Understanding Medicare, especially when you are first entering, can be a difficult. Trying to grasp what is and is not covered, along with how much this will cost you is overwhelming enough. Couple that with the available Medicare Advantage plans, Supplement plans, Part D Prescription plans and penalties for not signing up when first eligible, and many seniors will get thoroughly frustrated. This page is intended to give you a brief understanding of the Medicare system. It is not a complete synopsis and should not be considered a replacement for the Medicare Handbook or for obtaining professional advice from a licensed agent. Please request an appointment with a representative of Carter Jacobs Insurance for your personal consultation.
Part A – This covers hospital expenses and skilled nursing facilities along with hospice. There is typically no monthly premium, as most seniors have been paying into Medicare most of their working lives. However, it is not 100% coverage and you will be responsible for a deductible and typically co-insurance.
Part B – This covers physician services and supplies. The monthly premium is typically $104.90 or $121.80 (depending on when you started Part B). There is an annual deductible along with co-insurance. It is essentially an 80/20 plan after the deductible. There can be penalties if you do not sign up when first eligible and may have to wait for an open enrollment period. Please contact us for more details on this.
Part C – These are the Medicare Advantage plans. An Advantage plan completely replaces Original Medicare (Parts A&B) and has your benefits administered through an independent insurance company. Medicare requires that the benefits of an Advantage plan be as good as or better than Original Medicare. Most of the time Advantage plans will also include your Part D prescription drug plans. You cannot have an Advantage plan and a Supplement. If you are wanting a Supplement, you will need to stick with Original Medicare. These are the plans that have the annual enrollment period each autumn.
Part D – This is the prescription drug plan. Penalties can also be assessed here if Part D is not obtained when you are first eligible. The various plans will have a monthly charge, but each plan will have different charges for the individual medications and many will also have a deductible. It is imperative that you have an adviser run your specific prescriptions to make sure your prescription costs are as low as possible.
Supplement Plans – These plans are also known as Medigap plans and they supplement (or fill the gaps in) Original Medicare. The plans are standardized (by plan letter) by state and federal laws. This makes comparing prices easy since plans with the same letter must offer the same benefits with every insurance carrier. They work along side Original Medicare and will pay various deductibles, co-insurance, and excess charges that Medicare leaves as your responsiblity.
Dental and Vision – As a general rule, Medicare does not cover any dental or vision. It will cover the health of your eyes so that Glaucoma and Cataracts will be addressed. However, eyeglass prescriptions and dental procedures are typically not covered. Carter Jacobs does offer dental and vision plans for you.