Medicare Planning

Planning for medical care in retirement

As employees approach their 65th birthday, they likely will be barraged with solicitations urging them to buy a Medicare Advantage or Medicare Supplement plan. 

AmeriLife Benefits takes a different approach – educating employees and retirees on their medical and prescription drug plan options so they can make an informed decision.

 

Learn more about how and when your employees can sign up for Medicare, the costs, and what is covered.

Step #1: Learn the basics and how to enroll in Medicare

Apply for Medicare online at SSA.gov by creating a my Social Security account and completing the online application. Social Security will process the application and contact the applicant if more information is needed. Please note enrollment can be deferred but it could result in Plan B late enrollment penalties, depending on the circumstances.

Step #2: Learn the difference between the four parts of Medicare

The 4 parts of Medicare

  • Part A covers inpatient hospital services
  • Part B covers outpatient medical services
  • Part C Is a Medicare Advantage Plan offered by private companies approved by Medicare. It covers Part A and Part B services, and sometimes more
  • Part D provides prescription drug coverage to lower the amount you pay for medications

Medicare Advantage plans (Part C)

Medicare Advantage plans are offered by private insurance companies contracted through Medicare as alternatives for Original Medicare. These plans combine all of the benefits of Medicare Part A (hospital) and Part B (medical), and may also include prescription drug coverage, dental or vision coverage all for an affordable and sometimes $0 monthly plan premium.

Medicare Prescription Drug plans (Part D)

Medicare Part D plans add prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans. A prescription drug plan can help save money on existing prescriptions or on medication needs in the future.

Learn about Medicare Part A and B changes for 2023 from Robert Bache, founder of Senior Healthcare Direct, an AmeriLife company.

Step #3: Learn the difference between Medicare Advantage and Medicare Supplement plans

Coverage varies between Medicare Advantage and Medicare Supplement plans, and even amongst the different Medigap plans.

Medigap & Medicare Advantage Comparison

Medicare Advantage
No

Medicare Advantage plans do not work with Medicare, but rather instead of Medicare.

Plan members are still a Medicare beneficiary and entitled to Medicare, but it is a private insurance alternative to original Medicare A and B.

Medicare Supplement
Yes

Medicare Supplement insurance, also referred to as a Medigap policy, works in a complementary manner with Medicare insurance to help cover the costs that Medicare Part A and Part B do not.

Medicare Advantage
No

Plan members must go to certain providers to be eligible for plan benefits. Medicare Advantage plan benefits are typically negotiated specific to a county (s) area for a specific network, either an HMO or PPO plan. Members will have a primary care physician, and need to get referrals, and prior authorization from the insurance company.

Medicare Supplement
Yes

You have the right to go to any provider – nationwide coverage. No referrals are required.

Medicare Advantage
Yes

Some plans are advertised as zero premium or a small premium monthly premium.

Medicare Supplement
No

Medical Supplement plans have an annual premium.

Medicare Advantage
Yes

Unless plan members are getting a rebate. The private insurance company will receive the premiums instead of Medicare.

Medicare Supplement
Yes
Medicare Advantage
No

The Medicare Advantage plan will provide a coverage ID card to use.

Medicare Supplement
Yes
Medicare Advantage
Yes

Medicare Advantage plans have a summary of benefits or fee schedule.

Medicare Supplement
Yes

Medicare Part A and B beneficiaries are subject to Medicare deductibles and copays.

Medicare Advantage
Yes

Members incur a copay or a bill for services until the specified maximum is reached. Medicare Advantage plans have an out-of-pocket maximum for Medicare-covered services for each plan year. After spending this amount on in-network care and services, the plan pays 100% of the costs of covered services for the remainder of the year.

The annual limit excludes services not covered by Medicare such as hearing and vision, monthly premiums, and prescription medications. The maximum out-of-pocket limits vary by income.

Medicare Supplement
No

Original Medicare does not have an annual limit on potential charges during the plan year.

For example, if a member goes to the Doctor, they will incur a deductible. Medicare will pay 80% of the charge, and the beneficiary pays the remaining 20%.

The purpose of a Medicare Supplement policy is to help fill most of the gap between what Medicare covers and these out of pocket expenses. Medicare Supplement policies help eliminate uncertainty regarding how much medical care might be needed and its cost.

Medicare Advantage

Medical underwriting is not required when applicants become eligible for Medicare when they turn 65 years old or are new to Medicare. Enrollees can also switch to a Medicare Supplement plan, or vice versa, within the first 12 months of coverage, or by moving out of the Plan service area.

Medicare Supplement

Medical underwriting is not required when applicants become eligible for Medicare when they turn 65 years old or are new to Medicare. Enrollees can also switch to a Medicare Supplement plan, or vice versa, within the first 12 months of coverage, or by moving out of the Plan service area.

Medigap Plan Comparison Chart

Note: Plans with X do not cover that particular benefit. If you were newly eligible for Medicare starting on or after January 1, 2020, then Plan C and Plan F were not available for you. However, anyone who had Plans C or F before 2020 can keep it.

Step #4: Shop carrier plans to get the best value

Typically, there are multiple plan choices with different premiums and deductibles available in each service area. Prescription drug coverage options will also vary. The choices can be confusing. And, deciding which plan will be best can be intimidating given its importance to living a healthy, secure life in retirement. AmeriLife Benefits is available to help. We provide three options for expert assistance:

Local AmeriLife Agent

In-person assistance provided by a local licensed AmeriLife agent (available in select markets)

Senior Healthcare Direct

A toll-free telephone consultation “virtual meeting” with a Senior Healthcare Direct licensed agent

YourMedicareQuote.com

A comprehensive research tool for those who prefer to do their own research, and enroll in a plan online

Contact us today to learn more about Medicare Planning services available from AmeriLife Benefits

Not affiliated with the U.S. government or federal Medicare program.  

 

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