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Get Started With Medicare

Medicare is its own universe  with its own jargon, terms, rules, and regulations. This can be intimidating, especially for those of us just starting out. However, signing up for Medicare is a vital step in making sure that you and your family have access to the essential healthcare you need in your golden years. Beware of Medicare scams!   Protect your Medicare ID and enrollment information.    Read on to learn how to get stared with Medicare.

 Learn the Basics

Original Medicare has two parts: Part A and Part B. Part A is hospital insurance, and Part B is medical insurance. Within these two parts, many of the basic health care you will need is covered. There is also Part D, which are prescription drug plans that are purchased separately. Medigap, or Medicare Supplemental Insurance, refers to additional coverage purchased from private insurance carriers that helps pay for the out-of-pocket costs of Medicare. Another name for Medicare Part C is  Medicare Advantage.   Part C is an alternative to Original Medicare.  Private insurance companies offer MAPDs.   The federal government does not offer these plans. These are bundled plans that usually include hospital, medical, and prescription coverage.  You must enroll in Medicare to qualify for one of these plans.

Prepare to Sign Up – Enroll

Get started with Medicare.   Most become eligible at age 65. And, promptly sign up.  Individuals receiving benefits from Social Security are automatically enrolled in Part A of Original Medicare.   Part A is hospital insurance. When they sign up for Social Security benefits, they have a choice about whether or not to enroll in Part B (medical insurance). Therefore, individuals not receiving Social Security benefits, must enroll in Part A.  Enrollment is not automatic for these persons. Here are the easiest ways to sign up:

• Online, at Social Security. The website is the easiest, fastest way to sign up and access any financial help you may qualify for.

• Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

• You can contact your local Social Security office.

• If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

Regardless of method used to get stared with Medicare,  beneficiaries receive a welcome packet.     The welcome packet includes a Medicare card.   After enrollment, it takes about   2-3 weeks for the card to arrive.

Using Medicare

New enrollees will receive their Medicare card and start their coverage. It is a good idea to keep the Medicare card private, and only share it with medical professionals if necessary, as there are many scams around filing false claims to Medicare. The majority of doctors and service providers in the nation accept Medicare – about 93%. The most commonly excluded health care professionals, those who opt out of Medicare assignment, are psychiatrists and mental health practitioners, as well as pediatricians. It may also be helpful to give Medicare permission to share your information with someone you trust.  They can help if there is ever a medical emergency and you are unable to discuss treatment.

With these three simple steps, you will be well on your way to using Medicare successfully.

After Enrollment

The rise of automated and exclusively-online enrollment means that it can be easier to use technology to scam the unsuspecting.  Beware of Medicare scams!   Protect your Medicare ID and enrollment information. Medicare beneficiaries should always remember that Medicare will not reach out to beneficiaries via call or email unless they are answering their inquiry. Medicare will also never offer free gifts, medical equipment, or any other service for free.

Additionally, beneficiaries on an advantage plan do not need to show their Medicare card to providers.   Therefore, best if this card remains in a secure location not on them.

Licensed Agents

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Medicare Supplement Plan N

There are a large variety of Medicare Supplement plans to choose from. Medicare Supplement Plans, also known as Medigap, are plans that private insurance carriers sell to Medicare beneficiaries to remedy some of the gaps in coverage that occur in Original Medicare. Medicare supplemental plans can help pay the beneficiary’s share of out-of-pocket costs such as copays, coinsurance, or other fees. Medigap policies are named after letters of the alphabet in all but three of the continental United States.

Increasing Popularity

Medicare Supplement Plan N has become increasingly popular due to its wide range of coverage. Plan N covers 100% of the Medicare Part B coinsurance costs. Beneficiaries are left to cover a $20 copay for office visits and a $50 copay for emergency room visits. These low costs are appealing to many purchasers. Medicare Plan N also provides the following benefits:

• For hospitalization, Plan N pays for Part A (of Original Medicare) coinsurance plus coverage for an additional 365 days after Medicare benefits end. That is an entire year of additional hospitalization coverage.

• Plan N also pays for Part B’s coinsurance, excluding a $20 copay for office visits and a $50 copay for emergency rooms. Copayments for hospital outpatient services are also covered.

• The first three pints of blood each year are paid for by Plan N coverage.

• Perhaps most vitally for many seniors, Plan N covers the hospice care Part A coinsurance.

• Skilled nursing facility care is covered under Plan N.

• The Medicare Part A deductible for hospitalization is covered under these benefits.

