From Oct 15-Dec 7
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INDUSTRY INSIGHT
MEDICARE
Understanding Your Medicare Choices
SPONSORED CONTENT
Medicare health benefits can seem confusing, so it is important to know what is available and what to expect before you sign up.
You have three months before you turn 65, the month you turn, and three months after you turn 65 to decide the extent of Medicare benefits you want to have. The options are:
• Original Medicare, which is fee-for-service coverage traditionally provided by the government.
• Supplemental insurance( also known as Medigap) that works alongside Original Medicare.
• Medicare Advantage plans. You must sign up during the seven-month window to avoid being hit with lifetime penalties. Even if you are on an employer plan, you will need to take steps so you don’ t get dinged.
Original Medicare
Most beneficiaries have Original Medicare coverage( Medicare Parts A and B). It gives them the option to visit nearly any physician or hospital throughout the United States.
As long as a provider accepts Medicare coverage, services at that location will be covered as outlined in the Original Medicare terms.
Original Medicare covers most medically necessary services and supplies in hospitals, doctors’ offices, and other healthcare settings. Original Medicare doesn’ t cover some benefits, such as eye exams, most dental care, and routine exams. You can also enroll in Part D, which helps cover drug costs. People who want the Medicare Part D prescription drug benefit must choose an option that will work with Medicare benefits. If a person prefers to keep Original Medicare, it is best to select a drug plan that is a stand-alone policy offering strictly drug coverage.
Medigap Many of the people who sign up for Original Medicare purchase supplemental coverage to fill the gaps where Medicare is deficient. Medigap, also known as Medicare Supplement Insurance, is essentially extra health coverage that you buy from a private company to pay healthcare costs not covered by Original Medicare, such as copayments, deductibles, and healthcare if you travel outside the U. S. There are 10 types of Medigap plans, two of which were discontinued for new enrollees in 2020. Each of these plans covers deductibles, excess charges, and out-of-pocket expenses to varying degrees. You can compare plans at medicare. gov under“ Health & Drug Plans.”
Cusumano Insurance, a local family-owned business, has been serving the Pittsburgh area since 1958. The agency represents several insurance companies offering various options for your personal and business insurance needs. Its experienced staff are creative problem solvers who help find the suitable insurance companies, products and discounts to meet your specific needs. Give them a call today for a free insurance review.
This Industry Insight was provided by:
Joann Cusumano Sciulli, AAI Agency Principal
Rosann Cusumano Elinsky, AAI, LUTCF Agency Principal
Cusumano Insurance Agency, Inc. • 178 Clairton Blvd • Pleasant Hills, PA 15236
Medicare Advantage
Medicare Advantage is an“ all-in-one” alternative to Original Medicare. If you join a Medicare Advantage plan, you’ ll still have Medicare, but you’ ll get most of your Part A and Part B coverage from your Advantage plan, not Original Medicare. These“ bundled” plans include Part A, Part B, and usually Part D.
With Medicare Advantage plans, beneficiaries are usually required to obtain drug coverage as part of the package. Plans may have lower out-of-pocket costs than Original Medicare. Most offer extra benefits that Original Medicare doesn’ t cover— like some vision, hearing, dental, and routine exams. Plans can now cover more of these benefits. In many cases, you’ ll need to use doctors who are in the plan’ s network.
There are several plan types, including:
• Preferred provider organization
• Health maintenance organization
• Medicare medical savings account
• Point of service
• Private fee-for-service
• Special needs
• Provider-sponsored organization
2027 Medicare
Review
From Oct 15-Dec 7
Medicare plans can change annually. Make sure your coverage is still right for your needs! Contact us for a no-cost review.
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