Medicare Advantage plans take many shapes, HMO, PPO, HMO-POS, and more. An HMO plan uses
doctors within a network. PPOs and HMO-POSs allow you to see doctors outside of their network,
usually for a higher cost-share. Advantage plans also have low MOOP (maximum out of pocket) limits
that protect you in case of a catastrophic event. Most Advantage plans offer many ancillary benefits as well. These types of plans have low premiums or often no premium at all. There are even plans that have a national network to cover you out of your home service area for snow-birds and those on extended vacations.
If you want a low cost plan that offers a lot, this is a great option.
Medigap plans are a great option if you want freedom to see any doctor that bills for Medicare. In other words, you don't need to be in a network or have referrals. However, these plans come with a premium that typically see increases once or twice a year. They could include a small to moderate increase at the beginning of the carriers fiscal year, and up to a 3% "loss of early enrollment discount" near your anniversary date . In addition, you don't have a lot of the ancillary benefits that a medicare advantage plan has. If you travel a lot or don't mind a higher premium in order to direct your own care, this may be a good fit for you. Also, if you live in a rural area where the advantage plans are not as rich in benefits, and have much higher potential maximum out out pocket caps, you may want to consider a medicare supplement plan.
Prescription Drug Plans (PDP) are added to your original or traditional Medicare to cover your medications. When you first get Medicare Parts A & B, you will need to enroll into a part D or prescription drug plan. Failure to do so within your initial enrollment period could cause you to be subject to a late enrollment penalty. Many Advantage plans have part D included with no deductibles. However, adding a Part D plan to complement your supplement plan, there will be a premium, as well as a possible deductible. To learn more fill out the form at the bottom of this page.
Whether you are just turning 65 and new to Medicare, coming off of an employer group plan or retirement plan, just moved to a new county or state or just want to check out your options I would love to help. The COMPARE PLANS button above can show you plan options for your area. However, not ALL carriers participate on the platform. PLEASE reach out for an all inclusive comparison.
Lisa Caulkins is an independent licensed agent that is not affiliated with any Federal or governing health program.
Are you a small business owner with 2 to 100 employees? Are you thinking about offering medical benefits to your employees but are worried it's not affordable? Well good news, there's many plans to consider and it makes a lot of economic sense to have your employees insured. Benefits for your employees means greater morale, less emplo
Are you a small business owner with 2 to 100 employees? Are you thinking about offering medical benefits to your employees but are worried it's not affordable? Well good news, there's many plans to consider and it makes a lot of economic sense to have your employees insured. Benefits for your employees means greater morale, less employee turnover and greater overall productivity. You will see benefits also, like tax advantages, attracting more highly qualified employees and employee retention.
Extra Help with Your Medicare Prescription Drug Plan Costs
The Extra Help program assists people with limited resources and lower incomes in paying for Medicare Part D prescription drug coverage. It also makes it so your part
B premium ($163.90) is paid for you.
Receiving Extra Help with your Medicare Part D can:
Eliminate the Medicare Part D late enrollment penalty
Reduce your out-of-pocket costs for prescription drugs
Eliminate your monthly Medicare Part D premiums
Reduce or eliminate your annual Medicare Part D deductible
Eliminate the coverage gap, also known as the donut hole
As Extra Help removes the donut hole, your prescriptions will not cost more when you exceed the annual spending limit. The program saves beneficiaries nearly $5,000 in Medicare Part D costs per year.
What are the Medicare Extra Help Income and Resource Limits for 2023?
In 2023, the income limit for Extra Help for an individual is $1,842 a month. For a married couple living together, the income limit is $2,485 a month. When calculating your income, governmental assistance such as food stamps, housing assistance, and home energy assistance don’t negatively impact you.
You should apply if you think you qualify but your income exceeds the limits. You may still be eligible for Extra Help when your income is over the limit in some scenarios. These cases include when you or your spouse:
Provide financial support for other family members currently living with you
Earn money by working
Reside in Alaska or Hawaii
Resource limits also apply when determining your eligibility. To be eligible for partial Extra Help, your resources must be equal to or below $16,660 as an individual or $33,240.
If you’d like help applying for this program, call or text me and I am happy to help.
If you would like to apply on your own, visit https://secure.ssa.gov/i1020/start
