Helping Seniors Make Better-Informed Medicare Decisions
Trying to pick a health insurance plan can be a chore for anyone. For many people, just mentioning the word “open enrollment” sends shivers down the spine. It seems like there’s always a nagging feeling that you’re wasting money, choosing a plan with poor in-network care, or both. One would think that health insurance gets easier as you approach retirement age, but the truth is that picking an initial Medicare coverage plan can be daunting.
Unfortunately, the confusing process of signing up for Medicare causes many seniors to forego healthcare coverage altogether. After all, Medicare enrollment can involve several federal agencies, including the Social Security Administration (or SSA) and the Centers for Medicare and Medicaid Services (or CMS).
At Health Insurance Solutions, our passion is guiding seniors through the confusion of Medicare. That way, they can enjoy retirement with peace of mind knowing they are protected and ready for life after 65. We work with dozens of insurance companies, giving our clients the chance to choose a plan that best fits their lifestyle.
We choose to design our senior insurance plans with a focus on optimal benefits structure, lower costs, and personalized service. Some independent insurance agencies see their aging customers as nothing more than a financial transaction waiting to happen. In contrast, we treat each of our clients with respect and dignity as we help them navigate the confusing waters of Medicare. Combined with individualized service, we help older Americans make well-informed decisions about insurance. Whether you’re in need of Medicare Supplement Plan insurance in the country or simply have questions about signing up for Medicare, our team is here to help.
What is Medicare?
If you’re approaching the golden years of your life, it’s important you understand what Medicare is if you don’t already.
Medicare is a federal health insurance program reserved for people older than 65 who have worked full-time for at least ten years. The Medicare program is paid for by a combination of worker payroll tax, premiums paid by Medicare enrollees, and the U.S. government.
There are four parts of Medicare:
This type of Medicare is free for most U.S. citizens. Medicare Part A helps older adults pay for care in a nursing facility, hospital visits, and some forms of in-home senior care.
This tier costs around $100 per month. It covers different outpatient services like lab tests, preventative care, doctor’s visits, mental health care, clinical trials, and some forms of surgery.
This type of Medicare is most often called Medicare Advantage. This tier of Medicare allows seniors to choose health plans provided by insurance companies. Individuals who use Medicare Advantage commonly use Medicare supplement plan insurance to help pay for health care costs that Original Medicare won’t cover, like coinsurance, deductibles, and copayments.
Sometimes called “PDPs,” these plans add drug coverage to standard Medicare, some Medicare Private Fee-for-Service Plans (PFFS), some Medicare Cost Plans, and Medicare Medical Savings Account Plans (MSA).
The amount of money you pay for your health care depends on several factors, including:
- What kind of care you need, and how often it is needed.
- The type of Medicare coverage you choose.
- Whether there are alternative insurance policies that will help fill gaps in your coverage
- Whether a doctor agrees to charge you the same amount that Medicare will cover for a medical service
At Health Insurance Solutions, we offer a number of health insurance solutions for seniors. Two of our most used services include Medicare Advantage plan insurance and Medicare supplement plan insurance.
Medicare Supplement Plan Insurance in Charleston
Sometimes called Medigap, the purpose of Medicare Supplement Insurance is to help fill in “gaps” that might not be covered by Original Medicare. You can think of a Medigap policy as a supplement for your Original Medicare benefits.
Private companies like sell this type of insurance right here in South Carolina. While Original Medicare will pay for much of the cost associated with health care services you need, it may not cover all of your expenses. Generally, Medigap policies do not cover costs stemming from eyeglasses, private-duty nurses, dental care, hearing aids, or long-term care.
Depending on the Medicare Supplement Plan that you choose, it may cover out-of-the-country medical services when you travel abroad. Assuming you have Original Medicare coverage, your policy will cover its share of Medicare-approved health care costs. Once your Original Medicare coverage reaches its limit, your Medigap policy will pay its share of the fees.
Our Medigap policies are drafted to meet your specific needs, and can help cover remaining health care costs such as:
Deductibles
Copayments
Coinsurance
Important Information About Senior Supplement Plan Insurance
To dispel some confusion, you should know that a Medigap policy is not the same as a Medicare Advantage Plan. The latter helps you receive Medicare benefits, while the former supplements the benefits you obtain through your Original Medicare plan. As you begin to explore Medicare Supplement Insurance Plans, keep the following important information in mind:
AS YOU BEGIN TO EXPLORE MEDICARE SUPPLEMENT INSURANCE PLANS, KEEP THE FOLLOWING IMPORTANT INFORMATION IN MIND:
- To qualify for a Medigap policy, you must first have Medicare Part A and Medicare Part B.
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Payments on your Medicare Supplement Insurance Plan will be made to the private insurance company that you choose, like Health Insurance Solutions. These payments are made every month and are paid in addition to the monthly payment you make for Medicare Part B.
