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Medicare Guide 

Here is some information to better prepare yourself when deciding what to do with your Medicare Journey.
Contact us with any other questions you may have!

Doctor Office

Who Qualifies for Medicare?

Getting enrolled in Medicare can be a daunting task and knowing whether or not Medicare is something you can take advantage of is usually the first question. To help answer that, here is some information straight from "The Centers of Medicare & Medicaid Services." (CMS)

Medicare is a health insurance program for:

  • People age 65 or older.

  • People under age 65 with certain disabilities.

  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Seniors Socializing

What are Medicare Advantage Plans? (Medicare Part C)

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.

If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.

-Directly from the Department of Health & Human services website (HHS.gov) 

Filling Out Prescriptions

How do Prescriptions Work with Medicare? (Medicare Part D)

The rules for prescription drugs in Medicare are pretty straight forward. When enrolling in Medicare you have a couple of options. You can enroll in a stand alone Prescription Drug Plan (PDP) or you can enroll into a Medicare Advantage Plan with a Prescription Drug Plan. There are other types of plans that offer PDP's but the previously mentioned options are two of the most popular options. It's important to note that it is not permitted for Medicare Advantage enrollees to enroll into a stand alone PDP if the Medicare Advantage plan they choose offers a Prescription Drug Plan. For further, more specific questions please call or email us!

Organizing the Calendar

What is the Annual  Enrollment Period? (AEP)

The Annual Enrollment Period, commonly referred to as AEP is a time for members to reflect upon their coverage and to decide if they wish to remain enrolled in their current plans or to switch to a different plan that they believe may work better for their health needs. The window in which members may switch plans occurs every October 15 - December 7. 

Here is what CMS.gov says about AEP:

"Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs."

 

Where can people find Medicare plan information or compare plans?

1-800-MEDICARE

or

 Medicare.gov.

or 

You can contact a broker with Hill Country Life & Medicare 

or

Select the "Shop Carriers" tab and use the compare plans feature.

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