What LBA Offers

Take a closer look at the options our insurance coverage provides!

Medicare Coverage Options
 

What is Medicare?

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ERSD) and ALS knows as Lou Gehrig’s Disease

 

Medicare has four parts:
  • Part A (Hospital Insurance) Coverage for in-patient hospital admissions, home health care, skilled nursing and hospice
  • Part B (Medical Insurance) Coverage for outpatient services such as physician office visits, ambulatory surgical procedures, diagnostic tests, infusions administered by a medical provider, durable medical equipment, medically necessary ambulance services, emergency room visits and preventative care
  • Part C- Alternative to traditional Medicare.  Private companies that are contracted by the federal government to manage Medicare Part A, Part B and may include Part D (prescription drug coverage).  These plans provide additional benefits such as vision, dental, and coverage for hearing aids and gym memberships
  • Part D-Medicare approved prescription drug coverage managed by private companies

 

 
Medicare Coverage Options: Medicare Supplement and Medicare Advantage

 

1. Medicare Supplement

Also known as Medigap.  These plans help fill “gaps” in original Medicare, Part A and Part B.  Medicare pays for your Part A (Hospital) and Part B (Medical) expenses, while the Medigap plan simply covers certain cost sharing expenses, such as deductibles and coinsurance.

There are 10 standardized alphabetical plans (Plan letters A-N) offered by private companies.  The only difference is usually the cost.  The following table provides an overview of the available Plan letters and the percentage of that benefit that is covered.  A blank box indicates that the benefit is not covered.

 

Medicare Supplement Chart

This chart shows the benefits included in each of the standard Medicare supplement plans. Some plans may not be available. Only applicants' first eligible for Medicare before 2020 may purchase Plans C, F and high deductible F.

Plans F and G also have high deductible option which require first paying a plan deductible of $2,490 before the plan begins to pay. Once the plan deductible is met, the plan pays 100% of covered services for the rest of the calendar year. high deductible plan G does not cover the Medicare Part B deductible. However, high deductible Plans F and G count your payment of the Medicare Part B deductible toward meeding the plan deductible.

*Important Note: Medicare supplement plans do not provide prescription drug coverage.  If you purchase a Medicare supplement, you should also consider purchasing a stand-alone Medicare (Part D) Prescription drug plan to avoid possible permanent penalty fees.  Most Medicare Part D plans have a similar structure of benefits.  The price will vary depending on the company.

The best time to purchase a Medicare Supplement plan is during your Medigap open enrollment period.  This is usually a six-month enrollment period.  This six-month window begins when you obtain Part B coverage.  This is usually when you turn 65 or decide to apply for Part B coverage later because you have employer health coverage.

The open enrollment period provides a guarantee-issue opportunity to apply for a Medigap plan of choice, without having to medically qualify.  During this period, an insurance company cannot deny you coverage or charge you a higher premium for medical reasons.

Note: If you have original Medicare coverage only, you can apply for a Medicare supplement at any time of the year and are not subject to Medicare’s Annual Open Enrollment Period.

 

Medicare Supplement companies we represent:


 

2. Medicare Advantage (Part C)

Medicare Advantage Plans includes all the benefits of original Medicare, plus more.  Medicare Advantage combines hospital (Part A) and Medical Coverage (Part B), such as doctor visits and outpatient services.  Most Medicare Advantage plans usually include (Part D) prescription drug coverage, along with extra benefits such as vision, hearing, dental and gym memberships.

 

Medicare Advantage companies we represent:

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 to get information on all of your options.