Both with and without prescription drug coverage
I begin by discussing each client’s needs, because it is very important to understand that everyone is different. For example, do they have specific doctors they want to continue seeing, which may involve network considerations? Do they need access to a particular hospital?
My role is to educate each person about their options. I do this by creating a side-by-side comparison of plans and reviewing it with them until they feel comfortable and confident making a decision about which plan will work best for them.
Most Medicare plans are annual, meaning they renew each year on January 1. The Annual Election Period runs from October 15 through December 7 each year. This is the time when people with Medicare can make changes to their plan for the upcoming year.
If someone takes multiple medications, we also review prescription coverage carefully and reassess their options to make sure their plan continues to meet their needs.
I work with individuals who are approaching retirement and need to decide whether to stay on their employer group plan if they continue working or transition to Medicare. I also help determine when to enroll if you are turning 65 and are no longer working.
Medicare is a federal program. Part A is hospital insurance, and Part B is medical insurance. Both are provided by the federal government. If you choose to receive Social Security benefits, your Part B premium is typically deducted from your Social Security payment. If you do not take Social Security right away, you will pay the Part B premium directly to the federal government (CMS – Centers for Medicare & Medicaid Services).
Original Medicare generally covers about 80% of approved costs, leaving you responsible for the remaining 20%, unless you enroll—through me—in either a Medicare Advantage plan or a Medicare Supplement plan with a prescription drug plan.
There are many important points to discuss. First, does your doctor accept Medicare? If you choose a Medicare Advantage plan, provider networks and in-network doctors are very important. If you choose a Medicare Supplement plan and your doctor accepts Medicare, the supplement plan simply follows Medicare’s coverage.
Confused about your health insurance? Let us clear the path.