• And, Plan N provides travel abroad medical emergency help.

There was a previously very widely used Medicare Supplement Plan called Medigap Plan F. Plan F was discontinued in 2020, and carriers were no longer allowed to enroll additional beneficiaries in Plan F. Because of this new gap where the popular plan no longer exists, Plan N is one of the Medigap plans that is growing increasingly popular because of its wide range of coverage.

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Do I Need a Medicare Supplement

Medigap is the common term for Medicare Supplement insurance. Medigap is extra insurance that beneficiaries can purchase from private insurance carriers. The purpose of Medigap is to help pay for out-of-pocket expenses that can accrue in Original Medicare coverage.  Therefore, enrollees must be enrolled in Original Medicare in order to purchase a Medigap policy.

Medigap policies are standardized. This means that, unlike Medicare Advantage and other policies, all Medigap policies offer the same basic benefits regardless of carrier or location. There are ten different types of Medigap policy and they are lettered: there are plans A through D, F, G, and K through N. This is how companies distinguish which benefits and prices a plan has.  Price is the only difference between plans from different insurance carriers with the same letter. However, in Massachusetts, Minnesota, and Wisconsin, standardizes Medigap policies differently. All other states use the alphabet system.

 Original Medicare with a Medicare Supplement

There are many healthcare services that Original Medicare does not cover because it is not a blanket insurance policy. An example of where Medigap policies can be helpful is with copays and deductibles. Let’s say a beneficiary becomes ill enough that they need a say in the hospital. With Original Medicare, that hospital stay (bed and board) is 100% covered.   Keep in mind the Part A deductible applies. However,  the beneficiary may still owe up to 20% of other costs. An example is anesthesiologist fees. Those bills can be significant. Medigap policies can help with that coverage.

Do I Example

Here is an example.  If a beneficiary is in the hospital for 60 days, they will be paying $400 a day, and there are similar copayments for nursing homes and other facilities. Those numbers can quickly add up to prohibitive costs, particularly for seniors on a fixed income or who are struggling with their health in their increasing age.

For anyone who wants an increased coverage for copays, fees, and deductibles, Medicare supplement insurance policies can be a reasonable way to mitigate possible costs.

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How Do Medicare Supplement Plans Work?

Original Medicare consists of Part A and Part B, which are Hospital Insurance and Medical Insurance, respectively. Together, Medicare Parts A and B cover and pay for many, but not all, of the healthcare services and supplies that seniors will need. A Medicare Supplement plan will help pay for the beneficiary’s share of some things that Medicare does not cover.

Here are some important things to know:

• Medicare supplement plans are not the same as Medicare Advantage plans.

• Beneficiaries must pay a monthly premium for their Medicare Supplement plan in addition to the Part B premium from original Medicare.

• Private insurance companies that provide Medicare supplement policies cannot cancel the beneficiary’s coverage even if they have persistent health problems.

What Do Medicare Supplement Plans Cover?

Medicare Supplements help to cover costs not covered by Original Medicare. Each plan provides a range of benefits. Basic benefits can include the following:

• Part A coinsurance and hospital costs up to an additional 365 extra days after Medicare benefits are used

• Part B coinsurance or copayment

• Blood (first 3 pints)

• Part A hospice care coinsurance or copayment

Certain Medicare Supplement plans may include additional benefits such as:

• Skilled nursing facility care coinsurance

• Part A deductible

• Part B deductible

• Part B excess charge

• Foreign travel exchange (up to plan limits)

• Out-of-pocket limit

What Do Medicare Supplement Plans Not Cover?

While Medicare Supplement plans cover many things, there is a general list of procedures and services that they do not cover. This list includes the following:

• Long-term care (like non-skilled care you get in a nursing home)

• Vision or dental services

• Hearing aids

• Eyeglasses

• Private‑duty nursing

• Prescription drug coverage

Beneficiaries who need prescription drug coverage can find it under Medicare Part D. To get coverage for the previously mentioned products, and other goods and services, a Medicare Part C, a Medicare Advantage Plan, can be a good option.

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What is the difference between Part A and Part B of Medicare?

In order to help your clients choose the best healthcare coverage for their needs, you need to understand the coverage they already have: Medicare. There are four parts to Medicare.  Medicare Part A and Medicare Part B are provided by Medicare.  Those two parts make up the original federal health program.  Part A and B are referred to as Original Medicare.  Remember, Medicare is a US government entity.   Part C and Part D are purchased from private insurance carriers.

