Alderette Insurance Agency, Inc.
Call Us Today! (866) 639-1662
Alderette Insurance Agency, Inc.
Call Us Today! (866) 639-1662
Looking For Medicare Plans?
Medicare 101
The A, B, C (&D's) of Medicare
Part A
Covers Inpatient hospitalization, skilled nursing, hospice and home health care services. The first 60 days are subject to the Part A deductible. Once the Part A deductible is met there is a per day copay from day 61 - 90.
Part B
This is called your "Medical Insurance" (sometimes referred to as "Physician Services"). Part B covers things like doctor office visits, lab tests, MRI’s, outpatient surgery, and so on. You will have to pay the Part B deductible. Once the Part B deductible is met you are responsible for 20% of charges. There is no stop loss or limit to the dollar amount of the 20%.
Part C - Also known as "Medicare Advantage"
This is a way to receive your Part A (hospital), Part B (medical), and in many cases Part D (pharmacy drug coverage) all in one convenient plan. All Medicare Advantage plans have an out of pocket maximum that greatly limits your total financial exposure.
Part D
Typically covers prescription drugs that you pick up at a pharmacy. There are only two ways to get Part D coverage: 1) Enroll in a standalone Part D prescription drug plan or 2) Enroll in a Medicare Advantage plan that includes Part D prescription drug coverage.
Did you know there are two ways to receive your Medicare benefits?
Option #1
Medicare Supplement + Standalone Drug Plan
You keep Medicare parts A & B.
Enroll in a Medicare supplement plan (a.k.a. “Medigap”) to help cover your portion of medical expenses that Medicare doesn't cover. Also, enroll in a standalone Part D prescription drug plan to cover medications you have filled at a pharmacy (NOTE: Medigap plans do not include Part D drug coverage which is why you would also need to enroll in a standalone drug plan if you choose the Medigap option).
Option #2
Part C - "Medicare Advantage"
Enroll in a Medicare Advantage plan.
These plans are administered by private health insurance companies with a Medicare contract. Medicare Advantage plans incorporate parts A, B, and (in most plans) part D within one plan.
Not sure which Medicare option is right for you?
Let's take a closer look the pros and cons of Medicare supplements and Medicare Advantage plans.
Pros and Cons of Medicare Supplement (a.k.a. "Medigap") plans
Medicare supplement (also called “Medigap”) plans do exactly what the name suggests: they supplement, or ‘fill in the gaps’, of the health care costs Medicare doesn’t cover. Some people mistakenly assume that Medicare supplement plans offer benefits beyond what Medicare covers. The truth is that Medicare supplement plans follow Medicare benefits like a train and caboose. If Medicare covers a procedure or service, then a Medicare supplement plan will cover the same procedure or service – paying the portion Medicare does not pay up to plan limits. Medicare supplement plans are standardized; they offer the same benefits and provider choices regardless of the insurance company and are identified by letters A through N. Premiums are the only difference between Medicare supplement plans with the same letter sold by different insurance companies. Medicare supplement plans are also very portable – meaning that you can take it anywhere in the U.S. and the benefits will be the same. There are no network restrictions, so you can see any medical provider in the U.S. who accepts Medicare and there are no referrals required to see specialist doctors. Medicare supplement plans in general offer more freedom and flexibility compared to Medicare Advantage plans.
Things to consider regarding Medicare supplements
Medicare supplement plans have premiums that tend to be higher than Medicare Advantage plans and the premiums typically increase as you get older. The other downside is that you will also need to enroll in a standalone prescription drug plan, for an additional premium, in order to receive Part D benefits (Medicare Part D is pharmacy prescription drug coverage).
Pros and Cons of Medicare Advantage plans
Medicare Advantage plans have become increasingly popular over the years for a variety of reasons. Most notably the premiums will be considerably lower than Medicare supplement plans (in some areas Medicare Advantage plans have $0 premiums) and most include Part D coverage so there is no need to purchase a standalone drug plan. Copays are fairly nominal under most plans for everything from doctor office visits to diagnostic testing, rehabilitation, outpatient surgeries and inpatient hospitalization. Plus they may also include extra benefits for things that Medicare doesn’t cover like dental, vision, chiropractic and acupuncture. Many also have free gym memberships to help keep their subscribers active and healthy. Some Medicare Advantage plans will also offer free transportation to and from doctor office visits and other medically related appointments (including to and from the pharmacy).