- If you are the holder of a Medicare Advantage Plan, it is illegal for an insurance company to sell you a Medicare Supplement Policy. If you plan on switching back to an Original Medicare plan, you will be able to purchase a Medigap policy.
- If you have health problems as you age, your standardized Medigap policy is guaranteed to be renewable. So long as you pay your monthly premium, your insurance provider cannot cancel your policy.
- Medigap policies only cover one person. If you have a spouse or family member that would like coverage, they must purchase a separate policy.
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You may only buy a Medicare Supplement Plan from an insurance agency that is licensed to sell them in your state. Health Insurance Solutions has been licensed to sell Medigap policies in South Carolina for years. We have helped countless seniors get the Medicare coverage they need and continue to do so to this day.
- In the past, Medigap policies were able to cover costs related to prescription drugs. As of January 1st, 2006, prescription drug coverage is not available on Medicare Supplement Plans. The best way to get coverage for your prescription drugs is to join a Medicare Prescription Drug Plan, often called Part D. Contact our office today to learn more about paying premiums on Medigap and Medicare plans.
Medicare Advantage Plan Insurance in Charleston, SC
A Medicare Advantage Plan is a kind of Medicare health coverage designed to provide seniors with all their Part A and Part B Medicare benefits. Many Medicare Advantage Plans will often include coverage of the following:
- Preferred Provider Organizations
- Special Needs Plans
- Private Fee-for-Service
- Medicare Medical Savings Account Plans
- Health Maintenance Organizations
In addition, most Medicare Advantage Plans give seniors coverage for their prescription drug needs. When you enroll in a Medicare Advantage Plan through Health Insurance Solutions, your Medicare benefits are covered through your plan and will not be paid for by traditional Medicare.
How Medicare Advantage Plans Work
Sometimes called “MA Plans” or “Part C,” Medicare Advantage Plans are considered an “all in one” solution to Original Medicare. Medicare Advantage Plans are offered by private companies that are approved to offer these plans. Call us at Health Insurance Solutions. Seniors who enroll in a Medicare Advantage Plan are still on Medicare. However, these individuals enjoy bundled plans that give seniors the benefits of hospital insurance (Medicare Part A), medical insurance (Medicare Part B), and sometimes drug coverage (Part D).
Medicare Advantage Plans are very popular because they cover all Medicare services and make life a little easier for seniors who have trouble understanding the nuances of Medicare.
When you contact Health Insurance Solutions to choose your Medicare Advantage Plan, ask your agent about Medicare prescription drug coverage. Unless you already have drug coverage (Part D), you should seriously consider Part D coverage to help reduce costs associated with prescription drugs. You may also want to consider a Medicare Supplement Insurance Plan to help fill gaps in coverage that Original Medicare will not cover.
Medicare Advantage Plan Insurance Rules
Medicare works by paying a set amount of money to the companies that offer Medicare Advantage Plan insurance in the country. That money is used to pay for the care services that you need. Because Medicare Advantage Plans are different, you should expect out-of-pocket costs to vary depending on the plan you choose.
Different plans have different rules for how you receive services, such as:
- If you must go to facilities, suppliers, or doctors that belong to your Advantage Plan for non-urgent and non-emergency care.
- Whether you must get a referral to see a specialized doctor
Companies that offer Medicare Advantage Plans must follow strict rules, which are set by Medicare and can change every year.
Paying for Your Medicare Advantage Plan Insurance
How much you pay for your Medicare Advantage Plan varies and depends on a few different factors. In most cases, if you need a kind of medical service, you will need to rely on the doctors and providers in your plan’s service area and network to pay the lowest amounts. In some cases, if you choose to use a service outside of your plan’s network of coverage, you may have to pay out-of-pocket.
We encourage you to contact our office today to learn more about Medicare Advantage Plans, how they work, what your options are, and how often you will have to pay out-of-pocket, if at all.
The Health Insurance Solutions Commitment
Since our company was founded, we have led the insurance industry by providing our clients with the most valuable, helpful insurance solutions available. We are fully committed to our current and prospective clients by:
- Choosing to focus on personalized, one-on-one service. When you work with our team, know that we will always design your health insurance plan with your best interests in mind.
- Listening to your specific needs.
- Responding to all inquiries and questions promptly and with a friendly attitude.
- Providing you with the best customer service in the senior health insurance industry, whether you have questions or are ready to move forward with a Medicare plan.
Our mission is to help give seniors the best Medicare assistance available so that they may understand the Medicare process and make an informed health coverage decision. We have the knowledge, skills, and experience to assist anyone interested in Medicare. Our personal goal is to become a lifetime resource for our clients and give them greater confidence in choosing their insurance plans.
WHETHER YOU ARE LOOKING FOR MEDICARE ADVANTAGE PLAN INSURANCE IN THE COUNTRY OR A CUSTOM MEDICARE PLAN, WE ARE HERE TO SERVE YOU.
