Senior Health Solutions

Melbourne Medicare Solutions

kim honeycutt

There are several Medicare enrollment periods to understand and be watching for throughout each year.

Medicare can be a complicated decision and sometimes the choices can seem overwhelming when you are not sure what you need. To offer you a personalized plan, you will be asked for a list of your current doctors and prescriptions to make sure they will be covered. Let 321 Senior Health be your resource and guide you to make the best decision for your health needs. Kim Honeycutt can answer any questions you might have and help you step by step to enroll and to choose the right plan. Contact her for your one-on-one, no cost, no obligation consultation today!

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part a

Medicare Part A (Known as Hospital Insurance): This covers hospital expenses. You may be responsible for various deductibles, coinsurance, and copayments. Individuals earn Part A by paying taxes toward Medicare while working for 10 years (or 40 quarters). If you did not earn Part A, you will pay a premium.

It Helps Cover:

Hospital Stays
Skilled Nursing Facility Care
Hospice Care
Some Home Health-Care Services

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part b

Medicare Part B (Known as your Medical Insurance): This covers services that treat your conditions or illnesses. It also covers preventive services like cancer screenings, “wellness” visits, and flu shots. Most individuals pay a premium for Part B. Those who are enrolled in a Medicare Advantage plan that provides Part A and Part B benefits or those on a supplement plan will still pay the Part B premium.

It Helps Cover:

- Services from Doctors and other Health Care Providers
- Outpatient Care
- Home Health Care
- Durable Medical Equipment (such as wheelchairs, walkers, hospital beds, and other equipment)
- Multiple Preventative Services

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part c – Medicare Advantage Plans – MA Plans

Medicare Advantage Plans are an “all in one” alternative to Original Medicare (Part A & Part B). Private companies offer these with the approval of Medicare. If you decide to join a Medicare Advantage Plan, it will include:

Medicare Part A (Hospital Insurance)
Medicare Part B (Medical Insurance)
*Typically, but not always-Your Medicare Drug Coverage (Part D)

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part d – Prescription drug plans

Original Medicare (Part A & B) doesn’t cover prescription drugs. Although it is optional, individuals will pay a late-enrollment penalty if they don’t sign up for the Medicare Part D when they are first eligible to get it. Individuals can get the Medicare Part D prescription drug coverage through a stand-alone Prescription Drug Plan (PDP), or through a Medicare Advantage Plan that includes prescription drug coverage.

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prescription drug plans

These plans add drug coverage to Original Medicare Parts A & B, Supplement plans, Some Medicare Private Fee-For-Service(PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

Each Medicare Prescription Drug Plan has its own formulary, or list of covered drugs. Various Medicare Drug Plans categorize the specific drugs into different “tiers” on their formularies. Each drug tier has a different cost associated with them.

Tier 1 is Generics
Tier 2 is Preferred brand name drugs
Tier 3 is Non-Preferred brand name drugs
Tier 4 is Specialty drugs and injectables
*Some formularies can have up to six tiers

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medicare supplement insurance plans

A Medicare Supplement Insurance Plan is used with Original Medicare (Part A & Part B). It’s also called “Medigap.” It helps fill the “gaps” in Original Medicare and is sold by private companies. Any caregiver that accepts Medicare will accept a Supplement because they only need to bill Medicare. Original Medicare generally pays their part which is about 80% of the Medicare covered benefits. The remainder of the bill is sent and covered by the Supplement, which is generally about 20%. The Supplement pays for a large portion, but not all of the costs for covered health care supplies and services.

*Please Note:

1) Supplements do NOT include Prescription Drug Coverage (Part D, PDP). For those who do not get a PDP when first eligible, there will be a penalty when they do decide get a PDP (there are some exceptions that may apply to this).

2) Medicare Supplement plans remain the same on a yearly basis, but there are typically rate increases from year to year.

Medicare Supplement Insurance policy can help pay some of the remaining health care costs, such as:

Coinsurance
Copayments
Deductibles

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medicare special needs plans

Dual Eligible Special Needs Plan (also known as D-SNP)

The D-SNP (HMO) Plan, is when both Medicare and Medicaid benefits are combined into one simple health plan. Members don’t pay anything for covered medical services. They are a type of Medicare Advantage Special Needs Plan. The details of how much Medicaid will cover depends on the member’s resources, income, and other factors.

*States may vary with the categories in which they determine a person’s eligibility levels. Always refer to the Medicaid website for your information.

Chronic Condition Special Needs Plan (also known as The C-SNP)

Are a type of Medicare Advantage Part C Plan. These plans are designed to provide people with chronic or debilitating illnesses the medical care and treatments they need, all in one plan. They always include prescription drug coverage (Medicare Part D). To be eligible for this plan, you must meet the following requirements: Be eligible for Medicare, live in the plan’s service area, and must have a diagnosis with one or more severe or disabling chronic conditions. To ensure eligibility, your doctor may need to fill out a Chronic Condition Verification Form for the plan’s provider.

Ancillary Benefit Plans that I offer:

Dental
Vision
Critical Illness/Cancer
Life Insurance
Long-term care
Hospital Indemnity

need help selecting the right medicare plan for you?