Good Neighbor Insurance, Inc provides Medicare Advantage and Medicare Supplement plans (Part C) for our clients in Arizona and throughout the U.S. To understand more about U.S. Medicare please go to our web page at www.gninsurance.com/medicare.asp or go to our Arizona health insurance web site at dev.gninsurance.com.
What is Medicare?
- A U.S. Federal government health insurance plan for folks age 65 and onwards.
- There are four parts of Medicare.
- Part A and B are government run and cover up to around 75% to 80% of all medical cost minus Rx. You can stop there and pay the rest of all medical care out of your pocket or…
- Part C is private insurance to cover what Medicare Part A and Part B does not cover.
- Part D is Rx coverage
- Hospital coverage/insurance
- Fully handled by the U.S. Federal government
- It helps cover inpatient care in a hospital or skilled nursing facility
- It does not cover long term care in a nursing home
- It does cover hospice and some home health care
- It is free. Well, you have paid into it all your life if you worked in the U.S.
- 2011 monthly premium is around $95 for most beneficiaries and will only go up a few dollars in 2012 to right under $100 a month.
- Higher income individuals will pay more
- Covers outside the hospital medical expenses like doctor’s services, medical tests, hospital outpatient care, some home health care and durable medical equipment.
- Coverage includes many preventative services, such as flu shots and mammograms, which help maintain your health or detect an illness at an early, more treatable stage.
- Does not cover the majority of Rx drugs.
- Part A and Part B are called the “Original Medicare” package.
- You automatically have Part A the first day of the month of your birthday.
- Unless you “uncheck” Part B that also will start the first day of the month of your birthday.
- If you do not get Part B you will not be able to get Part C
- You do not have to purchase Part C or Part D or both together. However, all that Part A and Part B do not cover you will have to pay out-of-pocket.
- Two types; Medicare Advantage and Medicare Gap/Supplement plans
Part C Medicare Advantage plans:
- If you join a Medicare Advantage plan the U.S. government pays a fixed amount to the insurance company every month for your care
- The insurance company can then set its own rates for your out-of-pocket cost.
- The insurance company can make rules about how to access care, such as requiring you to use only certain doctors and hospitals – AKA use in network system
- Minuses of these plans: (1) More out-of-pocket than the Medicare Gap plans. (2) In-network to use. (3) Changes to the benefits each year
- Pluses of these plans: (1) Low monthly premiums from $0 to $50 on average. (2) Dollar cap/ maximum out-of-pocket for the calendar year. (3) Very similar to an under-65 health insurance plan.
Part C Medicare Supplement/Medicare Gap plans:
- These plans go by one or two names; Medicare Supplement or Medicare Gap plans
- Full blown medical coverage with no major out-of-pocket medical expenses.
- Higher premium
- Coverage benefits are set in stone by the U.S. Congress and have not decreased since inception of Part C
- Use any Medicare doctor/hospital/staff in the U.S.
- Premiums for someone at 65 around around $90 to $120 depending on smoker/non-smoker and resident zip code.
- Best option if you want to have more control over your medical insurance
- No underwriting for the first 3 months from the time you start Part B. However, after the 3 month window then one has to go through underwriting to be accepted.
- These plans cover 100% of all what the U.S. government states plus more.
- Part C Medicare Supplements/Medicare Gap plans allow you to have more control over your medical care since you are paying more.
- If you want low monthly premiums go with the Part C Medicare Advantage plan. However, changes each year happen to these plans and the U.S. government has more sway over these plans than the Medicare Supplement/Medicare Gap plans.
Part D Rx plans:
- Optional plan you may purchase for a monthly premium
- Medicare drug plans are managed by private insurance companies and help cover the costs of prescription drugs
- You can purchase these plans as a stand-alone plan or bundled with a Part C plan. However, if you bundle it with a Part C plan and you cancel your medical part of Part C than the Part D Rx plan will also be cancelled since they are bundled. Best thing to do is have it as a stand-alone plan even though you will pay a little higher premium.
- Plans differ in their cost primarily through a variety of co-pay options.
- Medicare does not cover most travel care overseas. If it does, depending on the plans, it is very minimal.
- Medicare for sure does not cover for medical evacuation overseas which is the most costly of medical cost when traveling outside the U.S.
- The best thing to do is have a short term travel plan and Good Neighbor Insurance provides that to our clients. You may go to http://www.gninsurance.com/travelinsuranceover65/ for different options that may fit your specific needs.
There are parts of Medicare that will be changing due to the new March 2010 health care law that was passed. Good Neighbor Insurance has a great article with all those changes and you may go there by clicking on this link, http://tinyurl.com/3g3r9yk.
Doug Gulleson loves to scuba dive overseas and makes sure he has his U.S. health care and overseas health care, www.gninsurance.com , information with him at all times when he travels Keep our blog close by you, www.gntravelinsurance.com, for continual updates on our U.S. health care.