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Medicare Plans

Enrolling in Medicare can be a perk of turning 65, but understanding Medicare is a challenge.

Understanding the types of insurance plans you can purchase in addition to original Medicare can be confusing too. We can help explain some of the basics. There are links to additional information from the federal government at the end of the article as well.

There are four parts to Medicare:

Medicare Part A - Hospital Benefits
Medicare Part B - Medical Benefits
Medicare Part C - Medicare Advantage Plans
Medicare Part D - Prescription Drug Coverage

Medicare Parts A & B are called Original Medicare. Although most people do not have to pay a monthly premium for Part A because they have paid taxes for this coverage during their working years, there is a monthly premium cost for Part B. This premium varies. You can find out what Medicare will cost for you by contacting your local Social Security office or www.medicare.gov.

Medicare Supplement insurance plans can be purchased to supplement Original Medicare. They help cover your cost shares for Medicare approved expenses. For example, Medicare Supplement plans can pay the 20% you owe for some approved Part B expenses. You pay a monthly premium for Medicare Supplement insurance (in addition to what you pay for your Medicare Part B coverage). However, you may find it easier to budget for this monthly premium than to cover unexpected out-of-pocket costs when you need medical care. Premiums vary based on your age, where you live, and the level of benefits you choose.

The best way to choose a Medicare Supplement carrier is by reviewing the premium cost and efficiency of administration for the carriers offering plans in your state. We work with the following Medicare Supplement carriers:

United of Omaha (Mutual of Omaha)
UnitedHealthcare (AARP)
Blue Cross Blue Shield of Arizona
Aetna

Medicare Supplement plans do not cover outpatient prescription drugs, so you'll want to consider enrolling in a Medicare Part D prescription plan as well. If you don't apply for a Medicare Part D plan when you're first eligible, there may be penalties if you want to apply later.

The best way to choose a Medicare Part D carrier is by reviewing each company's monthly premium and drug formulary to see if your prescriptions are covered. We work with the following Medicare Part D carriers:

UnitedHealthcare (AARP)
HealthNet
Aetna
CIGNA

Medicare Advantage plans are not Medicare Supplement plans. They offer a different way of receiving your Original Medicare Benefits, and often include additional benefits as well (such as dental coverage or fitness programs).The MA plans include medical benefits and the MAPD plans include medical benefits plus Medicare Part D prescription drug benefits. Often you do not have to pay an additional monthly premium for the MA or MAPD plan, but you still have to pay your Medicare Part B premium.

MA and MAPD plans include cost shares you must pay when you receive services. These are often copays or coinsurance for selected services. Although the monthly cost may be less expensive than a Medicare Supplement Plan, these cost shares mean that you incur more out-of-pocket expenses when you receive care (compared to the benefits of a Medicare Supplement plan).

The best way to choose a Medicare Advantage plan is by first reviewing which plans include your medical providers in their network and whether your prescriptions are included in the plan's formulary. Once you've narrowed the field with those criteria, you make a choice based on the premium cost and benefits of the plans. We work with the following Medicare Advantage carriers:

UnitedHealthcare (AARP
CIGNA
Aetna
Health Net
SCAN
CareMore

The type of plan that's best for you is going to depend on your unique situation. We can help you review your options. If you'd like to talk to a specialist, please call Shelly Winson at (480) 206-8294.

If you'd like to meet in person, we'll need to complete a Scope of Appointment form before we meet. Federal regulations do not allow us to talk about Medicare Advantage or Medicare Part D plans in person before this form is completed. The form is intended to ensure that you understand the types of benefits we're going to discuss and have given your written permission for the meeting prior to our meeting face-to-face. Here's an example of the form: Scope of Appointment Form.

When you talk with us about which plans might be best for you, it will be very helpful for you to have a list of your medical providers handy, as well as a list of medications you take. This will allow us to focus on insurance plans that include your medical providers in-network and cover your medications in their formulary.

Additional Information:

Federal Publication: Medicare and You 2012

Federal Publication: Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare

Federal Medicare Web Site: www.medicare.gov

 

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