Medicare Insurance FAQs
What things aren’t covered by Medicare Part A and Part B?
Medicare covers a lot, but not everything. Some things that are not included with Medicare:
Most dental care
Eye exams to prescribe glasses
Hearing aids and fitting exams
Long-time care
If any of these items are a concern of yours, let me know and I can find an affordable insurance plan to help cover these expenses.
What kinds of insurance do you sell?
I offer three different kinds of insurance that can help cover expenses not allowed by Medicare:
Medicare Supplement plans
Medicare Advantage plans
Part D Prescription Drug plans
What is a Medicare Supplement plan?
A Medicare Supplement plan, sometimes also called a “Medigap” plan, pays for things not covered by Medicare Part A & B. Medicare Supplement plans can cover expenses like:
Deductibles
Copayments
Coinsurance
When you have a Medicare Supplement plan, Medicare pays its portion of the Medicare-approved amount of your health costs, then the Medicare Supplement plan pays its share.
Medicare Supplement plans do not pay for prescription drugs. For that, you’ll need a Part D insurance plan or a Medicare Advantage plan.
Medicare Supplement plans also typically don’t cover expenses like vision and dental care, hearing aids, eyeglasses, long-term care, or private nurses. For that, you’ll need a Medicare Advantage plan.
A Medicare Supplement plan only covers one person. If you and your spouse both want coverage, you will have to purchase two policies.
You cannot have a Medicare Supplement plan and a Medicare Advantage plan at the same time.
Feel free to call me to have a private discussion about your needs and if a Medicare Supplement plan is right for you.
What is a Medicare Advantage plan?
Medicare Advantage plans, also known as Medicare Part C, provide your Part A and Part B coverage along with additional benefits. Medicare Advantage plans are sold and run by companies, not the government. Medicare does pay a fixed amount to the company for your coverage. You also have the same rights and protections that you would have under Medicare Part A and Part B.
Medicare Advantage plans can cover expenses like:
Prescription drugs
Hearing care
Vision care
Long-term and private care
Medicare Advantage plans pay medical service providers a negotiated rate for the services they perform. You may also be responsible for paying additional premiums, deductibles, copayments, and coinsurance.
A Medicare Advantage plan only covers one person. If you and your spouse both want coverage, you will have to purchase two policies.
You cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time.
Feel free to call me to have a private discussion about your needs and if a Medicare Advantage plan is right for you.
What is a Prescription Drug Coverage (Part D)?
Medicare Part D offers coverage for prescription drug expenses.
Plans have a list of approved drugs that it agrees to cover. Different companies offer different plans that cover a different list of drugs.
Plans typically include both name-brand and generic drugs. If a plan doesn’t offer a drug you use, you can work with your doctor to find a substitute that is covered, or ask the insurance company for an exception.
Medicare drug plans negotiate lower prices for the drugs that are on their lists, so using those drugs will typically lower your costs.
Plans may place drugs into different “tiers,” with different copayments assigned to each tier. Generic drugs that are commonly prescribed are typically placed in the lowest tier, with name-brand and speciality drugs placed in higher tiers. The lower the tier, the lower the copay cost.
If you are interested in buying prescription drug coverage, be sure to call me with a list of the prescriptions you are currently taking, so I can find a plan that covers them.
When can I enroll in any of these programs?
Medicare Supplement plans should be purchased during the 6-month open enrollment period which begins the first day of the month in which you turn 65 years of age. Plans usually costs less then. You also cannot be denied coverage then if you have medical problems. After the open enrollment period is over, you may not be able to buy a Medicare Supplement plan at all, or it may cost more if you have past or present health problems. I will be happy to discuss your situation in a free consultation by phone.
Medicare Advantage plans have three different enrollment periods. The first is three months before to three months after your birthday month the year you turn 65. There is also an Open Enrollment period between October 15-December 7 each year. The rules can sometimes be tricky, so please call me to discuss your situation.
Medicare Part D Prescription Drug Coverage should be added when you are first sign up for Medicare. You may have to pay a penalty to join later. There are a few exceptions. Call me at 1-800-515-0291 to discuss your options.
How do I tell what plan is right for me?
Call me at 1-800-515-0291, send an email to drussell@davidrussellinsurance.com, or fill out this contact form to make an appointment to discuss your needs in private. The consultation is free.