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'Tis the Season to Be Insured

Updated: Jan 25, 2022

Your Better-Than-Ever Medicare Health Insurance Plan AWAITS!

Medicare Health Insurance Plan AWAITS!

Beware Medicare health insurance recipients!

Open enrollment ends December 7th, 2021

The Medicare health insurance enrollment period which started October 15th, 2021, will continue to be in effect until December 07 of 2021.

If you sign up for one of the Medicare health insurance plans and policies available for residents of the state of Florida, you may be on your merry way to receiving affordable health care insurance coverage effective January 1, 2022.

Shop around for the best Medicare health policy that meets your lifestyle and health condition best

Whether you are new to Medicare or already receiving benefits, it can be confusing and tedious to figure out which distinct types of Medicare plans are available in your zip code, and which one out of the many health insurance typesis the best for you.

You may want to shop around for a better policy that adjusts to and covers more of your costs per year better than your current one. There are also changes in the marketplace health insurance policies and Medicare supplements that need to be addressed by every Medicare recipient. Be informed and know your Medicare health insurance options.

If you aren’t automatically enrolled, you can do so online in just a few minutes. Simply fill out a Medicare application through the Social Security website.

You may enroll any time during the three-month period before you turn 65 and after your 65th birthday.

If you are legally disabled, your Medicare health insurance benefits will begin as soon as you receive social security benefits.

Add up your yearly costs before choosing a plan

Know what your current health profile is and plan accordingly.

Medicare itself in its official website encourages visitors to learn more and find a plan that will help their beneficiaries meet the unexpected costs of healthcare such as emergency and hospital visits that may not have been in the books but were nonetheless necessary. Add up your final yearly medical costs based upon your deductible and out of pocket costs to have an estimate of what you should be planning for the coming year, especially so if you are receiving ongoing treatment.

Did you meet your health insurance deductibles; how much was your out-of-pocket total or estimate? All this information is available in your account profile.

Once you have a picture of your healthcare yearly costs including drugs and preventive care, you will know how much of a premium, deductible, and out of pocket your health care costs will likely run. You will then look at the plans in your zip code area and select the ones that fit your scenarios best.

It might also be smart to check if your family doctor, or any specialist you wish to see, are listed under providers before choosing and enrolling in any of the Medicare Advantage plans which will be effective on January 1, 2022.

Which Medicare Advantage plans? That is the conundrum.

With a Medicare Advantage plan you get a health insurance bundle that covers Part A, Medical, Part B, Hospitals, and Part D, Drugs. Medicare Advantage is Part C.

The most popular type of Medicare health insurance, Medicare Advantage plans are offered in every State. Once in the Medicare website, beneficiaries and the public can search for a plan that fits their needs. If you expect low and affordable healthcare costs and have a certain income range your Medicare Advantage Plan can help you cover the cost of healthcare every year with low premium, deductible, and out of pocket when you stay within the network.

Maximize healthcare service using in network providers and minimize costs of insurance and total healthcare costduring a year.

Choose up to three plans to compare. Once you have compared the providers lists in your zip code and adjacent areas, and you are sure about your knowledge of the terminology and what it will mean to you now and now and down the road, you are ready to choose.

Call your local health insurance broker or any of the numbers provided by the Medicare website portal.

Why choose a Medicare Advantage Plan instead of Medigap or none?

Perhaps, the reason they are so popular is that these MA plans also provide extra services such as transportation, over-the-counter drugs, gym memberships or discounts, plus vision, hearing, and dental care services per zip code. If you are unable to find providers in your area of residence, you can look up in network providers within up to 60 miles or more.

Some healthcare plans can be tailored for chronically ill patients requiring special treatments.

Although plans cover all emergency and urgent care in addition to most necessary medical services and preventive care, Medicare Advantage plans do not cover hospice services or clinical trials. However, these services will still be covered by Medicare.

You can also appeal the decisions made against medically necessary services when providers make referrals that are not covered or not in network.

What are the different types of Medicare Advantage Plans?

Different rules for different folks

Medicare Advantage Plans cover a wide range of plans:

1. HMO – A Health Maintenance organization (HMO) has some restrictions. You must choose a primary care doctor. This doctor refers you to see specialists. Most of the services you receive must be in network except for emergency care and out of area dialysis and urgent care. In some cases, out of network providers are covered but then your out-of-pocket costs will increase. Learn more here.

HMO are lower cost.

2. PPO – Medicare Advantage, Preferred Provider Organization (PPO) plans also require that you to choose from a list of in network providers and hospitals. Learn more here. The reduce cost of in network providers make these look very similar to HMO plans. They offer prescription drugs plans and you do not need to choose a primary care. You may or may not need a referral. It depends on the procedure, treatment, or screening.

3. SNP – Medicare Advantage Special Needs Plans limit membership to people who meet special healthcare characteristics and illnesses. These plans use a coordinator who makes sure beneficiaries get the services needed both preventive and on-going, such as

· Blood sugar monitoring

· Following a balanced diet

· Exercise

· Preventive care

· Prescription revisions

C-SNP – Chronic Condition Special Needs Plan are tailored to meet the health care needs of patients with chronic illnesses. Learn more here.

D-SNP – The Dual eligible, (D-SNP), means you receive both Medicare and Medicaid benefits.

I-SNP - If you are institutionalized or require nursing care at home (I-SNP).

Talk to a health insurance broker in your area who can help you navigate the enrollment process and answer all your questions during and after enrollment.

Medigap Plan may cover your medical costs 100%

Another type of Medicare health insurance option that may be beneficial and is the second most frequently used, is Medigap. Medigap is a supplemental insurance that offers standardized plans. Medicare Part B only pays for 80% of your healthcare services, and the remaining 20% is the gap you need to fill.

The plans are named by letters from A-N and are available in every state. There are 12 Medigap plans offered in Florida. To compare Medigap policies in your zip code select the plans you wish to investigate and choose one, if that is what you decide.

Your share of the healthcare costs after Medicare pays its part is left on your plate and Medigap will pick up the slack at rates between 100 and 50 percent of the total bill. Type in your State and zip code and you’ll get to review and choose policies to compare before enrolling in one.

Plans differ in deductible and premium rates. The lower the premium the higher the deductible. They were created in the 80s to help Medicare patients cover the increasing cost of health care.

The difference between a Medicare Advantage Plan and a Medigap policy is that the Advantage Plans offers coverage for healthcare services for all the Medicare parts (Part, A, Medical; Part B, Hospitals and Part D, Drugs). You are also able to sign up for additional services such as vision, dental, and hearing.

Medigap does not offer a Drug plan but may pay up to 100 percent of the costs to you after meeting your deductible.

No matter what kind of Medicare health insurance plan you get, Medicare Advantage Plan or Medigap, you’ll be better off with a plan than without a Medicare Health Insurance Plan and your finances will improve.

Medicare Part D Plans – The Formulary

The Formulary is a list of prescription drugs covered by Medicare Part D Plans. Learn more here. Plans that offer savings on insulin and other prescription drugs are available.

You may wish to enroll in a Part D plan when you choose Medigap policies, which do not offer Part D.

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