Medicare FAQ
The federal Medicare program pays most medical expenses for people 65 or older or for individuals under 65 receiving social security disability benefits. However, Medicare does not pay all expenses. As a result, you may want to buy a Medicare supplement policy that helps pay for certain expenses, including deductibles not covered by Medicare.
If you are 65 or older and elect coverage under Medicare Part B, either due to age or disability, you have a six-month open enrollment for a Medicare supplement policy, which guarantees you coverage with a plan and company of your choice. You may choose from a list of standardized plans – listed as A through L. If you do not purchase a plan within your six-month open enrollment, any company you apply to can deny coverage based on your health conditions. There are some limited additional open enrollment periods available to some persons unenrolling from a Medicare health maintenance organization (HMO).
Medicare supplement policies may not include prescription drug coverage. Those who currently have a policy with prescription drug coverage may opt to keep that coverage or switch to the new Medicare prescription drug plans.
Medicare Advantage plans (formerly known as Medicare+Choice plans) are private managed care plans that provide the standard Medicare benefits, plus additional supplemental benefits for a monthly fee. These plans may include prescription drug coverage. Medicare Advantage participants may even receive a subsidy for their prescription drug benefits in most cases.
Medicare select plans provide supplemental benefits through a network of providers similar to a Preferred Provider Organization (PPO). If the participant received care for a provider under contract with the insurer, the cost will be lower.
You have two options when you go on Medicare:
- a supplement
- an advantage plan.
Many companies want to sell you their product. They bought your name and information from a database company. They consider you a prospect for their product.
Some are strong in some areas, some in others. They all fall under one of two categories – either a supplement or advantage plan. It is my job as an independent agent to go over the positives and negatives of each plan and company.
There are two ways you can purchase a Medicare plan:
- Directly from a company, or agent who works solely for an insurance (insurer) company.
- From an independent agent (like SMART Plan Advisors) contracted with a number of companies.
Either way you purchase a plan does not affect cost.
Some of the major benefits of an independent broker such as SMART Plan Advisors are:
- a) if you have a problem you have one person to call, not an 800 number with a different stranger every time.
- b) an independent agent, like myself, can look out for your best interest and go over every option you have.
Because of paying into Medicare over the years, the government (Medicare) will pay a premium per month for you to have coverage with a company. This varies with each county.
As your agent, the company will pay SMART Plan Advisors (me) a commission. Your Smart Plan Advisor will be on record as your agent, available for you, to advise and help resolve problems. There are no additional charges to you.
Some companies are more aggressive with Medicare products. Some companies consider it a service to their current clientele.
This is called Part D with Medicare. Some advantage plans include drug coverage. Most people who go with a supplement enroll in a stand-alone drug plan.
This all comes down to coverage and cost. It is important to look at what coverage you have now and what it is costing you. Some people find that they can get better coverage for the same or equivalent price. Again, that is part of my job to go over your coverage and compare it to your options.
Service, Integrity, and Education to bring knowledge, tools and experience to simplify the complex. You will be presented with options with no bias for any particular company or plan since we are independent. My job is to get you all the information you need to make an informed decision about your coverage. And, you will have all my contact info and numbers in case you need support in the future too. Additionally, we annually review together for continued alignment of plans and your unique situation. Again, all at no cost to you.
No. Regardless of whether you choose Option 1 (Supplement) or Option 2 (Advantage), the price and benefits will be the same. A particular Medicare supplement will cost the same whether you use SMART Plan Advisors or deal directly with an insurance company. Your independent advisor will guide you through the process and help make you aware of the best combination of coverage and pricing available in your area. Another benefit of using SMART Plan Advisors is customer service, from here on out, goes through us and not a toll-free number with someone you never met.
No. SMART Plan Advisors is paid a commission by whichever health insurance company you choose. No additional fees are added to your insurance premium. Working with an advisor will likely save you money due to their awareness of the most competitive rates available in your area; but more importantly is the future service your advisor will provide when it comes to headaches and problems. You have the option to rely on us to handle any issues if they arise.
