We work with some of the largest and well known insurance carriers specializing in Medicare products for Wisconsin residents.
Medicare is a health insurance program for:
- people age 65 or older,
- Eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.
- people under age 65 with certain disabilities, and
- people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
Want to lea
rn more about the basics of Medicare and when you need to enroll in the Medicare program? Alisa Allen from WPS Health Insurance recently helped us with an educational webinar that reviewed what you need to know to navigate the federal Medicare program and when you can enroll in Medicare. Watch Now!
What is right for you?:
As part of our value added services, we can assist you in answering these very important questions…
- What is the difference between a Medicare Supplement and a Medicare Advantage plan? Click here for a quick overview.
- Based on my medical needs, which type of plan will help me the most?
- Can I keep my favorite doctors?
- How do I know if my prescription drugs are covered?
- Do I have to take a prescription drug plan if I don’t take any medications?
Medicare:
Part A Hospital Insurance – Most people don’t pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.
Part B Medical Insurance – Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors’ services and outpatient care. In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period.
Part D Prescription Drug Coverage – Most people will pay a monthly premium for this coverage. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.
Medicare Supplement Plans:
A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.
Things to know about a Medicare Supplement Policies
- You must have Medicare Part A and Part B.
- You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
- Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
Medicare Part C – Medicare Advantage Plans:
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.
Enrollment:
In general, a person becomes eligible for Medicare at age 65. If you are already getting Social Security retirement or disability benefits, you will be enrolled in Medicare Parts A and B automatically.
If you are not already getting Social Security retirement benefits, you will have to enroll for Medicare Part A and/or Part B.
You can enroll in Medicare Part A and/or Medicare Part B in the following ways:
- Apply online at Social Security.
- Visit your local Social Security office.
- Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
Long Term Care:
Many people are surprised to learn that Medicare does not cover long-term nursing care. Medicare does not provide coverage for people who need to go into nursing homes indefinitely because they are disabled or can no longer take care of themselves. Medicare also does not cover assisted living or adult daycare. Medicare also does not cover daily custodial care, such as assistance with eating, bathing and dressing.
Long-term care insurance from private insurance companies can help cover some of the costs of long-term care and can help you preserve your assets. Contact us to learn more about long-term care insurance options.