| Medicare Coverage FAQ For You |
 |
Medicare Coverage is available for people age 65 or
older and for people under age 65 on Social Security Disability. Since
Medicare does not cover all of your costs, many people choose to
purchase additional coverage, especially if they do not qualify for
Medicaide benefits. The determing factor in eligibility for the plans
outlined below is the effective date of your Part B Medicare Coverage.
There are
a variety of plans available for Medicare beneficiaries such as:
- Medicare Supplement or Medigap Plans.
These plans are issued by over 40 companies in NC and they fill in
the gaps in Medicare coverage. Each company must provide the same benefits for Plans A-J. Most companie's premiums are based on the insureds "Attained Age" which mean your premiums can go up as you
move into another age bracket...A few compainies are " Issue Age" companies and this means you can "lock-in" your premium age bracket and your premiums only increase due to claims experience.
- Medicare Advantage Plans
Medicare Advantage
policies provide a different set of benefits than Medigap
policies. These plans have co-pay and co-insurance features which do
not cover all of your costs. There are several types ofMedicare
Advantage plans such as: HMO/PPO plans that have in place a provider
network in the counties where these plans are available
PFFS or
"Private Fee For Service"
These plans have
limited providers in place and these providers may decide to accept or
not to accept the coverage on a "Case-by-Case" basis. Premiums are
usually lower than HMO/PPO MA plans or with Medigap plans. Recent
rules from the Medicare people require PFFS plans to have provider
networks in place within the next two years and premiums will have to
increase to allow for compliance with these rules.
Medicare
Advantage plans may beneficial to Medicare beneficiaries who cannot
afford a Medigap plan or for those who are willing to
assume some of their healthcare cost
- Medicare Drug Part D Drug Coverage.
These plans became available and were introduced in 2005 to become
effective on January 1, 2006. When you qualify for Medicare, you can
enroll in this coverage unless you have other credible drug coverage,
such as employer or VA drug coverage. You can enroll 3 months before
or after the month your Part B Medicare effective date. Should you not
enroll during this Initial Enrollment Period, you will have to pay an
increased premium of 1% per month for each month you did not enroll
when you were eligible to do so. Each year, in November, you may
change your drug plan to another drug plan to meet your needs based on
the drugs you are taking. This special period is known as the Annual
Enrollment Period. There is a Special Enrollment Period available for
people who lose their credible drug coverage or move to another state
where their existing provider does not offer the Part D coverage.
Our business is helping people with their insurance needs and
we find the best companies to serve our clients needs. We have over 25
years experience serving our clients and I hope you will allow us to be
of service to you and your family.
|
