Bernardini & Donovan Insurance Services

Medicare Health Insurance

Let us help Simplify your healthcare needs today

What is Medicare?

Medicare is a federal government funded program aimed to help adults over the age of 65 to receive Medicare Health Insurance. It also provides health insurance for disabled adults under 65 and anyone who has been diagnosed with End-Stage Renal Disease (permanent kidney failure).

Medicare has four different parts:

Part A

Is hospital insurance, which includes help paying for inpatient hospital care, a skilled nursing facility, limited home health, and hospice care.

Part B

Is medical insurance, which contributes toward doctor services and outpatient care such as diagnostic tests, ambulance rides, and preventative care. Preventative care includes things like pap tests and mammograms as well as medical equipment and supplies. You will pay a premium each month for Part B. The cost will either be taken out of your social security if you are getting those benefits or you will receive a bill. Your income determines your premium.

These two offerings make up what is called original Medicare. And where this can cover a significant portion of your medical insurance needs, this will not cover all of your medical costs. With the extra cost, some people want to consider how to get those additional costs covered through Medicare Parts C and D

Part C

Which can also be called Medicare Advantage plans. Part C includes what is covered in Medicare A and B and may help lower your costs and get additional benefits.

Part D

Helps you manage the costs of your prescription drugs because original Medicare generally does not provide prescription drug coverage.

Medicare Advantage

One of the options you will be considering when looking at Medicare is if you will want to receive original Medicare Insurance (Parts A and B) and Medicare Advantage (part C). So what is the advantage to Medicare Advantage, if there is an advantage at all?

Both of these options will cover many of the same services; it is a matter of deciding what will be the best for you and your health.

What is the Advantage of Medicare Advantage?

Medicare Advantage is an insurance option that is run through private insurance companies. These are companies that you would recognize like Blue Shield, United Health Care, and Kaiser Permanente. Medicare Advantage includes what you would find in Original Medicare with the doctor and hospital care. But it also may include things that you would not find. These additional offerings will depend upon which plan and organization that you go through. But you can expect these offerings to include things like vision, dental, and gym memberships. Medicare Advantage is also considered a less expensive option.
The premiums that you pay in Medicare Advantage can be less expensive, sometimes even no cost at all, than the premiums in Plan B especially if it is combined with the premiums for a Medigap policy which many do include if they go with Original Medicare. Also, Medicare Advantage includes a Maximum Out-of-Pocket Expense, which is a limit to the amount you pay out of pocket. The cap varies between plans, but after you reach the limit, all of your medical services are covered. Of course, with every plan, there are also drawbacks. Because the program is run through private companies, there may be stricter rules and more limited options for care available. If you are not satisfied with Medicare Advantage, you can switch to Original Medicare but will need to wait until the next open enrollment period (October 15-December 7 of every year for Medicare Advantage and Part D) to re-enroll in a Medicare Advantage plan.

Simplify your healthcare needs today

Now that you know four Parts of Medicare, this is how they work together.

If you ever hear the term “original Medicare” they are referring to Medicare Parts A & B. These were the first two parts of Medicare. Medicare Part C(Medicare Advantage Plans) and Medicare Part D (prescription) were added as parts to Medicare years later.

First, a person eligible for Medicare must enroll in Original Medicare, those are Medicare Parts A & B. We explain to our clients what Medicare A & B cover, and what it does NOT cover.

Once you that understanding you have 3 choices.

1

Knowing Medicare does NOT cover everything, you get take the HUGE risk and get nothing.

2

You could choose to enroll in a Medicare Supplement.

3

You could choose to enroll in Medicare Advantage Plan.

See the chart below and call us for an in depth Medicare 101 class / meeting.

Original Medicare

Pays for part of the Hospital costs.
Pays for part of the Doctor costs.

Choose A Medical Supplement

Choose to add one or both of the following to Original Medicare.

med-supply

Medicare Supplement Insurance Plan Offered by private companies

Helps pay some of the out-of-pocket costs not paid by Original Medicare

Medicare Prescription Drug (Part D) Plan Offered by private companies

Helps pay for prescription drugs

Choose a Medicare Advantage plan.

Medicare Advantage Plan Offered by private companies

Combines Part A (hospital insurance) and Part B (medical insurance) in one plan.
Usually includes prescription drug coverage.
May offer additional benefits not provided by Original Medicare

Questions about your Medicare Health Insurance Needs?