A Medicare Advisor
who helps you understand your benefits.
As you approach 65 or become eligible due to disability, understanding Medicare can feel overwhelming. At Riddle Insurance Solutions in Plant City, FL, we’re here to simplify the process and guide you through your Medicare options, ensuring you make informed decisions about your healthcare coverage. Get in touch with our team now.
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What Is Medicare?
Medicare is a federal health insurance program designed primarily for individuals 65 or older and certain younger individuals with disabilities. It offers comprehensive coverage for various healthcare needs, helping you manage medical expenses as you age or navigate health challenges.
Types of Medicare Coverage
Medicare is divided into several parts, each offering different types of coverage:
Medicare Part C (Medicare Advantage): An alternative to Original Medicare, private insurance companies offer Medicare Advantage plans and provide all Part A and Part B benefits, often with added coverage for prescription drugs, dental, vision, and more.
Choosing a
Medicare Supplement
- Predictable Costs: With a Medicare Supplement plan, you can avoid unpredictable expenses. Knowing that many of your costs are covered gives you peace of mind, especially for healthcare needs like doctor visits, hospital stays, and certain medical procedures.
- No Network Restrictions: Unlike some Medicare Advantage plans, most Medigap plans don’t restrict you to a network of doctors and hospitals. You can use any healthcare provider that accepts Medicare, giving you more flexibility and choice.
- Coverage When Traveling: Some Medicare Supplement plans provide emergency medical coverage when traveling outside the United States, which Original Medicare doesn’t typically cover.
- Specialized Coverage: For individuals who need frequent medical care or who are managing chronic conditions, Medigap can greatly reduce the financial burden of healthcare expenses.
These advantages can make Medicare Supplement plans an attractive option for those who want more comprehensive coverage and financial protection. Get in touch to our team now to receive answers to all your questions.
Choosing a
Medicare Advantage Plan
Medicare Advantage (Part C) plans offer a different approach to Medicare coverage by bundling Original Medicare benefits with additional services. Here are some key reasons why someone might choose a Medicare Advantage plan: All-in-One Coverage:
- Medicare Advantage plans combine Medicare Part A (hospital insurance) and Part B (medical insurance) into a single plan, often including additional benefits like prescription drug coverage (Part D), which isn't included in Original Medicare.
- Lower Out-of-Pocket Costs: Many Medicare Advantage plans have lower premiums than Medicare Supplement (Medigap) plans, and some plans have $0 monthly premiums. They often include an annual out-of-pocket maximum, which Original Medicare does not have, providing cost protection if you need extensive care.
- Extra Benefits: Medicare Advantage plans typically offer extra benefits that Original Medicare doesn't, such as:
-Vision, dental, and hearing coverage
-Fitness programs like SilverSneakers
-Wellness programs, such as gym memberships
-Over-the-counter allowances
-Part B Givebacks
While Medicare Advantage plans can provide significant benefits, it's important to weigh factors like provider networks and potential out-of-pocket costs to determine if it's the best fit for your health and budget needs. Get in touch to our team now to receive answers to all your questions.
Dual Plans for Medicaid Eligible Beneficiaries
If you have both Medicare and Medicaid, you are considered "dual eligible," which means you qualify for benefits from both programs. Here’s what you need to know and consider:
- Medicare: This will remain your primary insurance and covers most of your medical needs, such as hospital stays (Part A), doctor visits, and outpatient services (Part B). You can also have Part D for prescription drug coverage.
- Medicaid: Acts as a secondary payer, covering costs that Medicare doesn’t, such as copayments, coinsurance, and deductibles. It may also cover services that Medicare doesn’t, like long-term care or certain home and community-based services, depending on your state.
- Medicare Advantage for Dual Eligibles: You might qualify for a Dual Eligible Special Needs Plan (D-SNP), a type of Medicare Advantage plan specifically for people with both Medicare and Medicaid. These plans provide additional benefits, like care coordination, and may offer extra coverage for vision, dental, or hearing services.
- Prescription Drug Coverage (Part D): Medicaid can help with prescription drug costs by covering premiums, deductibles, and copayments for your Medicare Part D plan.
- Financial Help: You may receive help from Medicaid with Medicare premiums, including Part B premiums, and with cost-sharing for services. This is especially useful for managing healthcare costs.
- Having both Medicare and Medicaid gives you extensive coverage, but you should review your options to see if a D-SNP plan or traditional Medicare with Medicaid is better for your needs.
Get in touch to our team now to receive answers to all your questions.
2025
MEDICARE NEWS
No More Donut Hole for 2025
Starting in 2025, the Medicare Part D "donut hole" coverage gap will be eliminated, meaning beneficiaries will no longer face higher out-of-pocket costs after reaching a certain limit on prescription drugs.
$2,000 Out of Pocket Cap
$2,000 Out-of-Pocket Cap for Prescription Drugs: Starting in 2025, Medicare Part D enrollees will have a $2,000 annual cap on out-of-pocket prescription drug costs, providing significant relief for beneficiaries with high medication expenses.
Medicare Advantage Midyear Benefit Notices
Medicare Advantage enrollees will start receiving midyear notices, informing them of any unused benefits, including extras like dental and vision care, allowing beneficiaries to maximize their plan usage.
Expansion of Mental Health and Dementia Care Services
Medicare Advantage plans will be required to expand access to mental health services, including therapy and addiction treatment. Additionally, the GUIDE program will enhance dementia care services, offering more support for caregivers and patients​
Navigating Medicare doesn’t have to be confusing. Contact Riddle Insurance Solutions today. Let us help you make the best decisions for your health and future.
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