Medicare Part D prescription drug plans are stand-alone plans that help pay for prescription drugs. Part D plans may be added with Original Medicare and/or a Medicare supplement insurance plan, as well as with certain Medicare Advantage plans that don't include prescription drug coverage.
Medicare supplement insurance plans, also known as Medigap plans, help pay some of the out-of-pocket costs not paid by Original Medicare (Parts A & B).
Medicare Advantage (Part C) plans combine your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) in one plan and usually include prescription drug coverage. These plans often also offer additional benefits such as dental, vision and fitness.
Special Needs Plans are Medicare Advantage plans designed for specific needs that include prescription drug coverage. Plans may also include other benefits like care coordination. There are four types of Special Needs Plans including Dual Special Needs Plans for people with both Medicare and Medicaid.
Katie began her insurance career as a pharmacist. She has been helping her patients review their Medicare coverage options for over 10 years in her pharmacy. As the years have gone on the coverage options have become more confusing than ever. In 2022, she decided to flip the script and dive into the world of insurance to learn all the nuisances of the plans and options available. She offers a unique perspective from the point of view of how a person's health care journey may change in the course of year and how each plan will respond with their coverage options.
Outside of the exciting life of insurance and helping her patients at her pharmacy, she is enjoying life as a mom of 2 beautiful daughters, Charlee (5) and Lyla is (1), on her hobby farm she and her husband, John, have created. She lives in Pickens County and is so excited to be able to serve her community in this way!
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The answer to this may be easy to say but maybe not as easy to do. You need to understand your personal health care needs and choose Medicare coverage to help meet them. For example, if you take prescription drugs right now, when you get Medicare, you need to make sure you get Part D prescription drug coverage through either a stand-alone Part D plan or a Medicare Advantage plan.
You will likely pay the Part B premium to Medicare. Beyond that, you may pay other premiums, deductibles, co-pays and co-insurance. The total amount you pay will depend on the type of Medicare plan(s) you choose and the health care services you use during the year.
If you plan to work past 65, you may be able to delay enrolling in Medicare. Or, you may have to enroll during your Initial Enrollment Period in Parts A, B and D if you want to avoid late penalties. It will depend on your employer and if your employer coverage is creditable.
Some people who can delay Medicare still choose to enroll in just Part A when they turn 65 in addition to their employer coverage. Part A is premium free if you or your spouse worked and paid Medicare taxes for at least 10 years. Note though, if you do get Part A, you can no longer contribute to your HSA.
Original Medicare (Parts A & B) does not cover routine dental or vision care; however, some Medicare Advantage (Part C) plans do. Plans include all the coverage provided by Parts A and B, and often additional benefits like dental, vision, hearing and gym memberships, all in one plan.
No part of Medicare is mandatory, but if you choose to enroll in any part of Medicare after your Initial Enrollment Period, you could face financial penalties unless you qualify for a Special Enrollment Period with creditable employer coverage.
A Medicare Advantage HMO plan usually helps pay only for care you receive from providers in the plan network. A PPO plan will generally help pay for care received outside the plan network, but it may pay less than for the same care received within the network.
Financial assistance programs for people with limited income and assets include Extra Help for prescription drugs, Medicare Savings Programs and Medicaid, to name a few. Qualifications for each program and the level of help offered vary.
Your Medicare coverage choices will stay in place year after year unless you change your plan. This ensures that your coverage continues, but even if a plan renews, the plan benefits and costs may still change each year. It’s a good idea to review your Medicare choices every year during the Medicare Annual Enrollment Period each fall, which runs Oct. 15 – Dec. 7.
Your Medicare coverage choices will stay in place year after year unless you change your plan. This ensures that your coverage continues, but even if a plan renews, the plan benefits and costs may still change each year. It’s a good idea to review your Medicare choices every year during the Medicare Annual Enrollment Period each fall, which runs Oct. 15 – Dec. 7.
Medicare and Medicaid are both government health care programs, but they are very different. Medicare is generally for people who are 65 or older, or who have a qualified disability. Medicaid is a state-governed program for people with limited income and resources. Some people are eligible for both Medicare and Medicaid. These people are considered “dual eligible” and are often qualified for special Medicare plans.
Medicare and Medicaid are both government health care programs, but they are very different. Medicare is generally for people who are 65 or older, or who have a qualified disability. Medicaid is a state-governed program for people with limited income and resources. Some people are eligible for both Medicare and Medicaid. These people are considered “dual eligible” and are often qualified for special Medicare plans.
In general, you are eligible for Medicare after receiving Social Security disability benefits for 24 months. There are exceptions for people with certain medical conditions.
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