There are two separate paths you may choose to follow to complete your Medicare coverage needs. If you are enrolled in Medicare Part A and Part B, you may opt to stay with original Medicare fee-for-service, and purchase additional coverage to pay for some or most of the costs not covered by original Medicare (i.e., deductibles, copays, or co-insurances) by adding a Medicare Supplement plan, also called Medigap plans. These plans are offered as private insurance by health insurers, and require medical underwriting for eligibility in many instances, unless you qualify for a guaranteed issue. Although the plans are modernized and standardized by Centers for Medicare and Medicaid Services (“CMS”), they are offered by insurance companies and regulated at the state level. They serve to limit financial exposure to the costs for health events not covered by original Medicare. If the health event is a Medicare-covered occurrence, these plans cover some or most of the costs not paid by Medicare, depending on the Medigap plan chosen. Perspective Financial Group, LLC, agents are ready to help you decide on the plan that serves your needs.
Prescription drug coverage is not covered by Medicare Part A or Part B, except for certain instances of drugs administered by a medical facility or by infusion. However, Medicare has approved prescription drug plans available through private insurers that meet their requirements as a Part D Prescription Drug plan. These plans have certain requirements for formulary and cost-sharing parameters to qualify as a Part D plan. If you have private prescription drug coverage through an employer or retiree group plan that is deemed “creditable”, i.e., as good as or better than Part D plan provisions, you may or may not wish to have a Part D plan. However, if you are eligible for a Part D prescription drug plan, and you do not have other “creditable” prescription drug coverage, you may be subject to a Late Enrollment Penalty (“LEP”) that can add a monthly penalty surcharge to your Part D plan and may continue throughout your Medicare-eligible years. Perspective Financial Group, LLC agents can help you determine the plan that fits your formulary needs for the most competitive cost sharing available from among the many plans offered. Because formularies offered by insurers and drug costs can vary from year to year, we offer annual reviews for this coverage to ensure you are in the plan that fits your needs, and covers your prescribed drugs. In addition to a monthly premium, there are four cost-sharing phases to this coverage; a deductible phase, initial coverage limit phase, coverage gap phase (aka “the donut hole”), and the catastrophic phase. Reach out to a Perspective Financial Group, LLC, licensed agent to help you determine the plan that is right for you and your needs. If you are entitled to Part A alone or are enrolled in Part A and Part B, Part D coverage is available to you without underwriting, and you owe it to yourself to ensure you are in the plan that’s most cost effective for you. Let Perspective Financial Group, LLC, agents help you evaluate your options today!
Medicare Advantage plans, also known as Medicare Part C, are health plans offered by qualifying health insurance companies. Medicare Advantage plans are often considered “bundled” as they combined Part A and Part B coverage, and most often include Part D prescription drug coverage as well. In addition, many plans have added-value benefits for items not covered by original Medicare, such as routine dental, vision, and hearing coverages, as well as transportation, fitness, and virtual medicine options, among others. These plans are often network plans, such as HMO and PPO plans, among others, and require some analysis to ensure your preferred providers participate for the most cost-effective cost-sharing. Although networks are largely territorial, these plans cover urgently needed services and emergency coverages as in-network at times when you are outside of your network or plan coverage territory. Otherwise, they must cover what is covered by original Medicare fee-for service, but the cost sharing is different. Medicare Advantage health plans may or may not have a monthly premium have a deductible for medical and/or Part D drug coverage, will have copays and/or coinsurance amounts for services rendered, and will have an annual maximum out-of-pocket (“MOOP”) for medical coverages in a plan year. These plans are not medically underwritten for eligibility, except in cases of end-stage renal failure. Perspective Financial Group, LLC stands ready to help you shop and compare your plan options for Medicare Advantage policies.
Do you own a company that offers traditional group and/or retiree medical insurance to your employees or retirees over the age of 65, or are otherwise Medicare-eligible? Call Perspective Financial Group, LLC, to see if we can help you save precious premium dollars by offering Medicare plans for the eligible group population among your employee or retiree beneficiaries.
