Medicare Insurance Plan in Salt lake city

Posted by jennah kellen on July 4th, 2019

New To Medicare?

There are many details of Medicare which can be confusing. Rocky Mountain Insurance is here to make it easy and understandable. We help you choose the plan that works best for you.

  • Those 65 and older likely qualify
  • Those younger than 65 with disabilities of 24 months or more may qualify
  • People with end stage renal disease or other chronic conditions may be eligible

Timeline Of Medicare Enrollment Periods:

  • Initial Enrollment Period (IEP): 7-month period. Begins 3 months before you are eligible for it (i.e., turning 65), and ends 3 months after your eligibility begins.
  • General Enrollment Period (GEP): Jan 1 to Mar 31
  • Annual Election Period (AEP): Oct 15 to Dec 7
  • Special Enrollment Period (SEP): Anytime during the year
  • Medicare Advantage Disenrollment Period (MADP): Jan 1 to Feb 14

Special Election Periods

There are special situations where you may qualify to enroll in a plan, or change the plan you may be currently enrolled in, even when enrollment has ended.  Some of those situations include the following:

  • When you turn 65
  • When you move out of your plans service area
  • When you lose coverage
    • No longer eligible for Medicaid
    • Leave coverage from your employer or union
    • Involuntary lose other drug coverage
  • When you are eligible for both Medicare and Medicaid
  • When you qualify for extra help with your prescription drug coverage
  • When you have a severe or disabling condition such as Cardiovascular disease or diabetes and there’s a Medicare Chronic Care Special Needs Plan (SNP) available in your area
  • When you switch to a 5-star Medicare Advantage Plan, Cost Plan, or Prescription Drug Plan

Penalties

Medicare Part B Late Enrollment Penalty

If you do not sign up for Part B when you are first eligible, or if you drop Part B and enroll later, you may pay a late enrollment penalty:

  • The penalty will stay with you as long as you have part B unless you qualify for certain types of assistance with your states Medicaid or Medicare Savings Program.
  • Monthly premium for part B may go up 10% each full 12-month period that you did not sign up for Part B but were eligible

Medicare Part D Late Enrollment Penalty

If you don’t sign up for Part D when you’re first eligible, you may pay a late enrollment penalty:

  • Penalty in effect as long as you have Part D.
  • Penalty calculated by multiplying 1% of the “national base beneficiary premium” times the number of full, uncovered months you were eligible but didn’t join a Prescription Drug Plan and went without other creditable prescription drug coverage

Medicare Advantage Plans (Part C)

What Can You Get?

Medicare Advantage Plans cover the same benefits as Original Medicare, and often more. These plans have a contract with Medicare to provide at least the same level of medical and doctor coverage and often include drug coverage and additional benefits like dental & vision benefits, fitness programs, and more.

These health plans cover all the benefits of Medicare Part A, including hospital stays, skilled nursing care and home health care, but not hospice care (which is still covered by your Part A benefit). These plans also cover all the benefits of Medicare Part B, including doctor visits, outpatient care, screenings, shots and lab tests.

Many Medicare Advantage Plans also include Medicare Part D prescription drug coverage.

And Also…

Many Medicare Advantage Plans start at --content-- Premium.

You must have Medicare Part A and Part B to enroll on this type of Medicare plan. Most plans include urgent care and worldwide emergency coverage, an annual out-of-pocket maximum to help you budget for your health care costs, and most include prescription drug coverage. Many plans have no additional monthly premium beyond what you already pay for Part B.

There’s a lot of Medicare Advantage plans offered in the Rocky Mountain region, so make sure to contact us so we can help you compare Medicare plans available in your county, verify your doctor is covered and your prescriptions and any other medical equipment. We also assist you in finding a doctor, specialist or any provider that may need. We’re here to help and serve you!

MEDICARE ADVANTAGE PLAN TYPES:

HMO Plans-Health Maintenance Organization

  • Typically requires you to receive services from a network of local providers; except for emergency room, urgent care visits and renal dialysis services.
  • Often require referrals to specialists, depending on the plan.
  • Out-of-pocket costs are typically lower than PPO and POS plans.

POS Plans-Point-Of-Service

  • Similar to an HMO plan, but you can also see providers for certain services outside the provider network; generally at a higher cost.
  • Referrals to specialists may be required, depending on the plan.
  • Out-of-pocket costs are typically higher than HMO plans, but lower than PPO plans.

PPO Plans-Preferred Provider Organization

  • You can see providers for all covered services outside the provider network, generally at a higher cost.
  • Don’t require referrals to specialists.
  • Out-of-pocket costs are typically higher than HMO and POS plans.

Medicare Prescription Drug Plans (Part D)

What Are Medicare Prescription Plans?

Medicare Prescription Plans – Medicare Part D is the federal government’s prescription drug program; that covers both brand-name and generic prescription drugs at participating pharmacies in your area. The coverage is available to all people eligible for Medicare, regardless of income and resources, health status, or current prescription expenses. Medicare prescription drug coverage provides protection for people who have very high drug costs.

Good News! You May Qualify For EXTRA HELP…

…to help pay for your prescription drug plan and co-pays. If your income is below ,505 per year for a single person (or ,595 for a married couple living together or even more if you have dependent children or grandchildren living with you); AND if your assets are below ,440 for a single person (or ,860 if you are married). (DO NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.)

Medicare Supplements

What Are Medicare Supplements?

Plans are standard, so different companies all offer the same benefits, but the premiums do vary based on a number of factors. Consider these facts in deciding if Medicare Supplement insurance for hospital and medical coverage is right for you:

  • The policies may cover all of your co-insurance, co-pays and deductibles.
  • The policies may cover health care bills not covered by Medicare.
  • Premium may start from /month.

What You Should Know:

Every company offering Medicare Supplement insurance must offer Plan A. In addition, companies may have some, all, or none of the other plans. Plans are standardized, so different companies all offer the same benefits, but the premiums do vary based on a number of factors. Although private insurance companies are required to offer the same benefits for each lettered plan, they do have the ability to charge higher out-of-pocket costs for this coverage.

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jennah kellen

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jennah kellen
Joined: June 20th, 2019
Articles Posted: 42

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