Medicare Part A is hospital insurance.  As hospital insurance,  Part A generally covers the following.

• Inpatient hospital stays

• Prescription drugs administered in the hospital

• Skilled nursing facility stays

• Mental health inpatient stays

• Hospice care

• Limited or temporary home health care

Medicare Part B is medical insurance.  As medical insurance, Part B generally covers the following.

• Annual wellness exams

• Doctor and specialist visits

• Preventative services (flu shots, etc.)

• Bone mass measurements

• Tests and screenings for certain diseases

• CPAP machines for sleep apnea

• Certain diabetes equipment and supplies

• Limited home health visits

• Durable medical equipment (walkers, wheelchairs, etc.)

This is not a complete list of the medical services covered by Medicare Part B.  However, it is a starting point to help your clients understand where their gaps in coverage are and how to choose supplemental insurance to address those gaps.

Click here to learn how to compare Medicare Advantage plans.

Click here to learn how to compare Medicare Supplement plans.

Medicare Advantage and Supplemental Sales Video

Medigap Plans CT

Medigap plans Ct are also called Medicare supplement plans.   They provides coverage for these “gaps” in your Medicare coverage and can save you money.  Medigap plans are not Medicare Advantage plans rather, they provide coverage after Original Medicare A and B benefits pay.  As a result, it is important to note that Medigap plans will only cover services that are approved by Medicare. They will not help cover costs that Medicare does not allow/approve.

Access all Medigap plans CT (Medicare supplement plans) with this link.  Site will show you all plans and rates in CT.

Are you a broker looking to sell Medigap plans?  If so, click here to learn more about Medigap sales.

Medicare supplemental plans are offered by private insurance companies.  These plans help to pay the ‘gap’ between costs covered by original Medicare and your out of pocket costs.  Medigap plans are regulated by national and state governments and therefore benefits are generally the same, regardless of the insurance company.   For example, Plan A has the same benefits regardless of the company you purchase it from.  As a result, rates and value add benefits are the only difference from company to company.

Medigap plans do not cover medication expenses.  If you enroll in a Medigap plan, you should also consider a Medicare Part D (prescription drug) plan.  The rule is different for drugs under medicare part B. As a result, it is important to pick the right part D drug plan.  The pharmacy you like to use and the specific prescriptions you take make all the difference when selecting a drug plan.  Call our office to learn more or use the CMS drug plan finder tool. 

Want to learn more about the differences between a Medigap plan and a Medicare Advantage plan? Click here to learn about all your medicare options.

We are one of Connecticut’s leading Medicare brokerage firms.  Please call us at 203-796-5403 or email us at edward@croweandassociates.com if you have questions.  Better yet, we can set a time to sit face to face and discuss all of your options.  If you aren’t able to travel to our office, we will gladly come to you.

What is Medicare?

This blog will attempt to answer “what is Medicare?” by  providing a basic understanding of the Medicare program and how it works. In addition, it will detail the other parts of Medicare such as C and D.  First of all lets start with the official definition:   Medicare is the federal health insurance program for people who are 65 or older. It is also for certain younger people with disabilities and with End-Stage Renal Disease.  Most people are eligible for Medicare at age 65.

Medicare is made up of four components which can cause confusion.  Original Medicare (Red, White and Blue care with a Medicare ID on it) is Medical coverage with parts A and B.    This is what provides basic medical coverage for those on the program.   Medicare Part C is different than Original Medicare.   Part C is a Medicare Advantage Plan and is something a member can enroll in if they want.  Medicare Part C replaces Medicare A and B for those that enroll in it.   Another part of Medicare is part D which is prescription drug coverage (Also called a PDP). You can enroll in Medicare part D using a stand alone drug plan or access Medicare part D through the drug benefits on an Advantage plan.

Medicare Part A (Hospital Coverage)

Medicare Part B (Medical Coverage)

Medicare Part C (Medicare Advantage Plans)

Medicare Part D (prescription drug coverage)

Medicare Plans Connecticut

Medicare Plans Connecticut is a broad term that can refer to a number of companies or plan types in Connecticut.  Insurance companies offer either Medicare Advantage plans (MAPD), Medicare Supplement plans (Also called Medigap)  or Medicare Part D Rx plans.  A summary of both plans and companies has been provided below.  Choosing the right plan means matching up the needs of the insured (current health, doctors, as well as Medications and volume of care) with the strengths of the given plan type.

