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Medicare Facts and FAQs

What is Medicare?

Medicare is a government funded health insurance program designed to serve people over the age of 65 and younger individuals with disabilities, or End Stage Renal Disease.

Medicare helps with a portion of the costs associated with hospitalization, doctors visits, medical equipment and prescriptions drugs1. "Traditional Medicare", as it is sometimes called, generally pays 80% of covered services1. Medicare Beneficiaries (people who are entitled to, and enrolled in Medicare) are generally responsible for the remaining 20%.

There are options to help cover the Medicare beneficiary’s portion of Medicare covered expenses (the 20% co-insurance as it’s often referred to). Talk to a Local Medicare Specialist to learn more about how Medicare Advantage, Medicare Supplements and Prescription Drug Plans can help reduce out of pocket expenses.

When is the right time to enroll in Medicare?

Choosing the right moment to enroll in, or enquire about Medicare options often leaves people a little confused. We suggest consulting with one of our agents, as they’ll look at the entirety of your situation and can assist in timing. However, there are a few options for jumping in:

MILESTONE BIRTHDAYS
Turning 65 means that you’re now eligible for Medicare. However, it’s important to weigh all of your options, and all future variables before making a decision.

OPEN ENROLLMENT
Every year from Jan 1 to Mar 31, beneficiaries get the chance to reevaluate their coverage, and make the switch to a new plan.

ENROLLMENT FOR PART C & D
From Oct 15 to Dec 7, beneficiaries have the opportunity for specific Medicare and drug plan changes.

UPGRADES
During open enrollment periods, beneficiaries can reevaluate and upgrade certain coverage.

What are Parts A, B, C and D?

This is a very common question, and one that is extremely important. There are 4 different parts to Medicare, and depending which parts you qualify for, you’re entitled to the coverage under those.

So what does each part cover? We always recommend speaking to one of our experienced Local Medicare Specialists for more in depth information—however, here’s a quick rundown:

Part A – covers hospitalization, skilled nursing facilities (post hospitalization), hospice care and some home health services2.

Part B – covers medically necessary “medical expenses''. This includes doctor's services, outpatient care, preventative care and medical equipment2.

Part C – is an agreement between Medicare and a private insurance company (contracted with Medicare), to administer Part A, B and often Part D on behalf of the government. This is also called Medicare Advantage.

Part D – covers the cost of some prescription drugs* and is also administered by private insurance companies.

Talk to a Local Medicare Specialist to learn more about how Medicare Advantage, Medicare Supplements and Prescription Drug Plans can help reduce out of pocket expenses.

What is a Medicare supplement and do I need one?

Traditional Medicare (Part A & B) covers 80% of "medically necessary" hospitalization, and medical care expenses. This leaves 20% to be paid out of pocket by the Medicare Beneficiary (you).

A Medicare Supplement is designed to lighten the load significantly. There are many options available for Medicare Supplements, and each one has unique features covering different types of medical expenses. It's important to discuss your options with one of our Local Medicare Specialists, to find the best supplement for your needs.

Am I guaranteed to qualify for a Medicare supplement?

Yes and no, There are instances when a Medicare Beneficiary is entitled to a guaranteed issuance of a Medicare Supplement. However, there are times when enrollment in a supplement is subject to "underwriting". This is the process of answering questions about health conditions and circumstances.

Who administers Medicare supplements?

Medicare Supplements are administered by private insurance companies and are designed to work in conjunction with your "Traditional Medicare".

Talk to a Local Medicare Specialist to learn more about eligibility, pricing, and how Medicare Supplements vs. Medicare Advantage can help reduce out of pocket expenses.

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