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Medicare Health Insurance
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What Is Medicare?
Medicare is health insurance for Americans 65 or older (or under 65 years old with specific disabilities) or anyone at any age with End Stage Renal Disease (ESRD) or Lou Gehrig’s Disease. It’s administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).
Most U.S. citizens earn the right to enroll in Medicare by working and paying their taxes for a minimum required period. Even if you didn’t work long enough to be entitled to Medicare benefits, you may still be eligible to enroll, but you might have to pay more.
There are four different parts to the Medicare program. Parts A and B are often referred to as Original Medicare. Medicare Part C (Medicare Advantage) is private health insurance, while Medicare Part D offers coverage for prescription drugs.
If you’re not sure which one to choose, you can view the explanation and definitions below, or you can call us directly or set up an in-office appointment (see below).
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Medicare Health Insurance
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2024 Medicare Open Enrollment has Ended
You Can Only Buy Health Insurance During This Time
October 15th, 2023 through December 7th, 2023
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Your Medicare Coverage is Protected
MEDICARE & HEALTHCARE REFORM AKA “OBAMACARE”
Medicare is NOT a part of the Health Insurance Marketplace aka “Obamacare.” If you have Medicare, you do not need to enroll into the Nevada Health Link website, you’re considered covered.
No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. The same applies to your private Medigap plans too.
The Government “Marketplace” (in Nevada the website called Nevada Health Link) won’t affect your Medicare choices or benefits. No matter what Medicare option you have, whether you have Original Medicare or a Medicare Advantage Plan (like an HMO or PPO) or a private insurance Medicare Supplement plan (Medigap), you won’t make any changes with Nevada Health Link.
Each person has unique medical concerns, prescriptions, worries and budget. Our mission is to do a thorough analysis of what Medicare plan works best for you. Whatever your medical concerns are and your budget will allow, we will assist you and help you to enroll into the best plan that meets YOUR concerns and medical needs.
Get to know your A, B, C and D
There are 4 basic parts to Medicare:
1). Hospital Insurance (Part A)
Covers inpatient hospital stays, hospice care, care in a skilled nursing facility and some home health care.
2). Medical Insurance (Part B)
Covers preventative services, outpatient care, medical supplies and certain doctors’ services.
3). Medicare Advantage Plans (Part C)
Are health plans offered by private insurance companies contracted with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
4). Prescription Drug Coverage (Part D)
Adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.
What’s the Difference?
Medicare Supplement (Medigap)
With a Medicare Supplement Plan F, a person won’t have “co-pays“ or “deductibles“. They only have their premium to worry about each month, keeping their medical expenses predictable. No surprises with medical expenses like copays or deductibles.
Medicare Supplement (Medigap) is private health insurance. It sits on top of Medicare to supplement it. It fills in the “Gaps” of original Medicare. Medicare Supplement plans have a premium associated with them.
A person can choose their own doctors and hospitals that accept Medicare without having to worry about “Networks” or “Referrals”. They can travel anywhere in the country and be covered by seeing any doctor that accepts Medicare.
They can purchase a Medicare Supplement plan (Medigap) any time of the year. The Medicare Supplement plans don’t have certain times of the year when people enroll. They will, however, after they’ve had their Medicare Part B plan for 6 months, need to go through some “Underwriting” questions to see if they can be approved. The first 6 months they’ve had Medicare Part B, a person cannot be turned down.
Insurance companies can charge different rates for the exact same Medicare Supplement plan, so it makes sense to shop prices. A Medicare Supplement Plan F with insurance company A will have the exact same benefits for a Supplement Plan F with insurance company B. So shop around and get the best price.
Medicare Supplement plans generally require a separately purchased prescription drug plan. This is important. You’ll pay a penalty if you go without a qualified drug plan.
Please Note: It’s important to understand that a person cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time.