HELPING CLIENTS UNDERSTAND THEIR COVERAGE OPTIONS -CALL FOR APPOINTMENT
Hello, I'm Melinda Vazquez
As your Medicare Advantage plan agent, I am here for you, to help you learn and guide you to the process of selecting all benefits Medicare has to offer.
For faster assistance and questions please call me (714) 720-5968
DECIDE HOW YOU WANT TO GET YOUR COVERAGE
ORIGINAL MEDICARE
Part A (Hospital Insurance) and / or Part B (Medical Insurance)
Step 2: Decide if you need to add drug coverage.
Part D (Medicare Prescription Drug Coverage)
You can have part A and/or Part B to get this coverage.
Step 3: Decide if you need to add supplemental coverage.
Medicare supplement Insurance (Medigap) Policy
MEDICARE ADVANTAGE (Part C)
Part A (Hospital Insurance) and
Part B (Medical Insurance)
Step 2: Decide if you need to add drug coverage.
Part D
(Most Medicare Advantage Plans cover prescription drugs. You may be able to add drug coverage in some
plan types if not already included.)
If you join a Medicare Advantage Plan, you can't use a can't be sold a Medigap policy.
Is a Federal Insurance Plan
Medicare is a federal health insurance program for people age 65 and older, people of any age with permanent kidney failure, and certain disable people under age 65.
Medicare Covered Services:
Hospital Insurance- Part A
Skilled Nursing Facility Care
Hospital Insurance- Part A
Medicare hospital insurance helps pay for necessary medical care and services furnished by Medicare-certified hospitals, skilled nursing facilities, home health agencies, and hospices.
The number of days that Medicare covers care in hospitals and skilled nursing facilities is measured in benefit periods. A benefit period begins on the first day you receive services as a patient in a hospital or skilled nursing facility and ends after you have been out of the hospital or skilled nursing facility and have not received skilled care in any other facility for 60 days in a row. There is no limit to the number of benefit periods you can have.
Impatient Hospital Care
Skilled Nursing Facility Care
Hospital Insurance- Part A
Medicare Part A- helps pay for up to 90 days of inpatient hospital care in each benefit period. Covered services include your
semi-private room and meals, general nursing services, operating and recovery room costs, intensive care, drugs, laboratory tests, X-rays, and all other necessary medical services and supplies.
Skilled Nursing Facility Care
Skilled Nursing Facility Care
Skilled Nursing Facility Care
You may need inpatient skilled nursing or rehabilitation services after a hospital stay. If you meet certain conditions, Part A helps pay for up to 100 days in a participating skilled nursing facility in each benefit period. Medicare pays all approved charges for the first 20 days; you pay a coinsurance amount for days 21 through 100. Covered services include your semi-private room and meals, skilled nursing services, rehabilitation services, drugs, and medical supplies.
Home Health Care
Home Health Care
Home Health Care
If you meet certain conditions, Medicare pays the full approved cost of covered home health care services. This includes part-time or intermittent skilled nursing services prescribed by a physician for treatment or rehabilitation of homebound patients.
The only amount you pay for home health care is a 20 percent coinsurance charge for medical equipment such as a wheelchair or walker.
Hospice Care
Home Health Care
Home Health Care
Medicare helps pay for hospice care for terminally ill beneficiaries who select the hospice care benefit. There are no deductibles, but you pay limited costs for drugs and inpatient respite care.
Medicare Insurance -Part B
Medicare Part B helps pay for doctor's services, outpatient hospital services (including emergency room visits), ambulance transportation, diagnostic tests, laboratory services, some preventive care like mammography and Pap smear screening, outpatient therapy services, durable medical equipment and supplies, and a variety of other health services. Part B also pays for home health care services for which Part A does not pay.
Medicare Part B pays 80 percent of approved charges for most covered services. You are responsible for paying a $100 deductible per calendar year and the remaining 20 percent of the Medicare approved charge. You will have to pay limited additional charges if the doctor who cares for you does not accept assignment. This means the doctor does not agree to accept the Medicare approved charge for services.
Medicare- Part C
Medicare Advantage (Also Known as Part C)
Medicare Advantage is an “all in one” alternative
to Original Medicare These “bundled” plans
include Part A, Part B, and Part D.
Plans may have lower out of pocket costs than original Medicare.
In many cases, you’ll need to use doctors who are in the plan’s network. Most plans
offer extra benefit that original Medicare doesn’t cover, like
Vision, hearing, dental, and more. Some plans won’t cover services from
Providers outsider the plan’s network and services area.
You may need to get a referral to see a specialist. Each Medicare Advantage
Plan can have different rules that can change each year.
Medicare Part-D
(Prescription Drug Coverage) - Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage. Most people
pay a monthly premium for Part D.
The Original Medicare Plan with a supplemental Policy
Many private insurance companies sell Medicare Supplemental Insurance Policies (Medigap or Medicare SELECT) to help fill the coverage gaps in the Original Medicare Plan. If you remain in the Original Medicare Plan, you may want to consider buying one of these 10 standard policies for extra benefits. These policies help pay Medicare's coinsurance amounts and deductibles, and other out-of-pocket costs for health care.
The federal government does not sell these types of policies.
Do not delay. When you first enroll in Part B at age 65 or older, you have a 6-month Medigap open enrollment period. During that time your health status cannot be used as a reason either to refuse you a policy or to charge you more than all other open enrollment applicants. (The insurer may make you wait up to 6 months for coverage of a pre-existing condition.) If you try to enroll later, you may be denied a policy or charged a higher rate.
At age 65, Medigap open enrollment is available to beneficiaries who are enrolled in Part B. If you are under age 65, contact your state insurance department for information about open enrollment.