Medicare Supplemental Insurance & Medicare Advantage Plans

Someone on Facebook recently asked me,

“What’s the differences between Medicare Supplemental Insurance and Medicare Advantage Plans?”

Questions like these are the reason I love this business. People need to know that there are many options in Maine when you turn age 65.

There are many differences. One difference between Medicare Supplemental insurance (Medigap) and Medicare Advantage plans is that Medicare Advantage contracts operate on a calendar year basis (annually renewable) and Medicare Supplement policies are guaranteed renewable. Guaranteed renewable means that the insurance company cannot change what your Medigap policy covers once it is issued, or terminate your policy, unless you do not pay your premium within the grace period and/or you made a material misrepresentation on your application.

Faced with too many medicare options?

Another difference is the cost. Medicare Advantage Plans generally have lower monthly premiums than Medicare Supplements but you are required to share in your medical costs by paying co-pays as you use the plans.  Medicare Advantage Plans operate very similar to the Medical insurance you may have had before you retired if you had an HMO or a PPO plan.  Medicare Supplemental insurance (Medigap) plans generally have a higher monthly premium but you are usually not required to pay much else, if anything, out of pocket.

This is why many people turning 65 choose to meet with someone who can help them decide which plan is best for them. Choosing between these two types of Medicare insurance plans is an individual decision. What is the best plan for you may not be the best plan for your spouse.  For more information you can also visit the Medicare website at www.medicare.org or call your local Area Agency on Aging to speak with a volunteer.

Need more help comparing the different health insurance plans?  I can help you.

You can use the BOOK APPOINTMENT(link is external) button below to set up a time to speak with me on the phone or in person. I can also send you information ahead of time to get you started.
Have a question that needs to be answered right away? Just give me a call at your convenience.  You can talk to a licensed insurance agent at (207) 370-0143 or call toll free 866-976-9038.
Book an appointment with Maine Medicare Options using SetMore

Are you turning 65 and still working?  Read this.

If you would like me to come to your home and meet with you one-on-one please Contact Me.  My phone number is (207) 370-0143.

There is no obligation to you and no cost to meet with me.


Am I Eligible for Medicare if I am Receiving Social Security Disability Benefits?

If you are unable to work due to a disabling condition, your income is not the only thing that ends – in most cases your medical insurance ends as well. This is why so many Social Security Disability applicants wonder whether or not they will are eligible to receive Medicare benefits. The answer is yes you can receive Medicare benefits to help cover medical costs, but not right away.

If you have been entitled to Social Security Disability benefits for a period of 24 months then you will become eligible to begin receiving Medicare benefits on the 25th month.

What Does Medicare Cover?

The type of coverage you are provided through Medicare depends on the type of Medicare you decide to accept. Medicare Part A is hospital insurance. In most circumstances, there is no charge for Medicare Part A coverage. This type of Medicare pays for inpatient hospital care, skilled nursing facilities, long-term hospital care, inpatient rehabilitation, hospice care, home health care, inpatient psychiatric care and obesity bariatric surgery.

Medicare Part B is different from Medicare Part A. Medicare Part B is more like a traditional medical insurance plan. In most cases, you will need to pay a premium in order to receive Medicare Part B. Medicare Part B covers any services or supplies that are needed to diagnose or treat your medical condition as long as they meet the accepted standards of medical practice. Medicare Part B also covers preventative services such as vaccinations and routine physical exams.

You can learn more at www.medicare.org or by calling 1-800-MEDICARE.

You can also Contact Me to schedule an appointment and we can sit down and talk about your individual needs and answer any of your questions. There is no cost or obligation to talk or meet with me.  I would be glad to talk to you and answer questions about Medicare in Maine.  You can use the Contact Me page or call me at (207) 370-0143*. 

Medicare Advantage Is Living Up to Its Name!

Heritage policy analyst Kathryn Nix has analyzed research that shows that private health plans participating in Medicare Advantage are making strides in what Congress has tried—and failed—to achieve in traditional Medicare fee-for-service (FFS) for decades. Competition among private plans has maintained patient satisfaction, lowered costs, and increased the quality of care. Success is obvious and abundant in the MA program. Medicare Advantage (MA) is more advantageous to beneficiaries when compared to traditional FFS Medicare. It was created in 2003 to allow seniors to receive their Medicare benefits through a private health plan of their choice. The private plans are required to offer the same benefits as traditional FFS. MA has become increasingly popular, with almost 20 percent of the Medicare population enrolled as of 2010. The program’s popularity is justified by the astounding improvements to the quality of care. MA has led to the opportunity to compare the performance of participating plans with that of traditional Medicare. In a Center for Policy Innovation Research Summary, Nix analyzes two separate research studies that show MA outperforming FFS on several measures of health care quality:

  • MA performed better than Medicare fee-for-service on most measures reflecting patients’ receipt of appropriate care.
  • MA also performed better than FFS when assessed using discharge data on hospital utilization.
  • MA plans may be doing a better job of preventing unnecessary inpatient care by increasing use of outpatient services and office visits.
  • MA plans may be avoiding unnecessary re-admissions through superior discharge planning and coordination of care following an inpatient episode of care.

read more

Remember: At any time during the year, you can switch to a Medicare Advantage Plan or Medicare Prescription Drug Plan that has a 5-star rating. Plan ratings are based on member surveys, information from doctors and health care providers, and other sources. The plan ratings are scores that show the quality and performance of the plan, on a scale of 1 to 5 stars, with 5 being the highest rated plans.
You can Contact Me to schedule an appointment and we can sit down and talk about your individual needs and answer any of your questions. There is no cost or obligation to talk or meet with me.  I would be glad to talk to you and answer questions about Medicare in Maine.  You can use the C.

Medicare Covers Hospice and Comfort Care

Do you care for someone who is terminally ill? It isn’t always easy to care for a loved one in difficult times, but Medicare can help – you don’t have to do it alone.

Medicare covers care for people who are terminally ill, and they have resources to help you. Hospice is a program of care and support for people who are terminally ill. The focus is on comfort, or “palliative” care, not on curing an illness. Hospice care can include doctor and nursing services, counseling, medical supplies, pain medications, and other services. If your doctor has certified that your loved one is terminally ill, Medicare covers hospice care, which is usually provided in the home. Medicare will still pay for covered benefits for any health problems that aren’t related to your loved one’s terminal illness.

To get more details about Medicare’s coverage go to http://www.medicare.gov/forms-help-and-resources/index.html Remember, you’re not alone – Medicare has resources to help. You can get more information from http://www.medicare.gov/coverage/hospice-and-respite-care.html.   If you or a family member would like to learn more you can also contact me anytime.  There is no cost or obligation to talk or meet with me.  I would be glad to talk to you and answer questions about Medicare in Maine.  You can use the Contact Me page or call me at (207) 370-0143. 

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