The Basics of Medicare

The Basics of Medicare
I know you would all prefer to make this quick and easy. But there is NO BEST MEDICARE PLAN. You all have different health needs, you all doctor differently. So, you really need to understand you BASIC choices and that is what I’d like to do here today.
Let’s go over the basics of Medicare:
A = everything that happens in a hospital. You pay for Part A while you are working they take it out of your weekly paycheck so that at age 65 it is paid up.
B – covers everything that happened OUTSIDE of the hospital. Dr. visits, therapy, medical equipment. You have to sign up and pay for Part B when you turn 65 or go onto Medicare after age 65. It costs about $100 a month and they take it directly out of your Social Security Check.
C-private Medicare called Medicare Advantage. These plans often have $0 monthly charges, but you can only go to certain doctors and hospitals (unless it is an emergency) These plans are known by many names: HMO, PPO, POS, PFFS and may included your drugs or not.
D-drug plans. You can buy a plan by itself or pair it up with a health plan. If you have VA benefits you can still buy a plan and may want one, or just use your VA benefits. You cannot have a Part D drug plan AND a group drug plan from your employer.
These are the basic ABCs of Medicare. I could take hours explaining it all to you—and I won’t—but as long as you understand these points you have a good grasp of the basics!
People may tell you otherwise, but I’m here to bring the bad news: your drugs are very expensive and the government’s drug plan is not going to cover all your drugs and your brand name drugs may have a co-pay of $60 or higher! Not all companies cover all drugs, and many of the most expensive drugs are not covered at all.
The average cost of a drug plan in 2008 is about $32 a month PLUS co-pays for each drug! I’ll show you your options, but as for drugs, you don’t have a lot of choices.
Generics work for many people, but not all. Try to work with your doctor to see if generics are an option for you
Here are your basic choices:
Medicare Supplement OR Medicare Advantage Plans
MS are like a buffet restaurant . You pay one flat fee and nothing more. You can eat as much or as little as you want at a buffet, everyone pays the same. A Medicare Supplement Plan F for an average Hoosier age 65 is about $100 a month. You can see any doctor, go to any hospital and never pay more than your monthly premium.
The alternative is like an Ala Carte Restaurant. You only pay for what you eat. There are many plans that have $0 monthly premiums. But you pay as you go to a certain yearly limit.
Some people think a buffet is a rip off because they just each a sandwich and coffee. Others just love a buffett because they go back for three plates and really have a lot of desserts. (try to get them laughing and nodding to this)
If you go to the doctor all the time and have a few conditions that need a lot of care, you may need a different plan than the person who sees a doctor 3 times a year.
There are many, many choices and I can help by showing you several good options. But remember, there is no BEST plan. I wish it were that simple.
There are plans that require you to use a certain hospital or network of doctors. Some plans have a little dental, vision or hearing. We have a Medicare Supplement that gives you a free health club membership (AARP but don’t mention the name)!
Medicare will be your health insurance for the rest of your life. Medicare is a great plan but you can expect to pay a larger and larger share each year. You pay about $100 a month for your Part B, which comes out of your Social Security check. Then you pay about $100 for a Supplement, $32 for a drug plan and more if you are taking drugs.
So, best case is $232 a month for someone taking all generics or no drugs.
Medicare cost are going to go UP every year!
What they take out of your Social Security will increase each January. No matter what health plan you chose, it will go up every year. Your drug plan will go up too!
The Bottom Line:
Medicare is confusing, but we can help take the guess work out of it for you. Ohio Premier Health Solutions is an independent insurance agency – which means that we work for dozens and dozens of companies, not just one.
That should mean a lot to you, because one shoe never fits all and especially in health insurance! You don’t have to meet with 10 different agents to look at 10 different products. We can show them all to you. We represent many of the top companies in the nation: United Health Care, AARP’s Medicare Supplement, Pyramid, Coventry, Mutual of Omaha, Great American and many others. I know you don’t want to buy the only plan you look at, you want to see options – that is what we offer you. The convenience of many products through ONE AGENT! Call us at 330-394-7400 to meet with one of our Medicare Specialists.