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Medicare Made Simple
Before choosing a plan, it's important to understand the different types of Medicare coverage available and how they work together.
Many people assume Medicare Advantage and Medicare Supplement plans are the same, they're not. Understanding the differences now can help you avoid costly mistakes later.
Janeen Brady
MEDICARE EDUCATION
The Parts Of Medicare
PART A
HOSPITAL COVERAGE
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Inpatient hospital stays
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Skilled nursing facility care
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Hospice care
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Some home health services
PART B
MEDICAL COVERAGE
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Doctor visits
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Preventive services
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Outpatient care
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Durable medical equipment
PART C
PRESCRIPTION COVERAGE
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Prescription medications
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Pharmacy networks
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Drug formularies
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Cost-saving options
UNDERSTANDING YOUR
Medicare Coverage Options:
Now that you understand the parts of Medicare, let's look at the different ways you can receive your coverage.
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Predictable Coverage. Nationwide Flexibility.
Original Medicare + Supplement (Medigap)
Medicare Supplement plans work alongside Original Medicare (Parts A and B) to help cover many of the out-of-pocket costs Medicare doesn't pay.
Works with Original Medicare
Freedom to see any provider that accepts Medicare
Predictable Coverage
No Network Restrictions
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2.
All-In-One Medicare Coverage
Medicare Advantage Plans (Part C)
Medicare Advantage plans combine Medicare Parts A and B and often include prescription drug coverage, dental, vision, hearing, and wellness benefits.
Bundled Coverage
Prescription drug coverage often included
Additional benefits available
Network-Based Plans
3.
Prescription Drug Coverage
Medicare Prescription Drug Plans (Part D)
Part D plans help cover the cost of prescription medications and can be added to Original Medicare and many Medicare Supplement plans.
Prescription drug coverage
Multiple Plan Options
Formulary-Based Coverage
Annual plan review recommended
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HOW I HELP
Medicare Education
Understanding Medicare can feel overwhelming.
I provide clear explanations and guidance so you can understand your options before making decisions.
Plan Comparisons
Not all plans are the same. Together we'll compare available options based on your doctors, prescriptions, healthcare needs, and budget.
Enrollment Assistance
I'll help guide you through the enrollment process step by step and ensure important deadlines aren't missed.
Annual Reviews
Your healthcare needs and plan benefits can change each year. Annual reviews help ensure your coverage continues to meet your needs.
Helpful Medicare Resources:
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FAQ Medicare:
Q: What is Part D? A: Medicare Part D provides prescription drug coverage. Part D plans are offered through private insurance companies approved by Medicare and help cover the cost of prescription medications. Enrolling when first eligible may help you avoid future penalties.
Q: What happens if I miss my designated enrollment window into Medicare? A: Missing your enrollment period can result in late enrollment penalties and delays in coverage. Some penalties may remain for as long as you have Medicare. That's why understanding your enrollment timeline is so important.
Q: What is a Part C plan? A: Medicare Part C is also known as Medicare Advantage. These plans are offered by private insurance companies and provide an alternative way to receive your Medicare benefits. Most Medicare Advantage plans include Parts A and B coverage and often include prescription drug, dental, vision, and hearing benefits.
Q: Where do I go to get signed up for Medicare? A: You can enroll through the Social Security Administration online, by phone, or at your local Social Security office. If you'd like guidance understanding your options before enrolling, Janeen can help walk you through the process.
Q: What is creditable coverage? A: Creditable coverage means your current insurance is expected to pay, on average, at least as much as Medicare's standard coverage. Having creditable coverage may allow you to delay certain parts of Medicare without facing late enrollment penalties.
Q: Should I have both a Medicare Advantage Plan and a Medicare Supplement Plan? A: No. Medicare Advantage and Medicare Supplement plans are two different ways to receive additional coverage beyond Original Medicare. You cannot be enrolled in both at the same time. Choosing the right option depends on your healthcare needs, budget, doctors, and preferences.
Q: Does Janeen's assistance cost anything? A: No. Janeen's Medicare guidance, plan comparisons, enrollment assistance, and ongoing support are provided at no additional cost to you.
Q: Do I need a Medicare plan review every year? A: Annual reviews are highly recommended because plan benefits, provider networks, prescription drug formularies, and premiums can change from year to year. Reviewing your coverage annually helps ensure your plan still meets your needs.
Q: I'm turning 65 this year and plan to retire. When am I eligible to enroll in Medicare? A: Most people become eligible for Medicare when they turn 65. Your Initial Enrollment Period begins three months before your 65th birthday month, includes your birthday month, and continues for three months after. Missing this window could result in penalties or delayed coverage, so it's important to plan ahead.
Q: Can my dependent spouse be on my Medicare plan? A: No. Medicare is individual coverage and does not offer family plans. If your spouse is not yet eligible for Medicare, they will need their own health insurance coverage through an employer, Marketplace plan, or another source.
Q: Can I keep my employer coverage? A: In many cases, yes. Whether you should enroll in Medicare while keeping employer coverage depends on the size of your employer and the type of coverage you have. It's important to review your specific situation before making a decision to avoid penalties or gaps in coverage.
Q: Do I need to enroll in Part A and Part B of Medicare? A: Most people enroll in both Part A (Hospital Insurance) and Part B (Medical Insurance) when they become eligible. However, if you're still working and have qualifying employer coverage, your enrollment timing may be different. Reviewing your options before enrolling is always recommended.
Q: Can I just have Original Medicare (Parts A & B) as my health insurance in retirement? A: Yes, but Original Medicare does not cover all healthcare costs. Medicare generally covers about 80% of approved medical expenses, leaving you responsible for deductibles, coinsurance, and other out-of-pocket costs. Many people choose a Medicare Supplement plan or Medicare Advantage plan for additional coverage.
Q: Can I keep all my same doctors when I'm on Medicare? A: It depends on the type of Medicare coverage you choose. With Original Medicare and most Medicare Supplement plans, you can generally see any provider nationwide who accepts Medicare. Medicare Advantage plans often use provider networks, so it's important to verify that your preferred doctors participate.
Q: Does Medicare cover me if I'm in a nursing home? A: Medicare may cover certain short-term skilled nursing facility stays following a qualifying hospital stay. However, Medicare generally does not cover long-term custodial care in a nursing home. Long-term care planning may be necessary for extended care needs.
Q: Does Medicare have dental plans? A: Original Medicare typically does not cover routine dental care. However, many Medicare Advantage plans include dental benefits, and standalone dental insurance plans are also available.
Q: I am entitled to retiree benefits. Does that mean I won't need Medicare? A: Not necessarily. Some retiree health plans work alongside Medicare and may require you to enroll in Medicare Parts A and B when eligible. It's important to review your retiree benefits carefully before deciding whether to delay enrollment.