Things to consider regarding Medicare Advantage plans
With a few exceptions, Medicare Advantage plans are network based plans. A majority of Medicare Advantage plans are HMO’s, which are very network restrictive. As with most HMO plans, if you go out of the network for routine care you will be responsible for the entire cost (emergency care is covered in-network for all Medicare Advantage plans regardless of where it occurs). There are Medicare Advantage PPO plans offered in a few areas but they tend to have higher premiums and out-of-pocket costs (i.e.: deductibles, copays and co-insurance) than their HMO counterparts. And even though PPO plans will cover you in the event that you want to see an out of network provider, the out of network costs are typically 50% of charges – which cost wise could be too steep for some people.
One other thing you want to be especially aware of is the “Out of Pocket Maximum” (sometimes referred to as the Annual Out of Pocket Maximum or Maximum Out of Pocket, etc.). This is the most you could be responsible for in a given year should you need extensive care. If you do choose a Medicare Advantage plan you will want a plan with an Out of Pocket Maximum as low as possible.
How To Choose The Right Plan
The best plan for you is going to boil down to a few things:
- Are the plan premiums and other cost sharing affordable in the long run?
- Does your doctor (or doctors) accept the plan(s) you are considering? (If you're considering an HMO and you have specialist doctors, are all of your doctors in the same medical group network?)
- Are your medications covered on the plan’s formulary? If so, are they covered at the lowest copays or coinsurance possible?
- Should you need to be hospitalized, does the medical center you would want to be treated at also accept your plan?
Once these questions are answered to your satisfaction, then you can look at any extra benefits that a plan may offer.
When working with people who are Medicare eligible, we understand that everyone has different health care needs. We have a process we go through to make sure that the health plan you choose is the one that best serves your needs. We start the process by researching medical providers and prescription drug formularies based on your individual health care requirements. We present side by side plan comparisons that are easy to understand and we will answer any questions you may have. We don’t discriminate or play favorites with any insurance company and there is never an obligation to enroll in any of the plans we present. After enrollment, we also provide ongoing support to help resolve any issues that could come up in the future. Our services are offered at no additional cost to you and your costs will be the same no matter if you enroll through us, direct with an insurance company or through any other source.
Click here to get a free quote or call us direct at: (866) 639-1662
Looking For Medicare Plans?
Medicare 101
The A, B, C (&D's) of Medicare
Part A
Covers Inpatient hospitalization, skilled nursing, hospice and home health care services. The first 60 days are subject to the Part A deductible. Once the Part A deductible is met there is a per day copay from day 61 - 90.
Part B
This is called your "Medical Insurance" (sometimes referred to as "Physician Services"). Part B covers things like doctor office visits, lab tests, MRI’s, outpatient surgery, and so on. You will have to pay the Part B deductible. Once the Part B deductible is met you are responsible for 20% of charges. There is no stop loss or limit to the dollar amount of the 20%.
Part C - Also known as "Medicare Advantage"
This is a way to receive your Part A (hospital), Part B (medical), and in many cases Part D (pharmacy drug coverage) all in one convenient plan. All Medicare Advantage plans have an out of pocket maximum that greatly limits your total financial exposure.
Part D
Typically covers prescription drugs that you pick up at a pharmacy. There are only two ways to get Part D coverage: 1) Enroll in a standalone Part D prescription drug plan or 2) Enroll in a Medicare Advantage plan that includes Part D prescription drug coverage.
Did you know there are two ways to receive your Medicare benefits?
Option #1
Medicare Supplement + Standalone Drug Plan
You keep Medicare parts A & B.
