(865) 712-5711 benneaf@charter.net
Medicare Insurance

Medicare presents you with options.  We are here to help you sort through those options and make the choices that fit you best.  Fit the need, Fit the Budget

Traditional Medicare is made of up several parts that work together to give you a complete package of coverage.  The first two parts are Part A and Part B.  You paid in a bit on each paycheck during your working career, that was your “Part A” premium.  When you enter the Medicare system (typically at the age of 65) you are covered by part A, but have no more premium to pay.  That’s a good thing.  Part B does have a premium to be paid and for most people it will be $121.80 a month for 2016 (higher income earners may pay more and lower income earners may qualify to pay less).  That $121.80 typically comes directly out of your Social Security check.  If you have not yet elected to take your social security then you will need to make arrangements to pay.

Part A

Often referred to as your, “Hospitalization Benefit” it actually covers the following.

  • In patient care in hospitals
  • Skilled nursing facility care
  • Hospice Care
  • Home Health Care

Part A is what you paid for while you were working

Part B

Often referred to as your “Doctor Benefit” it works like 80/20 co-insurance where you pay the 20%..

  • Services from Doctors and other providers
  • Outpatient care
  • Home Health Care
  • Durable Medical Equipment
  • Some Preventive Services

Part B is $121.80 a month typically

Part D

This is the part that covers your prescriptions.  One of the problems with Part D is called “The Donut Hole.”  The “donut hole” is a flaw in the coverage that causes people with a high prescription load to pay a disproportionate amount after a certain dollar amount has been spent.  The chief way the “Affordable Care Act” (i.e. Obamacare) impacted Medicare benefits was to end the donut hole.  The benefits for high usage patients will improve each year until the year 2020 at which point there will be no more donut hole.  Unless you visit Dunkin Donuts…they still have them.  It’s a good thing for retirees that the “hole” is getting filled.

Medi-Gap

Also known as a Medicare Supplement, this helps pay the parts of your Medical Bills that traditional Medicare doesn’t cover.  Traditional Medicare is often described as working like at 80/20 plan, but there are times that it can work like a 65/35 plan…which is not hardly as good.  In addition, there is no out of pocket maximum with traditional Medicare.  A supplemental policy can give you that financial protection.  I often recommend either the High Deductible F (though it is called a deductible, it works more like at out of pocket maximum).  It is the least expensive supplement available.  Many people prefer the regular “F” supplement or the “G.”  Both of these are structured to minimize or virtually eliminate your out of pocket costs, but naturally for a higher premium.