What is Medicare?
For those who are turning 65 in Chino or anywhere in Southern California, the time has come to explore your options for signing up for Medicare. This service is provided by the US Government’s Department of Social Services, and is available to almost seniors age 65 or older and to those under age 65 with certain disabilities. The good news: Medicare has a variety of coverage options that enable each individual to create an insurance portfolio that is tailored to handle their own individual medical needs and risk profile. Unfortunately, this variety of coverage options can make creating such a package extremely complicated, and Medicare levies a heavy penalty on those who don’t enroll in the right way.
That’s where CAP Insurance Services comes in. Our agency specializes in insurance for those who are approaching Medicare eligibility or are already on Medicare. No matter what your needs are, our agents will help create a custom insurance plan catered for your current and future medical and prescription drug needs.
We understand that no one wants to pay for premium insurance they are not using, and because healthcare costs continue to rise – even for seniors – it is imperative that you find the right coverage to meet your needs. You need to get this right the first time, and that’s exactly what we help you do with our custom tailored approach.
Medicare Program Details
Medicare is a Federally-sponsored health care system for people age 65 and over, or for some people who qualify early with certain disabilities. It is not affiliated with Medicaid – a different service designed to provide coverage for the poor. Medicare is composed of four basic plans (A, B, C, and D). We teach you the “ABCDs” of Medicare so that we can help you determine which approach would best suit your needs. When you become initially eligible for Medicare, you can enroll in the coverage three prior to turning 65, the month you turn 65 or in the three months after. We help you with the timeline so that your coverage can start when you want it to.
You have two basic choices: you can either have Medicare be the primary payer of your hospital and medical expenses or you can choose to enroll in a Medicare Advantage (Part C) plan, which is where you sign up with an insurance carrier to be your primary coverage for your Medicare needs.
By understanding how Parts A and B work, you will understand that there are gaps in being covered under the original Medicare. To address these gaps, insurance companies offer Supplement Plans A through N. Although these Medicare supplements plans require additional premium, they will pay the deductibles, copays, and coinsurance charges that Plans A and B do not. Those who choose Medicare A and B can get services anywhere in the United States or its’ territories – from any service provider that contracts with Medicare.
If you choose Part C (Medicare Advantage), then you are asking a private insurance company to be your Medicare coverage. Such companies can save you money on premiums in a variety of ways, such as:
- Negotiated rates
- Special services
- and custom coverage options
However, those who sign up through these companies are limited to their provider network, which means that they will face restrictions when choosing a doctor and will be subject to copays and deductibles.
Enrollment and Its Challenges
Because you only have 7 months to apply for Medicare, you want to make sure you are ready. This means you first have to apply for Medicare Parts A and B. It doesn’t hurt to have a health check-up right before to ensure that you have the latest information on all your health needs. You will want to take plenty of time to learn all the possible combinations of coverage you have to choose from. After we work together to determine the plan that best suits your needs for Medicare, it will be time to enroll.
Many people find this process overwhelming. Not only are there too many combinations to consider, there is no way for a new senior to understand exactly how they will need to use their coverage in the first year, let alone twenty years after they sign up. No one can predict the future, and as people age, they can develop health problems that are severe and unprecedented. However, by making an informed decision at the beginning, seniors can enjoy the benefits of a solid coverage plan well into their golden years.
CAP Insurance Services excels at sorting through the countless possible combinations of Medicare plans in order to find a package that will serve you well during retirement. We also see you through the enrollment process, ensuring that the package you sign up for is the one you wanted and the one that best fulfills your needs.
Medicare Plan D
Medicare Plan D pays for your prescription drugs, and is only available to participants who select Medicare Plans A & B. Private insurance companies offer Plan D, and each usually offer more than one option. If you choose Medicare Plan C, then you must select a plan that includes the prescription drug coverage that you need. Whether you get your prescriptions coverage as a benefit under a Part C (Medicare Advantage) or a Part D (Stand Alone) plan, each plan has its own list of covered drugs known as a formulary, ranking them in tiers that determine drug costs. And each charges different copays for these drugs, depending on how they are ranked. We can assist you as you go to the Medicare.gov website and determine by the prescriptions you take, which plan will give you the best possible outcome.
