Senior Products – Medicare & Ancillary

Medicare
Supplemental & Medicare Advantage

As you approach Medicare eligibility in the traditional sense by turning age 65 (aging in), what are my options? We take the time to provide clarity to what many consider a very confusing line of coverage.

Medicare is a single-payer, national, socially funded insurance program administered by the U.S. federal government since 1966. There are currently 30–50 private insurance companies nationwide that have contracts with the government to provide and administer Medicare plans. Medicare is funded by the general public through payroll taxes, premium from beneficiaries, and the federal general revenue. It provides health insurance to Americans age 65 and older who have paid into the system through the payroll tax from their jobs. Medicare also provides health insurance to younger people with disability status, as well as people with end-stage renal disease and amyotrophic lateral sclerosis, as determined by the Social Security Administration.

Knowledgeable and experienced in helping members find the right coverage to fit your needs. We begin with the CMS required Scope of Appointment form; its purpose is to determine which plans to discuss with Beneficiary. We then proceed with a Suitability Guide to assist in selecting the proper plans to meet your personal needs.

Our discussion topic includes:  When and How to Enroll, Benefit Information, networks, Summary of Benefits, Entire enrollment process, Billing and Carrier Access.

Medicare Basics

Medicare is Federal Health Insurance, you are eligible for Medicare if you are:

  • A citizen or permanent resident of the United States
  • Age 65 or older
  • Younger than 65 with certain disabilities
  • Any age with end-stage renal disease or ALS

Original Medicare – you can decide to get Original Medicare, Medicare Advantage plan, or prescription drug plan.

Medicare has 4 parts:

  • Part A – Hospital Insurance. Part A covers inpatient care, skilled nursing facility, hospice and some home healthcare. You will have out of pocket deductible and co-insurance costs.
  • Part B – Medical Insurance. Part B helps pay the costs of doctor visits, outpatient services and some preventive services. You will have additional costs such as Part B monthly premiums based on your past income, a annual deductible and co-insurance.
  • Part C – Medicare Advantage also known as MA and MAPD plans. When you join a Medicare Advanatge Plan, you get Part A & B (and usually Part D / Drug) in one plan. Many of these plans also offer extra benefits not found in Original Medicare. Can include Dental, Vision, Hearing and Gym Memberships.
  • Part D – Prescription Drug Coverage. Part D helps cover the costs of prescription drug coverage with a couple of options. 1) can buy a stand-alone RX drug plan and add to your Original Medicare or you can enroll in a Medicare Advantage Plan that offers Part D coverage (MAPD)

Medicare Supplement Insurance Plans/ Medigap

Medicare Supplement plans complement Original Medicare. These plans cover most of your out-of-pocket costs with Part A and Part B. You still get your health insurance from Medicare, but your Medicare Supplement plan pays your deductible and coinsurance. If Medicare doesn’t cover a service, neither will your Medicare Supplement plan.

Medicare Supplement plans don’t pay your out-of-pocket costs with Part D. You will need to buy a standalone Part D plan in addition to the supplemental plan. Medicare Supplement plans don’t have restrictions such as provider networks and prior authorization. You can use your plan with any provider that accepts Medicare.

Product and plan availability varies by state, county, and zip code.

Medicare Advantage

Our portfolio options consist of both regional and national Medicare Part C plans.

Medicare Advantage Plans

Medicare Advantage plans are popular among Medicare beneficiaries. They often offer affordable premiums and additional benefits. There are several types of Medicare Advantage plans such as: Medicare Advantage Plans with Prescription Drug Coverage (MAPDs), Chronic Medicare Advantage Plans (C-SNPs), and Dual Medicare Advantage Plans (D-SNPs). Medicare Advantage Plans are often subject to enrollment periods. Product and plan availability varies by state, county, and zip code. For more information on what plans are available in your market, please contact us.

  • BlueCross Blue Shield of Minnesota
  • Aetna/Allina
  • Health Partners
  • Medica
  • UnitedHealthcare
  • UCARE

Medicare Part D Prescription Drug Plans

Medicare Part D Prescription Drug Plans can help you afford prescriptions. We work with multiple carriers who offer private plan options. Product and plan availability varies by state, county, and zip code. The following link to Medicare has a Prescription Drug tool to help you to determine your potential out of pocket costs with various Part D Prescription Drug Plans.

https://www.medicare.gov

Some of our contracted carriers:

  • Blue Cross Blue Shield
  • Mutual of Omaha (OHIC)
  • SilverScript RX
  • WellCare

Some of our contracted carriers:

  • Blue Cross Blue Shield
  • Mutual of Omaha (OHIC)
  • SilverScript RX
  • WellCare

 

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