Medicare Advantage plans-

Managed Medicare plans offered with (MAPD) and without (MA) drug coverage.  Medicare Advantage plans take the place of Original Medicare.  They are the primary insurance and have a network as a result.  There  in network only (HMO) and out of network (PPO) plans available. In Connecticut, most plans are HMO style plans.  Connecticare, United Healthcare, Aetna and Wellcare as well as Anthem BCBS offer plans in Connecticut.

There are two plans with a $0 monthly premium. Both require referrals to specialists. There are a number of plans in the $29 to $44 a month range. The higher end HMO and PPO plans have a premium from $99 to $128 a month. The positive points with MAPD plans are, they have a very low to no monthly premium.  These plans include Medicare part D coverage and they offer some benefits that Original Medicare does not.  Some of the negatives can be, the copay for medical services, provider networks as well as referrals for specialists.  Click the links for plan designs of some of the more popular plans in CT.

Connecticut does not have medical underwriting which is important to consider.  Medicare rules allow someone to change plans every January 1st during OEP.  Without checking health, a member can change from a Medicare Supplement to a Medicare Advantage plan.  If someone develops a health condition, they could change to a supplement without any issues.

Medicare Plans Connecticut 

United Healthcare Medicare Complete Plan 1

UHC Medicare Complete Plan 2

United Healthcare Medicare Complete Plan 3

Aetna Medicare Plan HMO Connecticut

Anthem Mediblue Plus HMO

Anthem Mediblue Select HMO

Medicare Plans Connecticut can also be Medicare Supplement Plans (Medigap)– Medicare Supplement plans are offered by a number of companies in CT.  These plans are standardized. This means benefits are the same from company to company.  Common plans offered in CT are Plans F, High F, N, K, L and G.  AARP offered by United Healthcare tends to be the first choice in CT.  A number of companies including Humana, AARP, Anthem BCBS, Combined Life, United American and Cigna all offer a number of plan choices.

Click here for standardized Medicare supplement rates in CT

Medicare Part D plans (stand alone Rx plans)-  Medicare part D plans are offered by a number of companies in CT.  Some of the more popular choices are UHC branded Saver, UHC branded Preferred RX, Humana Walmart Rx, Silver Scripts, Express Scripts Rx.  There are too many plans to list them all.   You cannot purchase a stand alone Rx plan with a Medicare Advantage plan.  Clients can only purchase these plans along with a Medicare supplement.  You can also combine these plans with Medicare A and B.  If you buy a supplement plan, you do not have to use the same company for the Rx plan.  Clients can choose any company they feel is offering the best plan for them.  Note: The Humana Walmart Rx plan is  the current lowest cost (lowest monthly premium) plan in CT.

Need to sign up for Original Medicare A and B?  Click this link to sign up online through the Social Security Website.

States offer  programs to individuals in need of assistance.  In fact, you may qualify for assistance.  Click here to learn about programs offered and determine if you are eligible.

 If you have either additional questions or need a quote, Click here.

Medicare Supplement High Deductible Plan F

Medicare Supplement High Deductible Plan F includes cost-sharing features.  These features allow you to save on premiums while still receiving dependable coverage.

In fact, The high deductible Medicare Supplement insurance plan pays the same benefits as Plan F.   AFTER you have paid the annual deductible of $2,180.  Benefits  from the High Deductible Plan F will not begin until out-of-pocket expenses are $2,180.

What’s does Medicare include in a Medicare Supplement High Deductible Plan F?

• Your $1,260 Part A deductible and coinsurance
• The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
• $147 Part B Medicare deductible
• Your Part B coinsurance and the cost of the first three pints of blood
• 100 percent of Part B physician charges that are in excess of the Medicare-approved amount (by law no physician may charge more than 115 percent of Medicare-approved amounts).
• Skilled nursing facility copayment
• Hospice care
• Foreign travel emergency care

Medicare Part A Coverage:

Medicare Part B:

CT Medicare Advantage and Supplements

There are many choices when it comes to CT Medicare Advantage and Supplements.  These choices can confuse anyone. We can help you feel comfortable not only with your choice of health care plans but the cost as well.  Crowe and Associates is one of the region’s leading Medicare brokerages.  Are you looking for CT Medicare Advantage and Supplement information in Connecticut?  We can help. Crowe and Associates is an independent brokerage agency that works with all major Medicare Advantage and supplement plans.  We work with clients everyday to help them understand the difference between Advantage plans and supplements. We use that knowledge to choose the best plan and company for them.  The insurance companies pay us so you will never receive any type of bill or fee for our services.

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