CAP Insurance Services gives you a complete selection of options for Plan D. We will find the best option that gets your current prescriptions paid for while accounting for deductibles, coverage limits, and coinsurance. We take into account factors that are unseen by those new to Medicare. And because companies are free to update their plans every year, we will monitor these changes for you to help you change your plan as needed.
Medicare Supplement Coverage
In addition to the many forms of coverage that Medicare and its affiliates offer, some private health insurance companies offer coverage that compliments your Medicare coverage. Medicare Supplement Plans (Supplements A, B, C, D, F, G, K, L, M, and N) are only available to those who have enrolled in Medicare Parts A and B. These supplemental plans are designed to fill the gaps that Medicare Parts A and B will not.
Medicare Supplement Plans are standardized. That means that any companies that offer the same plan (Plan F for example) must provide the exact same coverage for the exact same services. They can charge different premiums for these services, however, which means that you definitely want to be thorough when evaluating your option. A good broker will help you weigh these factors in your decision.
If you have Medicare, then you may be interested in supplementing your coverage with a dental plan. Dental Insurance carriers offer these plans to Medicare Subscribers for this exact reason. If your Medicare plan doesn’t cover dental, insurance carriers offer these plans to Medicare subscribers for this exact reason. If you are looking for a Medicare Advantage plan, CAP Insurance Services will be happy to find you a plan that includes the dental coverage you need. If you are on Medicare A & B, then we can find a supplement plan to help you cover dental procedures of all kinds.
Dental coverage is not a Medicare provided benefit. If you want dental coverage, you will have to pay an additional premium. If you have a Medicare Advantage Plan (Medicare Part C), then your dental coverage can be bundled with your regular healthcare plan. No matter what kind of Medicare plan you have, you will still benefit greatly from a broker like CAP Insurance Services, who will work with you to find the best plan out there for you.
Medicare subscribers may desire to supplement their coverage with a vision plan. Vision insurance carriers generally have plans available tailor-made for Medicare participants. If you are looking to sign up for a Medicare Advantage Plan, CAP Insurance Services can find you one that has the right vision coverage for you. If you are on standard Medicare (Parts A & B), then we can find a vision plan with a private insurer that will supplement your Medicare coverage.
Because vision insurance does not come standard with Medicare, you will have to pay an additional premium for it. If you sign up for a Medicare Advantage Plan, you can bundle your vision coverage with your regular healthcare plan. A broker such as CAP Insurance Services can be a valuable asset to you no matter what kind of Medicare plan you have. We work with you to find the best available plan, bar none.
If you are new to Medicare, or if you have been on it for a while, we know the companies that offer it very well. If you are on Medicare A & B and need a supplement, we can walk you through the different options for supplement plans, and the companies that offer them. If you need prescription drug coverage, we know all of the plans and can find you one with a formulary that includes all of the prescriptions that you currently use. And if you want a Medicare Advantage Plan (Medicare Part C), we can offer that as well. We also can come to your aid if you find you are having trouble transitioning between plans, or if you are late in signing up. We know Medicare laws backwards and forwards, and can help you avoid penalties.
This expertise is critical for seniors; many who are new to Medicare simply don’t understand how the law applies to them. It’s important to get started on finding a policy before turning 65. However, we can help you find the right plan, no matter when you get started.
CAP Insurance Services Gives you the Best Possible Coverage
Every senior has different Medicare needs. When the time comes for you or your loved one to sign up for Medicare, you will want to make sure that you have an expert in your corner that will help you make the best possible choice – for now and your future. Navigating the coverage provided by Medicare A & B, the many private companies that offer Medicare C and their plans, the various prescription drug plans, and the private companies that offer Medicare Supplmental Insurance can be daunting for anyone. It makes sense to choose the services of an experienced insurance agent that can assist you in navigating the Medicare waters!
CAP Insurance Services does exactly that while treating you like family. We have mastered Medicare coverage. Give us a call, and find out exactly how to save money on monthly premium expenses, and on deductibles and copays. You’ll feel much better in your golden years knowing you have made the best possible choice for coverage, and that when challenges come, you’ll be ready.