We hope this page provides you with a helpful introduction to your Medicare coverage options.
Your taxes have paid for your Part A (Inpatient) of Medicare, and the standard monthly Part B premium (Outpatient) of $174.70 is normally deducted from a retiree’s Social Security check.
You have two coverage options outside of Original Medicare: Medicare Advantage or Medicare Supplemental insurance.
We can discuss either of these options with you and review your prescription drug plan choices.
What are my Medicare coverage choices?
There are two main ways to get your Medicare coverage: Original Medicare or a Medicare Advantage Plan. Use these steps to help you decide which way to get your coverage.
Medicare Part A
Part A will pay for inpatient hospital stays after a $1,632 deductible.
Part B
Medicare is basically an 80/20 plan with deductibles. Part B will pay 80% (after an annual deductible of $240) for outpatient physician and surgical services, tests, therapy, diagnostic procedures and more.
Part C Medicare Advantage
Combines A, B & D. Medicare pays the company you select around $1,050 monthly so your monthly premium is often $0 (depending on which plan you choose), and you pay copayments.
Part D Drug Coverage
Part D Drug coverage will be included in your Medicare Advantage
or
can be purchased separately if you enroll in a Medicare Supplement.
There are 3 Phases of Medicare Part D Drug Coverage:
- Initial Phase – You will pay co-pays until the total cost of your drugs reaches $5,030. The total cost is the amount you have paid plus the amount your insurance company has paid.
- Coverage Gap – The “doughnut hole” begins after your drug costs have reached $5,030 (the amount you and your insurance company have paid).
- The starting point for the doughnut hole is the amount you paid during the initial phase. For example, if you paid $500 in copayments during the initial phase, then your coverage gap would start at $500 and lasts until $8,000.
- Example: You start at $500 and last until $8,000; you will pay 25% for brand and 25% for generics.
- Example: If a prescription retails at $300, then you would pay $75. $300 would count toward “tiering” (not just the $75 that you paid); that is how you go from the $500 starting point to $8,000.
- The starting point for the doughnut hole is the amount you paid during the initial phase. For example, if you paid $500 in copayments during the initial phase, then your coverage gap would start at $500 and lasts until $8,000.
- Catastrophic Phase – You will no longer have copays.
You can choose a Medicare Advantage Plan or a Medicare Supplement
Advantage Plans often do not have a monthly premium and drug coverage is included. This is because Medicare pays the insurance company directly to handle your health care. You will have co-payments.
Medicare Supplement insurance will pay the gaps in Parts A and B or Medicare. You will have to pay a monthly premium for supplemental insurance and a separate drug plan.
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Phone:
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Address:
13374 Ridge Rd.
North Royalton, OH 44133
