Medicare Products.

There are three main Medicare product groupings: Supplements (aka Medigap), Medicare Advantage Plans (aka PART C) and Drug Plans (aka PART D).  All are designed to enhance the Federal insurance program (aka Traditional or Original Medicare) which consists of PART A:Hospital, PART B:Medical, PART C:Medicare Advantage and PART D:Prescription Drugs.  Within the groupings of products, there are several types and within those types, several variations.  All designed to allow beneficiaries to elect the products to best serve in their situation.

We have offerings in all product groups. 

Additional Benefits (aka Supplemental, aka Extra, aka Ancillary, aka pot sweeteners, aka incentives, aka, goodies).  Advantage Plans offer an array.  All are designed to enhance the market attractiveness of the product.

These are benefits that Medicare does not offer as part of mandated Medicare benefits but Medicare has expanded what can be offered.

The companies have responded.  Depending on the plan, you can enjoy an Over-The-Counter credit account (where you can buy food/vitamins etc., pay utility bills), transportation to appointments, meals after hospitalization, fitness club memberships, dental, vision, hearing and so on.

The latest 'bennie' is Premium Reduction, (aka The Giveback, aka Rebate).  Here's how the pitch works...'Buy our plan and we, the insurance company, will provide a cash rebate in some form'.

However...not all is as it seems.  The benefits have to be funded.  Somehow.  So.  An attractive benefit here, usually means making you pay more there.  Whether or not that attractive benefit actually improves your cash flow in the next year depends on how the upcoming year works out.

Think carefully about those attractive goodie.  What is your situation?  What is offered?  What is your risk needing the actual medical benefits?  An ethical agent will not recommend you increase your risk.

Supplement plans, aka Medigap (as titled by Medicare) are paid monthly in advance to have your share of charges paid by your insurance company.  They pay your share of Original Medicare benefits under PART A and PART B.  There are 10 plan variations.   Not all companies offer all the variations.  Coverages vary from covering (your share of) all of Medicare's medical benefits to specific benefits.  Premiums vary by plans, companies, age and geographic location.  Usually, more premium, more coverage.  Premiums are company specific which can stay the same or increase monthly or annually.

The Medicare statute has a provision to allow insurance companies to offer approved plans that bundle the provisions of the statute: PART A:Hospital, PART B:Medical and, most of the time, PART D:Prescription Drugs, all into one plan (aka PART C:Medicare Advantage).

Medicare Advantage Plans offer bundling your PART A, PART B and PART D and additional benefits (perks...not covered by Medicare; dental, vision, etc) into one package.

While the 'perks' are attractive, remember, the reason you purchase the plan is your medical and drug coverage..

Medicare approves, oversees and disciplines companies that offer these plans.  Not all plan designs are available everywhere or to everyone.

Plans are designed where one sees only network providers.  Plans are designed where one can see either network or non-network providers. Plans are designed for regions and groups of counties within states.  Plans are designed for different income and health circumstances. Plans are designed for Medicare only recipients.  Plans are designed for those on Medicare and Medicaid.

The way the plans work is Medicare pays a stipend to the plan in return for the plan becoming the administrator of the benefits.  The members pay a monthly premium, usually low to zero (some 'rebate').

PART C plans require you to agree to pay a share of costs when you use the benefits. Some plans pay all of your costs.   While all benefits offered by Medicare must be offered by each plan, the cost share may vary between plans and between companies.

All plans feature, by law, an annual maximum out-of-pocket (MOOP) limit which is a trigger amount. where, should the sum of the medical copays total the MOOP amount, the plan converts to 100% coverage for the rest of the policy year.  Only a small percentage of beneficiaries ever reach the trigger within a policy year.

As one of the Medicare Advantage variations, the Medicare statute authorizes companies to offer plans that pay upfront funds annually to beneficiaries to use as they see fit.   The cash payment belongs to the beneficiary who is free to use the funds as they wish; note there are tax implications if used for non-medical expenses.  The plan has a trigger (MOOP) where coverage converts to 100%.  There are specific rules.

At this time, we do not have an offering for this type of plan.

The Medicare Statute authorizes private insurance companies to offer PART D:Medicare Rx Plans which cover Medicare approved prescription drugs using statutory provisions mandated by Congress.  Medicare uses a Master Formulary (drug list) from which each plan can select all, most or some drugs to cover in their plans.  All PART D plans follow statutory mandates.   At least 2 drugs from each category.  An annual deductible can be waived or partially applied.  Defined coverage stages, each governed by a defined amount threshold and defined co-pays.  Here too, Medicare approves, oversees and disciplines.