Medicare: A + B = ?   Where does D come in?

Medicare: A + B = ? Where does D come in?

Aug 29, 2018

I’m getting so much information in the mail! What do I need to keep?

I am the presenter at the Mission Hospital Conference Center in Mission Viejo, and we fill the room each month with people just like you that want to know more.

You are not alone.

Most of you start getting stacks of Medicare information mailed a full year before you turn age 65 and then again, beginning October which starts the Medicare Annual Election Period for changing plans. If you haven’t yet, watch out here it comes!

With Medicare Insurance Plans, all the insurance carriers want your business, but they must stay compliant for government regulations and therefore must provide every detail of benefits so as not to mislead a senior. Insurance Agents and Insurance Carriers are not allowed to call you or show up live at your doorstep, so they must mail everything to get your attention.

Let me help you with some basics:

Medicare A covers hospitalization, and Medicare Part B covers Doctors and services outside the hospital. But, the more detailed explanation will show you there are deductibles and copays and financial exposures if you relied only on A & B.

This is called your “Original Medicare” and will be the paper card with your name, it’s red/white/blue at the top. And now will have a unique AlphaNumeric ID # assigned specifically to you (no longer will your SS# be floating around).

What is D? Think of Medicare Part “D” = Drugs. This is not included when you activate your Medicare A & B. You need to make a choice on how you will cover prescriptions outside of the hospital. You might think...I don’t take medications, so I don’t need to enroll in Part D now. This can be a BIG mistake by not choosing a plan! You will start to incur penalties each month for not doing so. AND those penalties never go away!

There are a variety of solutions that help fill in the holes of Medicare A & B and include Part D coverage, this is the basis behind all the mailings you might be getting right now.

Supplemental /Medi-Gap plans are the plans that function most like a PPO. Medicare Advantage are primarily HMO plans, with a few exceptions. The biggest difference between these two solutions is that an HMO plan is “managed care” and requires that you select a primary doctor and that doctor coordinates all referrals to specialists that are affiliated with their group. The PPO type of offering is called Supplemental/or Medi-Gap and these plans allow you to self refer to specialists.

Some choices include drug coverage, and some do not. Some plans have a monthly cost and some do not. Thankfully here in Orange County, we have many plans available. Competition is a great thing.... But hard to navigate on your own.

How would you begin to know what is the best plan for you? Your neighbors plan may be perfect for them, but you can’t assume it covers all of your needs.

Beyond making sure your doctors accept the plan, one of the most important and hardest areas to do your own research is with the Part D component. Everyone’s medications are unique and must be reviewed to verify what might be the best solution each year.

Medications can vary greatly in costs from one plan to the next. One plan may offer XXX drug at $0 copay, and yet another will charge a higher copay of $47 for the same medication. You must shop, or find a trusted Insurance Agent (like me) that will help you.

Most people don’t know the role of an Independent Insurance Agent/Broker... Including many of my friends. It means you have a resource available to you that does not charge a fee and can meet with you one on one. We must be educated in all the plans we represent, not just one. We must re-certify each year to keep that status. We help you to get set up and enrolled into the plan you took part in understanding and narrowing down.

We can simplify and help you to understand Medicare A & B & D. And what next steps to take to insure you have the full solution and not incur any penalties if you are new to Medicare or just need a review.

Think about it, if you called each insurance company directly, you will need to meet with each of those representatives that will provide you all the wonderful information about their 1 plan. This can mean several meetings and can get confusing because they each will be able to tell you all the great aspects of their benefits, but won’t be able to show you side x side comparisons. Don’t get Blind Sided.

OK, so what should you do now in the month of September?

Get prepared for your Medicare Review and compile your list of medications.

Tear out this page with the listings of all our upcoming meetings!
If you are already age 65 and in Medicare, then your ANNUAL NOTICE OF CHANGE (ANOC) should be showing up soon. This is the document from your current insurance plan that details out the changes you can expect going into the next year (2019).

This coincides with the Annual Election Period. Oct 15th – Dec 7th of each year. This is your time to either stay with your current plan, or make a change. I can tell you, I’ve already been privy to a “SNEAK PEAK” of the new 2019 Benefits, and you will definitely want to talk to me! Many good benefits and changes are coming.


Call me now to set up your one on one appointment or to rsvp to one of my upcoming seminars.


Tear out this page with the listings of all our upcoming meetings!

COMMUNITY MEETINGS

OCT. 4TH - 6:00P.M. Basics of Medicare
Mission Hospital Conference Ctr
26726 Crown Valley Pkwy
Mission Viejo 92691
Free Validation for Parking

Oct. 19th - 10:00A.M. New 2019 Benefits
Ayres Hotel, 24341 El Toro Rd
El Toro 92637

Oct 24th - 6:00P.M. New 2019 Benefits
San Clemente Senior Center
117 Avenida Victoria
San Clemente 92672

Oct 27th - 9:00A.M. New 2019 Benefits
Marie Callendar
31791 Del Obispo St
San Juan Capistrano 92675

Nov 1st - 6:00P.M. Basics of Medicare
Mission Hospital Conf Ctr
26726 Crown Valley Pkwy
Mission Viejo 92691
Free Validation for Parking

Nov 3rd - 9:00 A.M. New 2019 Benefits
Marie Callendar
31791 Del Obispo St
San Juan Capistrano 92675

Nov 7th - 5:30P.M. New 2019 Benefits
Marie Callendar
31791 Del Obispo St
San Juan Capistrano 92675

Nov 10th - 9:00A.M. New 2019 Benefits
San Juan Hills Golf Club
32120 San Juan Creek Rd
San Juan Capistrano 92675

Nov 14th - 1:00P.M. New 2019 Benefits
Ocean Institute
24200 Dana Point Harbor Dr
Dana Point 92629

Denice Merrill

Merrill Insurance Services, Inc.
Specializing in Medicare Plan Choices with over 12 Years Experience.
She can reached by calling 949-388-7332
CA LIC# 0D99790

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