Medicare Insurance

from Wagner Insurance Agency

Medicare Insurance

Your retirement days should be relaxing and rewarding. We won’t allow Medicare to be a stressful experience. Follow the “First Step” outlined in the next paragraph and leave the rest to us.

The first step is often the longest. You must sign up for Medicare Part A and Part B. This is done at your local social security office. We recommend calling ahead for an appointment. Making an appointment will minimize the amount of time you sit around waiting.

Types of Medicare in Ohio

This is the easy part. Here you have only a single decision to make. That decision is whether to elect a Medicare Supplement Plan (also known as a Medi-Gap Plan) or a Medicare Avantage Plan. We will help you become familiar with both choices. Then, you to pick the plan that best fits your lifestyle and budget. Until then, here is a brief desription of the two choices.

Medicare Supplement Plan

A Medicare Supplement Plan (Medi-Gap Plan) provides additional coverage to your standard Part A and Part B coverage. This coverage is used mostly for the 20% co-payment you share with standard Medicare coverage. Rather than you paying the 20%, there plans pay the 20% co-payment. The best of plans allow you to pay a defined premium every month to eliminate unkown medicare co-payments as they pop up. No deductibles, no other payments other than the monthly premium. These plans are provided by major insurance companies in the U.S. to “supplement”, or “fill the gaps in” the Medicare Coverage you get through the government.

Medicare Advantage Plan

A Medicare Advantage Plan is a little more involved. These plans are also provided by major insurance companies in the U.S. The biggest difference is that the government pays the insurance company to assume the role of your Medicare for you. By doing this, the government pays a fixed monthly fee in exchange for the insurance company paying all your related medicare claims. The government believes this system can save millions of dollars through this type of plan. The insurance companies then offer benefits similar to the plans mentioned above. The monthly premiums you pay are lower, however there is a rather large annual deductible.

Medicare Part D

The plan you pick will determine how you obtain Medicare Part D. Medicare Part D is your prescription plan. We also help you with this part of Medicare insurance. As you will learn when we meet, most Medicare Advantage Plans come with a Part D plan. If not, or if you choose a Medicare Supplement (Medi-Gap) Plan we will help you pick from a wide variety of Medicare Part D plans. This will based mostly upon the prescritions you are taking.

Terms You Should Know

COINSURANCE – The percentage of cost you may have to pay for services after the dedkuctible has been paid.

COPAYMENT – A specified dollaar amount you pay when you see a doctor, hospital or other covered services.

DEDUCTIBLE – The amount you must pay before the insurance plan begins to pay.

INPATIENT HOSPITAL CARE – Healthcare that you receive when you are admitted to a hospital.

OUT-OF-POCKET LIMIT – This is the most you would have to pay for medical services during the plan year for deductibles, copayments and coinsurance. (in-network and out-of-network will be different)

OUTPATIENT HOSPITAL CARE – Healthcare you receive in a hospital when you are not admitted as an inpatient.

PREMIUM/PLAN PREMIUM – The payment you will make on a regular basis for your health plan.

PRIMARY CARE PHYSICIAN – The doctor/physician you typically see first for the mojority of your health issues.

SPECIALIST – A doctor with training and expertise in a specific area of medicine or surgery. For example, an Ophthalmologist is a specialist for the eye and a Cartiologist is a specialist for heart conditions.