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January 25, 2017 // News

Why Work with an AMAC Broker Agent?

Are you searching for a Medicare plan? Your local AMAC Broker Services agent is a trusted advisor who can help you navigate the complex world of Medicare and give you the tools you need to choose a plan that’s right for you!

Why you should care about who your agent contracts with:

AMAC AGENTS MAKE IT EASY FOR YOU TO CHOOSE THE INSURANCE PLAN THAT IS RIGHT FOR YOU

Making Sense of Medicare; Let an AMAC Broker Services AGENT be Your Guide!

History

Medicare was created in 1965 as an American health insurance program for people age 65 and older and for people under age 65 with certain disabilities, such as End-Stage Renal Disease. Medicare is run by the Centers for Medicare and Medicaid Services.

President Lyndon B. Johnson signed Medicare into law on July 30th, 1965. The first Medicare beneficiary was former president Harry S. Truman who was presented with the first Medicare card at the bill-signing ceremony.  When first implemented, the original Medicare had only two parts; Part A- Hospital Insurance (Inpatient Care) and Part B – Medical Insurance (Outpatient Care).  In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was the largest overhaul of the program since its inception and added prescription drug benefits to the program effective January 1, 2006.

Medicare Advantage Plans

Medicare Advantage Plans provide a way for beneficiaries to receive their Part A, B, and D benefits offered by private insurers contracted with Medicare. Medicare Advantage Plans are sometimes referred to as Part C – which includes Parts A and B, and can include Part D – in one comprehensive plan, by replacing Original Medicare. There are different types of Medicare Plans, such as HMOs, PPOs, Special Needs Plans, Private Fee for Service Plans, and Medicare Savings Accounts. If you are married, both you and your spouse must buy separate policies.

Medicare Supplement Plans

Also known as Medigap Plans, Medicare Supplement Plans are sold by private insurance companies. A basic Medicare Supplement Plan works with Original Medicare to help pay for some of your out-of-pocket costs, such as co-payments, co-insurance, and the annual Medicare Parts A and B deductibles.

There are 11 Medicare Supplemental Plans from which to choose, and your AMAC Broker Services agent can help you understand your choices. There can be big differences in the premiums of these plans with varying benefits. The plans are called Plan A, B, C, D, E, F, High Deductible Plan F, G, K, L, M, and N.

A Medicare Supplement Policy can only cover one person. If you are married, both you and your spouse must buy separate policies. This also applies to Medicare Advantage Plans and Medicare Prescription Drug Plans.

MEDICARE HAS:

Medicare Eligibility

As long as you or a spouse have worked for 10 or more years and have paid into Medicare via payroll deduction, there is no charge for Part A. The cost for Part B in 2017 is _________ per month, or more for high income earners. All single beneficiaries with earnings of more than $85,000 per year, and couples with incomes above $170,000 will pay higher premiums.

Medicare: Out-of-Pocket Co-Payments, Co-Insurance, and Deductibles

People who have Medicare Parts A and B are required to pay some costs out-of-pocket, such as co-payments, co-insurance, and deductibles. For example; for each inpatient benefit period, a beneficiary will pay a Part A deductible of $_____ for a hospital stay of 1-60 days. Under Part B, a beneficiary must meet a yearly deductible of $_____, and they are required to pay 20% of the Medicare approved costs for most services covered by Part B. Beneficiaries may also be required to pay excess charges up to 15% of services rendered by non-participating Medicare providers.

All of these costs can amount to thousands of dollars, draining a beneficiary who does not have the means to pay for the rising medical costs or expensive prescription drugs. For this reason, many people choose to consider additional coverage to save them money.

HOW TO ENROLL in MEDICARE Part A and Part B:

Frequently Asked Questions

Can I enroll in a Medicare Part D plan, Medigap plan, or Medicare Advantage plan if I am not enrolled in Medicare?

No. You must be enrolled in Medicare in order to be eligible to enroll in a Medicare Part D plan, Medigap plan, or Medicare Advantage plan. A Medicare Part D prescription drug plan only requires that you be enrolled in Medicare Part A. However, in order to enroll within a Medigap plan or a Medicare Advantage plan, you must first be enrolled in both Medicare Part A and Medicare Part B.

Do all Medicare Part D plans cover the same medications?

No, each plan may have a unique list of covered drugs. The list of covered drugs is known as a formulary. Medicare requires all Medicare Part D plans to cover at least two medications in each therapeutic category/class approved by Medicare. The drugs within the formulary are assigned to tiers. The tier determines the co-payment or out-of-pocket costs a person within the plan will pay for the drug. If you take a medication that is not covered on your Part D plan’s formulary, you will pay full retail price.

Do I have to be enrolled in Medicare Part B before I enroll in a Medicare Advantage program?

Yes.

If I enroll in a Medicare Advantage plan or a Medigap plan, do I still have to pay my Medicare Part B premium?

Yes. You will have to pay your monthly Medicare Part B premium to Medicare alongside the monthly premium you pay to your Medicare Advantage plan or Medigap plan.

If I enroll in a Medigap plan, will it also cover my spouse?

No. You and your spouse must each enroll in a Medigap plan in order to obtain Medigap coverage.

Are Medicare and Medicaid the same thing?

No. Medicare is a federal health coverage program designed for the elderly as well as individuals with certain qualifying health conditions such as End Stage Renal Disease. Medicaid is a state-run health coverage program primarily targeting low-income individuals within the state.

 

 

Join the Discussion  Add Your Comment

  1. Thomas Greninger says:

    I enjoy helping people with complex insurance problems. After 40 plus years of successfully doing so, I feel comfortable in representing the approved companies.

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