Enroll in a Medicare supplement plan (a.k.a. “Medigap”) to help cover the portion of Medicare parts A & B you are responsible for. Also enroll in a standalone Part D prescription drug plan to cover medications you have filled at a pharmacy (NOTE: Medigap plans do not include Part D drug coverage which is why you would also need to enroll in a standalone drug plan if you choose the Medigap option).
Option #2
Part C - "Medicare Advantage"
Enroll in a Medicare Advantage plan.
These plans are administered by private health insurance companies with a Medicare contract. Medicare Advantage plans incorporate parts A, B, and (in most plans) part D within one plan.
Not sure which Medicare option is right for you?
Let's take a closer look the pros and cons of Medicare supplements and Medicare Advantage plans.
Pros and Cons of Medicare Supplement (a.k.a. "Medigap") plans
Medicare supplement (also called “Medigap”) plans do exactly what the name suggests: they supplement, or ‘fill in the gaps’, of the health care costs Medicare doesn’t cover. Some people mistakenly assume that Medicare supplement plans offer benefits beyond what Medicare covers. The truth is that Medicare supplement plans follow Medicare benefits like a train and caboose. If Medicare covers a procedure or service, then a Medicare supplement plan will cover the same procedure or service – paying the portion Medicare does not pay up to plan limits. Medicare supplement plans are standardized; they offer the same benefits and provider choices regardless of the insurance company and are identified by letters A through N. Premiums are the only difference between Medicare supplement plans with the same letter sold by different insurance companies. Medicare supplement plans are also very portable – meaning that you can take it anywhere in the U.S. and the benefits will be the same. There are no network restrictions, so you can see any medical provider in the U.S. who accepts Medicare and there are no referrals required to see specialist doctors. Medicare supplement plans in general offer more freedom and flexibility compared to Medicare Advantage plans.
Things to consider regarding Medicare supplements
Medicare supplement plans have premiums that tend to be higher than Medicare Advantage plans and the premiums typically increase as you get older. The other downside is that you will also need to enroll in a standalone prescription drug plan, for an additional premium, in order to receive Part D benefits (Medicare Part D is pharmacy prescription drug coverage.
Pros and Cons of Medicare Advantage plans
Medicare Advantage plans have become increasingly popular over the years for a variety of reasons. Most notably the premiums will be considerably lower than Medicare supplement plans (in some areas Medicare Advantage plans have $0 premiums) and most include Part D coverage so there is no need to purchase a standalone drug plan. Copays are fairly nominal under most plans for everything from doctor office visits to diagnostic testing, rehabilitation, outpatient surgeries and inpatient hospitalization. Plus they may also include extra benefits for things that Medicare doesn’t cover like dental, vision, chiropractic and acupuncture. Many also have free gym memberships to help keep their subscribers active and healthy. Some Medicare Advantage plans will also offer free transportation to and from doctor office visits and other medically related appointments (including to and from the pharmacy).
Things to consider regarding Medicare Advantage plans
With a few exceptions, Medicare Advantage plans are network based plans. A majority of Medicare Advantage plans are HMO’s, which are very network restrictive. As with most HMO plans, if you go out of the network for routine care you will be responsible for the entire cost (emergency care is covered in-network for all Medicare Advantage plans regardless of where it occurs). There are Medicare Advantage PPO plans offered in a few areas but they tend to have higher premiums and out-of-pocket costs (i.e.: deductibles, copays and co-insurance) than their HMO counterparts. And even though PPO plans will cover you in the event that you want to see an out of network provider, the out of network costs are typically 50% of charges – which cost wise could be too steep for some people. One other thing you want to be especially aware of is the “Out of Pocket Maximum” (sometimes referred to as the Annual Out of Pocket Maximum or Maximum Out of Pocket, etc.). This is the most you could be responsible for in a given year should you need extensive care. If you do choose a Medicare Advantage plan you will want a plan with an Out of Pocket Maximum as low as possible.
How To Choose The Right Plan
The best plan for you is going to boil down to a few things:
- Are the plan premiums and other cost sharing affordable in the long run?
- Does your doctor (or doctors) accept the plan(s) you are considering? (If you're considering an HMO and you have specialist doctors, are all of your doctors in the same medical group network?)
