McCay and Associates has worked with Medicare Part D since its existence in 2006, and each year, during annual enrollment, we bring in each of our Medicare clients for an annual review of their Medicare Part D, Medicare Supplements, and/or Medicare Advantage plans. The plans, their premiums, and their formularies change each year. It is EXTREMELY IMPORTANT to check on your Medicare coverage each and every year. At times, we have seen THOUSANDS of dollars in savings by changing drug coverage!
We offer full-time customer service to take care of your needs, and quite often, we are working on the needs of our Medicare clients. If you, family members, friends, or acquaintances need help with your Medicare questions, come to the agency that does the most work with ALL the parts of Medicare!
We are here to work with you the entire year.
Part A generlly covers Hospital care, Skilled nursing facility care, Nursing home care (as long as custodial care isn't the only care you need), Hospice, and Home health services. Typically Part A is known as Hospital Coverage. A person who is only on Medicare Part A and B, also known as original Medicare, have a deductible as well as coinsurance of 20% of the charge they are responsible for.
Part B covers things such as Clinical research, Ambulance services, Durable medical equipment, and Mental health hospitalizations. There is typically a premium associated with Part B, unless you qualify for some form of help from the government. Part B is known as Physician Services and Supplies. Part B is considered optional; however, a penalty will be accessed if an person does not have "creditable coverage". This penalty is accessed by Medicare.
Medicare Part C is also known as a Med-Advantage Plan. Medicare Advantage plans offer many benefits. Many of them are offering Part D, Dental, Vision, and Hearing benefits. The premium is typically lower than a supplement and there are co-pays with the plan. Most people view this option as similar to most group insurance plans. There are not health questions assocaited with a Med-Advantage, with the exception of End Stage Renal Disease.
Medicare Part D, also known as Part D, PDP or Prescription Drug Plan, is coverage for your medications. Prescriptions are determined, by each insurance company, to be on a certain tier level. What each company covers is known as a formulary. If a company does not cover a drug on its plan then you need a formulary exception form. You may also need a tier exception, or a prior authorization. Each plan covers drugs differently.
A supplement, also known as a Medigap, is used to fill the wholes in Medicare. It covers the deductible and co-insurance associated with original medicare. The are different plan options available. A "F" plan covers 100% of the cost, a "G" plan covers everything excepts a $183.00 deductible, and a "N" plan covers everything except the $183.00 deductible and a $20.00 copay to see a doctor and a $50.00 for a hospital. All of these options must be a "Medicare approved charge" for the Supplement to pay on them. Supplement premiums are typically higher than a Med-Advantage and are based on passing underwriting, unless you have guaranteed issue for turing 65 or losing group coverage, and are based on if you use tobacco, and age.
The Affordable Care Act, often referred to as Obamacare, was implimented to help people get insurance regardless of pre-existing conditions.
There are four categories of health insurance plans, Bronze, Silver, Gold, and Platinum. The categories refer to how you and the plan share cost. It does not refer to qulity of care. You pay a premium each month, and out of pockets cost, including a deductible when you recieve care. Some plans allow you to see any doctor or hospital whereas other plans limit your choices to in network doctors or charge more. Your premiums are based off your household income.