There is a great deal of confusion and uncertainty surrounding the many choices with our insurance options these days. This is especially true for the elderly, disabled and impoverished who seldom have "instant access" to information on the internet.
Important decisions about Medicare Supplements (also known as "Medi-Gap" policies), Medicare Advantage Plans, Special Needs Plans, Long Term Care insurance, Life Insurance, and Final Expense or "Burial insurance" coverage can be very confusing.
The assistance of a local, professional Agent provides you and your family with the additional information, support, and expertise needed to navigate today’s insurance landscape. Good choices about lifestyle and healthcare coverage are critical steps to ensure that you maintain control of your ability to choose when, where, and how you receive care.
Today’s insurance decisions can also have lasting effects on your ability to maintain the quality of life that you desire for you and your loved ones. Below, you will see some examples of the many services and areas where I can help YOU:
Medicare supplement plans (also known as "medigap" plans) are private insurance plans available to people of Medicare age for purchase.
Most of the Medicare supplement plans cover 100% of costs (i.e. deductibles, co-payments, co-insurance, etc.) above and beyond what Medicare itself pays.
In addition, a stand alone prescription plan (i.e. "Part D") must be purchased with a Medicare supplement to meet federal requirements and avoid penalties. The average cost starts around $18 per month.
Medicare supplement benefits were standardized by the federal government in the 1990's. Why is this important and what does it mean to you? It means that all Medicare supplement plan benefits MUST be the same, regardless of which private insurance company you buy it from.
The primary differences are in the monthly premium, how frequently it increases and the stability of the company from which a person buys a Medicare supplement. The average cost for a Medicare supplement starts around $95 per month at Age 65.
Benefits of most Medicare supplements:
No networks required.
Go to any doctor, specialist or hospital in the country.
No deductibles, co-pays or co-insurance.
Coverage during foreign travel
Medicare Advantage plans:
Medicare Advantage plans were created to combine, provide and cover a person's Medicare Part A (hospitals), Part B (doctors, specialists) and usually their Part D (prescription drugs) benefits.
Medicare Advantage plans usually required the patient to use doctors, specialists, hospitals and pharmacies within the insurance provider's network.
There are usually zero $ (or low dollar) co-pays for every visit to the patient's PCP (primary care physician) and specialist(s). There are also copayments for each hospital, skilled nursing facility, emergency room or urgent care center visit.
A few examples of most Medicare Advantage plan:
A set maximum out-of-pocket costs per year.
Additional benefits included, such as dental, vision, hearing, fitness membership and rides to medical appointments, which are things NOT typically covered by Medicare OR Medicaid.
Potential to get "extra help" paying some or all of the Part B deductible.
Most plans INCLUDE prescription drug coverage, which lower or eliminate the cost of your drugs each month.
Zero dollar or very low monthly premiums.
You get to keep your primary doctor and specialist, if they are in the network.
Stand alone Part D drug plans:
A stand alone Part D (prescription drugs) drug plan is required if a person has original Medicare only or a Medicare supplement plan. Most Medicare Advantage plans have a drug plan benefit included in them.
There are usually zero $ (or low dollar) co-pays for generic prescription drug taken by the patient and prescribed by their PCP (primary care physician and specialist(s).
While there may be co-pays for some drugs, the patient can usually get a $0 co-pay if their doctor prescribes a 90 day supply on Tier 1 and Tier 2 generic drugs and sends the prescription through their drug plan's preferred mail order pharmacy, often times with free shipping to their home address included at no cost.
A few benefits of Part D stand alone drug plans are:
A $0 or low annual prescription drug deductible.
Potential to get "extra help" paying some or all of the Part D deductible from a person's home state.
Most Medicare Advantage plans INCLUDE prescription drug coverage, which lower or eliminate the cost of your drugs each month.
Zero dollar or very low co-pays on most drugs.
Save money by using preferred mail order pharmacy through their stand alone drug plan or Medicare Advantage plan insurance carrier
Term Life Insurance Policies:
Usually taken out for a longer "term" (a.k.a. period of time) such as 15-30 years.
The most cost effective way to get the maximum life insurance pay-out for a person's family and/or spouse beneficiaries.
Usually taken out for larger face amounts, typically $100,000 or greater.
Usually intended to protect assets, pay off specific things (i.e. mortgage, debt) or provide an inheritance to the family.
Several life insurance policies can be converted to cover Long Term Care (aka "LTC") at the end of the term length.
Final Expense Insurance
Also known as "whole life insurance", Final Expense insurance policies are typically in place for your "whole life" and used to pay for a person's burial or cremation expenses.
Usually taken out in smaller face amounts, typically between $3,000 - $25,000.
Since Final Expense policies are in place until a person passes away, the policies usually have a "level" set premium which does not increase over time.
Long Term Care:
Often confused with "Long Term Disability", which is offered by most employers, a "Long Term Care" insurance policy is a different product altogether and sold by a private insurance company.
Long Term Care insurance keeps the control of where you will receive extended care in YOUR hands, instead of the state or federal governments.
Long Term Care is typically needed when you are no longer able to perform some or all of the "Activties of Daily Living", such as eating, bathing, dressing, going to the bathroom and moving from bed to chair without assistence. Your primary care physician can attest to these medical needs.