- Are your medications covered on the plan’s formulary? If so, are they covered at the lowest copays or coinsurance possible?
- Should you need to be hospitalized, does the medical center you would want to be treated at also accept your plan?
Once these questions are answered to your satisfaction, then you can look at any extra benefits that a plan may offer.
When working with people who are Medicare eligible, we understand that everyone has different health care needs. We have a process we go through to make sure that the health plan you choose is the one that best serves your needs. We start the process by researching medical providers and prescription drug formularies based on your individual health care requirements. We present side by side plan comparisons that are easy to understand and we will answer any questions you may have. We don’t discriminate or play favorites with any insurance company and there is never an obligation to enroll in any of the plans we present. After enrollment, we also provide ongoing support to help resolve any issues that could come up in the future. Our services are offered at no additional cost to you and your costs will be the same no matter if you enroll through us, direct with an insurance company or through any other source.
Tap here to get a free quote or call us direct at: (866) 639-1662
Looking For Medicare Plans?
Medicare 101
The A, B, C & D's of Medicare
Part A
Covers Inpatient hospitalization, skilled nursing, hospice and home health care services. The first 60 days are subject to the Part A deductible. Once the Part A deductible is met there is a per day copay from day 61 - 90.
Part B
This is called your "Medical Insurance" (sometimes referred to as "Physician Services"). Part B covers things like doctor office visits, lab tests, MRI’s, outpatient surgery, and so on. You will have to pay the Part B deductible. Once the Part B deductible is met you are responsible for 20% of charges. There is no stop loss or limit to the dollar amount of the 20%.
Part C - Also known as "Medicare Advantage"
This is a way to receive your Part A (hospital), Part B (medical), and in many cases Part D (pharmacy drug coverage) all in one convenient plan. All Medicare Advantage plans have an out of pocket maximum that greatly limits your total financial exposure.
Part D
Typically covers prescription drugs that you pick up at a pharmacy. There are only two ways to get Part D coverage: 1) Enroll in a standalone Part D prescription drug plan or 2) Enroll in a Medicare Advantage plan that includes Part D prescription drug coverage.
Did you know there are two ways to receive your Medicare benefits?
Option #1
Medigap + Standalone Drug Plan
You keep Medicare parts A & B.
Enroll in a Medicare supplement plan (a.k.a. “Medigap”) to help cover the portion of Medicare parts A & B you are responsible for. Also enroll in a standalone Part D prescription drug plan to cover medications you have filled at a pharmacy (NOTE: Medigap plans do not include Part D drug coverage which is why you would also need to enroll in a standalone drug plan if you choose the Medigap option).
Option #2
Part C - "Medicare Advantage"
Enroll in a Medicare Advantage plan.
These plans are administered by private health insurance companies with a Medicare contract. Medicare Advantage plans incorporate parts A, B, and (in most plans) part D within one plan.
Not sure which Medicare option is right for you?
Let's take a closer look the pros and cons of Medicare supplements and Medicare Advantage plans.
Pros and Cons of Medicare Supplement (a.k.a. "Medigap") plans
Medicare supplement (also called “Medigap”) plans do exactly what the name suggests: they supplement, or ‘fill in the gaps’, of the health care costs Medicare doesn’t cover. Some people mistakenly assume that Medicare supplement plans offer benefits beyond what Medicare covers. The truth is that Medicare supplement plans follow Medicare benefits like a train and caboose. If Medicare covers a procedure or service, then a Medicare supplement plan will cover the same procedure or service – paying the portion Medicare does not pay up to plan limits. Medicare supplement plans are standardized; they offer the same benefits and provider choices regardless of the insurance company and are identified by letters A through N. Premiums are the only difference between Medicare supplement plans with the same letter sold by different insurance companies. Medicare supplement plans are also very portable – meaning that you can take it anywhere in the U.S. and the benefits will be the same. There are no network restrictions, so you can see any medical provider in the U.S. who accepts Medicare and there are no referrals required to see specialist doctors. Medicare supplement plans in general offer more freedom and flexibility compared to Medicare Advantage plans.
