Services Offered
Supplementing Medicare is not a one size fits all approach.
Your specific needs are unique. It’s important to protect your livelihood by carefully selecting the right Medicare Supplemental, that will serve you well and meet your expectations.
Medicare Advantage Plans
Medicare Advantage Plans incorporate parts A & B (Medical) with Part D (Drug). They include extra benefits like dental, vision and hearing. These are networked HMO & PPO’s plans.
Supplemental Plans
Traditional Medicare Supplements, also known as Medigap plans help pay for the 20% not covered by original Medicare. They offer no network restrictions, high level coverage and lots of freedom.
Prescription Drug Plans
A stand-alone Prescription drug plan, known as Part D, provides medical prescription drug coverage. Prescription drug plans work in conjunction with traditional Supplemental plans and with Medicare.
Why Should I Supplement Original Medicare?
There are three important reasons why you should supplement Original Medicare.
Reason #1 – Original Medicare does not provide you with a financial safety net. What I mean by this is that Original Medicare has no Maximum Out of Pocket cap within a given calendar year to protect you, if you have a difficult year medically and really use your insurance a lot. Because of this, those who only have Original Medicare statistically are more opt to find themselves in a medical bankruptcy type of situation.
Reason #2 – You will pay more for many services if you only have Original Medicare. Many services through Original Medicare will charge you a 20% copay or coinsurance. Depending on the service, that can be a lot of money.
*If you choose an economical Medicare Advantage Part C Plan, most of your services will instead be charged as a set copay, which is often much lower in cost than paying for 20% of a service. Advantage Part C plans also provide you with a Maximum Out of Pocket per calendar year, which is your financial safety net. Medicare Advantage Part C plans have either no monthly premium/cost or a low affordable premium monthly cost. These are networked plans such as HMO’s (Health Maintenance Organizations) and PPO’s (Preferred Provider Organizations).
*If you choose a traditional Medigap Lettered Supplemental, you will pay a higher monthly premium, but will also gain access to high level coverage with either no copays or very limited copays and no network restrictions.
Reason #3 – The Medicare Advantage Part C plans offer several benefits that are not covered by Original Medicare, such as Dental, Vision, Eyewear Credit, Hearing, Chiropractic, Fitness Club Network Membership, and a Monetary Credit to Purchase Over the Counter Health and Wellness Products.
Travel Abroad: Original Medicare does not provide you medical benefits when you are outside of the United States. The various supplementals, including both Advantage Part C Plans and Traditional Medigap Lettered Supplements plans provide you Worldwide Medical Coverage.
Avoiding Part B and Part D Penalties:
Let’s be proactive together and protect you from acquiring Part B & Part D Penalties.
Part B Penalty – This is referring to someone who is Medicare eligible and has chosen not to get original Medicare Part B. Unfortunately, a penalty starts calculating and one would pay an extra 10% for each year they could have signed up for Part B, but didn’t.
Part D Penalty – Part D is Prescription Drug Coverage. If you decide to forgo acquiring a plan that will provide you creditable drug coverage, then unfortunately Medicare calculates a penalty by multiplying 1% of the “National Base Beneficiary Premium” times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
New to Medicare:
I provide free coaching and personalized guidance, every step of the way. I will educate you on how to get your original Medicare set up through Social Security. There are specific time lines involved in this process, so being properly informed and proactive will save you many headaches.
*I highly recommend contacting Social Security a full three months prior to when you gain access to Medicare.
*Please don’t procrastinate! It can take upwards of 8-12 weeks for Social Security to process and set up your original Medicare, once you initiate contact.
Individuals age into original Medicare when they turn 65.
Younger people who are on long term disabilities also gain access to original Medicare, once they have been on their disability for two-years (24-month mark). Medicare is awarded on month 25.
Delayed Part B:
Some individuals have already set up their Medicare Part A, but have chosen to delay their Medicare Part B because they still have access to employer sponsored medical insurance coverage. When these individuals retire or lose their employer medical coverage, they will be provided a “Special Election Period” that provides them a time-specific enrollment opportunity to enroll into a Medicare Supplemental.
Recent Residential Move:
If you have recently made a permanent residential move to a new state or even to a new county within the same state, you will likely need to change your supplemental insurance coverage if you have a Medicare Advantage Part C plan.
You will be provided with a Special Election Period, that will allow you to enroll into a new Advantage Part C plan within the month prior to your move, or up to 2 months after your move.
*Don’t miss your window to make these important changes!
Veterans:
I honor, respect, and appreciate Veterans and their service to our country.
I offer specialized plans that will allow Veterans to continue to keep full access to the VA, TriCare and Champ VA, but that also provide additional benefits and coverages that the VA typically does not offer.
These plans have no monthly cost or premium and provide additional coverages like:
Part B Rebate (cost reduction for original Medicare Part B), Dental, Vision, Eyewear Credit, Hearing, Chiropractic, Fitness Club Network Membership and a substantial Monetary Credit to Purchase Over the Counter Health and Wellness Products.
These Veteran plans offer a separate path where a Veteran can access private medical, without losing any access to the VA or their benefits provided through TriCare or Champ VA.
*These plans can lower the cost of original Medicare Part B by up to $75 each month. That’s an annual savings of up to $900 per year. It’s like receiving a $75 payment increase to your monthly Social Security.
Lower Income Individuals:
I will research and determine if you qualify for any State or Federal Financial Assistance programs and enroll you. These programs (State Medicaid & The Extra Help Program) can significantly lower the cost of Medicare Services & Prescription Drugs.
There are several different levels of state Medicaid (Welfare) and Medicaid benefits vary from state to state. Depending on your Medicaid level, you may qualify for state Medicaid to cover the cost of your original Medicare Part B.
Individuals who have certain higher levels of Medicaid may also be eligible for specially designed Medicare Advantage Part C plans (Dual Special Needs plans) that coordinate your Medicare and Medicaid benefits. These plans do not cost anything (No monthly premium) and often have ZERO copays. They are also VERY GENEROUS in the extra benefits they offer.
Extra Help Program:
The Extra Help Program, also called a Lower Income Subsidiary, is a Federally funded program that lowers the cost of prescription medications and removes any Part D Penalties.
Many people who don’t consider themselves low income still qualify for this program. Because of this, I screen all my clients to determine if we can substantially lower the cost of their prescription medications.
Individuals with Access to Retiree Plans:
If you have access to an Employer Sponsored Retiree plan, but are unsure regarding how competitive it is compared to original Medicare and Medicare Supplementals, I can help. I do this by comparing the cost and benefits offered between the two options.
Some retiree plans are amazing and make sense to choose. Many are not though and can actually end up costing more and providing fewer benefits than going onto traditional Medicare and a Medicare Supplemental.
Higher Income Individuals:
If you are a higher income individual, you could be subject to IRMMA (Income Related Monthly Adjustment). This is something that can affect the cost of both original Medicare Part B, as well as Part D.
I can help you understand IRMMA better. I also provide guidance in situations where the higher income is only temporary, due to something like Capital Gains that may need to be adjusted with Social Security.