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3435 Camino Del Rio South, Suite 315
San Diego, CA 92108
Monday - Friday
8:30 am to 4:00 pm
Evenings and Weekends by Appointment
When we think of Medicare, often we imagine it simply as government provided medical insurance, for the elderly, with benefits that are set in stone and standardized. Are you aware that is not the case?
The Medicare program provides beneficiaries with multiple benefit program options, outside Original Medicare, that allows them to have medical coverage provided by private insurance companies with a varying rage of benefits. Often times, the benefits provided under these plans are more comprehensive than Original Medicare and can include dental and vision coverage that regular Medicare does not.
MEDICARE OPTIONS AVAILABLE
We know the topic of Medicare can be complicated for some individuals. At the Windsor York we make understanding Medicare, and your options, simple. As agents certified to offer Medicare products to consumers, we have the knowledge, tools and resources to help guide you to the right Medicare plan that meets your needs.
Your Medicare options include:
Original Medicare is a national social insurance program, administered by the U.S. federal government. Its purpose is to provide medical insurance for senior citizens, and in some cases, disabled individuals under the age of 65. Original Medicare comes in two parts:
Part A, hospital benefits, and Part B, doctors benefits.
Part A & B benefits are nationally standardized by the federal goverment. Medicare reimburses doctors and hospitals a specific dollar amount for services performed, leaving Medicare enrollees responsible for out-of-pocket deductibles and copayments. Original Medicare does not provide prescription drug coverage, dental or routine vision coverage. There are no maximum out-of-pockets limitations, so beneficiaries could potentially be liable for medical bills that range to the tens-of-thousands of dollars.
Medicare Supplement Plans:
Medicare Supplement plans (also know as Medigap plans) are insurance policies that work side-by-side with Original Medicare and are administered by private insurance companies. They are designed to pay secondary to your original Medicare benefits and cover the out-of-pocket deductibles and copayments Medicare beneficiaries are normally responsible for. Medicare Supplement plans do not include prescription drug coverage. Private insurance companies charge premiums to enroll in Supplement plans and can require the enrollee to be medically underwritten before approval and enrollment.
Medicare Part D (Prescription Drug Coverage):
Until Medicare Part D was established in the mid 2000's, the Medicare program did not provide beneficiaries with prescription drug coverage. Medicare Part D is regulated by the federal government. However, private insurance companies provide and administer these prescription drug plans that must be purchased. Plan benefits, copayments, covered drugs and premiums vary depending on your chosen carrier and plan.
Medicare Part C (Medicare Advantage Program):
Medicare Advantage, or Part C plans, are medical plans offered by private insurance companies. While an individual is enrolled in one of these plans, they temporarily forgo their federal standardized Medicare benefits in lieu of the benefits offered through the Medicare Advantage plan of their choice. Medicare Advantage plans are very popular because plan benefits are structured in either an HMO or PPO format. Furthermore, Advantage plans include prescription drug coverage and can include dental and vision coverage. Even though Medicare Advantage plans are administered by private insurance companies, several carriers offer plans that have no monthly premiums to enroll!
Contact us at the Windsor York so we can help guide you to the plan that best fits your needs. We will also explain to you your restricted timeframes for enrollment and the possible delayed enrollment penalties for not joining when first eligible.