information below on the different parts of Medicare and the options you have.

MEDICARE PART A

Part A is your hospitalization. This will cover your inpatient hospital care, skilled nursing facility, hospice and home health care.
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For most Americans, their Part A is free and does not cost them anything if they have worked 40 quarters (10 years) or longer. If you have not worked 40 quarters there are still ways to get Part A, but it will usually have a premium associated with it.

​MEDICARE PART B

Part B is your outpatient medical insurance that will cover medically necessary and preventive services. This is mainly used for when you go to your primary care or you get testing and x-rays done. There is a premium associated with Part B and for 2022 most people will pay $170.10. However, depending on your tax bracket you may end up paying a little bit more. 

MEDICARE PART C

Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. These companies step in and take care of your Part A and Part B coverage. You must be enrolled in Part A and B to be eligible for a Medicare Advantage plan.

Most Part C plans include prescription coverage and additional benefits like dental, vision, hearing, transportation, over the counter (OTC) products and some even include food cards. Original Medicare (Part A and B) does not cover your routine dental, vision or hearing care and it does not provide OTC products. These are huge benefits for seniors and they are included, usually for no extra cost.

Most of these plans have $0 premiums or very low premiums per month depending on the company and the plan you choose within that company. They break down your out-of-pocket expenses into manageable copays or coinsurances. Once you have paid enough out-of-pocket costs, the plan will step in and pay the rest of your bills for the remainder of the year.

There are many different types of plans but the most common are HMOs and PPOs. HMOs. They have a network of doctors you have to stay within. Think of a fenced in area and you are restricted within that fence. While PPOs have more flexibility and you’re still in that fenced in area but now you have a gate on that fence and you can leave the area whenever you want.

MEDICARE PART D

When you sign up and enroll into Medicare Part A and B you also need to purchase a separate Part D prescription plan. Just like the late enrollment penalty for Part B you will also have one on your Part D if you don’t enroll at the time you get your A and B started. The penalty is 1% of the national average Part D plan for every month you didn’t have creditable coverage. So even if you aren’t taking prescriptions at the moment, we advise you still pick up Part D.

Not all prescriptions are in each Part D plan. Each plan has a drug formulary so making sure your prescriptions are covered is crucial or you may have some expense drug costs on your hands. Part D plans have different premiums, deductibles and copays.
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There are also different phases like the initial deductible, initial coverage, coverage gap (donut hole) and catastrophic coverage.  

MEDICARE SUPPLEMENTS - (MEDIGAP)

With Original Medicare (Part A and B) there are no out-of-pocket maximums. That means if you are experiencing a bad health year or are just having a lot of healthcare expenses, you don’t have a stopping point. You just keep paying out of your own pocket and that can be VERY costly.
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Medicare Supplement plans help to cover these expenses. You chose a plan based on your needs and pay a certain premium per month and you do not receive any bills or have any copays. Over time these premiums do increase with your age.

These plans are different letters (A, B, C, D, F, G, J, K, M and N) and cover different services. A plan G Supplement in company X is the same plan G Supplement in company Y. The only difference is how much you are paying per month. Plan C and F are only available to those how were Medicare eligible before Jan 1, 2020.

You cannot be enrolled in a Medicare Supplement plan and a Medicare Advantage plan at the same time. 

​What now?
We are brokers for all of the major insurance companies in the Richmond, Virginia area (also many other states) so contact us today and we can let you know if we can help.

What does that mean to you?
That means we don’t have any allegiance to any one company and can give you a completely unbiased opinion on what option is right for you. We work for YOU. Our job is to help you navigate the Medicare system and let you make an educated decision based on your current situation.

Whether you are brand new to Medicare and don’t know where to start or you are currently enrolled in a Medicare Advantage plan or Medicare Supplement plan and would like a second opinion, please reach out to our office and we would be glad to help you.

Contact us today!  ▷▷​▷