At Mature Health Insurance Partners (MHIP), we help you navigate the sometimes complicated process of transitioning to Medicare. This includes walking you through the changes to your health care with Medicare and keeping you informed about pertinent enrollment dates, coverage options, and supplemental insurance.
what is medicare?
Medicare is health insurance available to persons who are 65 or older, as well as for persons who have certain disabilities or end-stage renal disease. Medicare is broken down into four different parts:
- Covers hospitalization, skilled nursing facilities, hospice care, and home health care
- No premium (you’ve been paying into Medicare ever since you began working)
- Automatically goes into effect the first day of the month in which you turn 65
- Covers doctors and outpatient services, as well as some preventive services, x-rays, tests, physicals, occupational and speech therapy, ambulance services, and medical supplies and equipment
- Must notify Social Security that you want Part B, normally 3 months before you’re eligible (Note: if you’re already receiving Social Security benefits, you will automatically be enrolled, so you have to notify them if you do NOT want it. If you are still working and enrolled in a group health plan, you may want to delay enrollment in a Part B until you retire or leave the group plan)
- Premiums depend on your financial situation and can come directly out of your Social Security check (if you are not yet receiving Social Security, you can arrange for billing or automatic bank draft)
- Must be enrolled in both Medicare Part A and Medicare Part B to apply for an Advantage Plan
- Sold by private insurance companies and replaces Medicare as your primary insurance
- Cost-sharing in the form of co-pays, deductibles, and coinsurance
- Many Advantage Plans include prescription drug coverage; some will provide routine dental/vision/hearing
- Several different Medicare Advantage Plans options, including HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), PFFS (Private-Fee-For-Service), and SNP (Special Needs Plan)
- Standalone drug plan used to complement Original Medicare, Original Medicare with a Medicare Supplement plan, or certain Medicare Advantage plans that don’t include prescription drug coverage
- Monthly premiums, deductible, and copays
- Covers prescriptions at different amounts depending on your plan and coverage level
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LEARN MORE ABOUT MEDICARE SUPPLEMENT INSURANCE
With a Medicare Supplement, Medicare is still your primary insurance, but the supplement plan fills in the gaps of Medicare by paying your deductibles and coinsurance so that you don’t have copays (except with certain plans). These plans also allow you to go to any provider that accepts Medicare nationwide.
The most popular plans are F and G. These plans and their benefits are described below. A complete Outline of Coverage is available upon request.