Things to consider regarding Medicare supplements
Medicare supplement plans have premiums that tend to be higher than Medicare Advantage plans and the premiums typically increase as you get older. The other downside is that you will also need to enroll in a standalone prescription drug plan, for an additional premium, in order to receive Part D benefits (Medicare Part D is pharmacy prescription drug coverage.
Pros and Cons of Medicare Advantage plans
Medicare Advantage plans have become increasingly popular over the years for a variety of reasons. Most notably the premiums will be considerably lower than Medicare supplement plans (in some areas Medicare Advantage plans have $0 premiums) and most include Part D coverage so there is no need to purchase a standalone drug plan. Copays are fairly nominal under most plans for everything from doctor office visits to diagnostic testing, rehabilitation, outpatient surgeries and inpatient hospitalization. Plus they may also include extra benefits for things that Medicare doesn’t cover like dental, vision, chiropractic and acupuncture. Many also have free gym memberships to help keep their subscribers active and healthy. Some Medicare Advantage plans will also offer free transportation to and from doctor office visits and other medically related appointments (including to and from the pharmacy).
Things to consider regarding Medicare Advantage plans
With a few exceptions, Medicare Advantage plans are network based plans. A majority of Medicare Advantage plans are HMO’s, which are very network restrictive. As with most HMO plans, if you go out of the network for routine care you will be responsible for the entire cost (emergency care is covered in-network for all Medicare Advantage plans regardless of where it occurs). There are Medicare Advantage PPO plans offered in a few areas but they tend to have higher premiums and out-of-pocket costs (i.e.: deductibles, copays and co-insurance) than their HMO counterparts. And even though PPO plans will cover you in the event that you want to see an out of network provider, the out of network costs are typically 50% of charges – which cost wise could be too steep for some people. One other thing you want to be especially aware of is the “Out of Pocket Maximum” (sometimes referred to as the Annual Out of Pocket Maximum or Maximum Out of Pocket, etc.). This is the most you could be responsible for in a given year should you need extensive care. If you do choose a Medicare Advantage plan, you will want a plan with an Out of Pocket Maximum as low as possible.
How To Choose The Right Plan
The best plan for you is going to boil down to a few things:
- Are the plan premiums and other cost sharing affordable in the long run?
- Does your doctor (or doctors) accept the plan(s) you are considering? (If you're considering an HMO and you have specialist doctors, are all of your doctors in the same medical group network?)
- Are your medications covered on the plan’s formulary? If so, are they covered at the lowest copays or coinsurance possible?
- Should you need to be hospitalized, does the medical center you would want to be treated at also accept your plan?
Once these questions are answered to your satisfaction, then you can look at any extra benefits that a plan may offer.
When working with people who are Medicare eligible, we understand that everyone has different health care needs. We have a process we go through to make sure that the health plan you choose is the one that best serves your needs. We start the process by researching medical providers and prescription drug formularies based on your individual health care requirements. We present side by side plan comparisons that are easy to understand and we will answer any questions you may have. We don’t discriminate or play favorites with any insurance company and there is never an obligation to enroll in any of the plans we present. After enrollment, we also provide ongoing support to help resolve any issues that could come up in the future. Our services are offered at no additional cost to you and your costs will be the same no matter if you enroll through us, direct with an insurance company or through any other source.
Tap here
to get a free quote or call us direct at:
(866) 639-1662
© Alderette Insurance Agency, Inc. CA Insurance License #: 0F82790, NV Insurance License #: 524416, AZ & OR Insurance License #: 8583235, WA Insurance License #: 1053162
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every Medicare plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.
© Alderette Insurance Agency, Inc. CA Insurance License #: 0F82790, NV Insurance License #: 524416, AZ & OR Insurance License #: 8583235, WA Insurance License #: 1053162
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.
© Alderette Insurance Agency, Inc.
CA Insurance License #: 0F82790, NV Insurance License #: 524416, AZ & OR Insurance License #: 8583235, WA Insurance License #: 1053162
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.