Medicare & You
American Insurance Group, LLC offers access to insurance products from the top “A” rated companies in the industry that provide value and long-term protection for your family. Many people find choosing a plan to cover the gaps in Medicare confusing to say the least. Our goal is to help you sort through the different plans available in your area and help you determine the plan that is appropriate for your situation and budget. We make it simple and convenient for you to obtain coverage. Your personal broker can help you decide what is suitable for you at no cost to you.
Medicare Made Simple:
- Created in 1965 as a Fee for Service Federal Health Insurance Program
- CMS (Center for Medicare/Medicaid Services) Manages Medicare
- Social Security Administration works with CMS by enrolling people in Medicare, enrolling in LIS (Low Income Subsidy) if appropriate, and collecting premiums through monthly Social Security check deductions.
- Its for people under 65 with certain disabilities, people 65 and older, and people with End Stage Renal Disease (ESRD).
The Different Parts of Medicare:
You can get the most from your Medicare benefits by learning what Medicare covers and by taking advantage of all that Medicare has to offer. Medicare has the following parts:
- Medicare Part A (Hospital Insurance) helps cover your inpatient care in hospitals. Part A also helps cover skilled nursing facility, hospice, and home health care if you meet certain conditions.
- Medicare Part B (Medical Insurance) helps cover medically-necessary services like doctors’ services and outpatient care. Part B also helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse.
- Medicare Part C (Medicare Advantage Plans) is another way to get your Medicare benefits. It combines Part A, Part B, and, sometimes, Part D (prescription drug) coverage. Medicare Advantage Plans are managed by private insurance companies approved by Medicare. These plans must cover medically-necessary services. However, plans can charge different co-payments, coinsurance, or deductibles for these services.
- Medicare Part D (Medicare Prescription Drug Coverage) helps cover prescription drugs. This coverage may help lower your prescription drug costs and help protect against higher costs in the future.
PLAN CHOICES (3)
1 – Medigap (Medicare Suppliment)
- Insurance Plans created by Medicare to cove the gaps in Medicare parts A and B.
- Been around since mid 60’s.
- Issued by private insurance companies.
- No network and no referrals.
- Works with all state approved Part D plans, allowing you to choose the plan that best matches your prescription usage.
- Cost are competitive with Medicare Advantage Plans.
- Usually the only difference between Medigap policies sold by different insurance companies is the cost.
2- Medicare Advantage (Part C)
- Established by the Balance Budget Act of 1997.
- Its another way to get your Medicare benefits. Combines Part A, Part B, and in most cases Part D.
- Managed by private insurance companies. All claims are handled by the private insurance company and not by CMS.
- Can charge different:
- monthly plan and part D premiums
- co-payments
- coinsurance
- deductibles
3 – Types of Medicare Part C Plans
- HMO – Health Maintenance Organization Plans
- PPO – Preferred Provider Organization Plans
- PFFS – Private Fee-for-Service Plans
- MSA – Medical Savings Account Plans
