Q. Why do seniors need help selecting a Medicare plan?
A. It's every person for themselves when it comes to Medicare. There's no such thing as a family Medicare plan. Often, we see couples on entirely different plans. There is a myriad of options available beyond Basic Medicare for people 65 and older and younger people with specific disabilities. It's split into Part A and Part B. Part A covers hospitalization and skilled nursing services, Part B covers preventive and medically necessary services, such as doctor visits, testing, medical equipment, outpatient services, and surgeries, and limited prescription drugs. Some services aren't covered under Original Medicare. There are deductibles for Part A and Part B and co-insurance for Part B. A person typically won't pay a premium for Part A if they or their spouse worked for at least 40 quarters. There may be a monthly premium for Part B services, that amount is contingent on income. Beneficiaries must choose one option among three categories of Medicare:
1. Stay with Original Medicare and enroll in a Part D Prescription Drug Plan. There are 25 drug plans in Connecticut.
2. Medicare Supplement and enroll in a Part D Plan. There are up to 12 Supplement Plans in Connecticut designed to reduce out-of-pocket costs of Original Medicare.
3. Medicare Advantage Plans: Private insurance companies offer these, they have a calendar year maximum out of pocket cap and offer embedded benefits that Original Medicare doesn't. Benefits include vision, dental, gym memberships, over the counter, eyewear, and hearing aid allowances. There are 27 Medicare Advantage plans offered in Connecticut, depending on where you live.
Q. How do you determine which option is right for you and then select a plan?
A. As Personal Insurance Advisors, we have a unique four-step process that analyzes your physical and emotional needs to help you select the best fit. We guide you and outline the process, starting with signing up for Original Medicare and the plan selection. We walk you through the enrollment process. We're currently certified with available plans in Connecticut, Florida, Massachusetts, North, and South Carolina.
Q. What's most important when selecting a plan?
A. Each person is unique, your plan should be right for you. Make sure your providers are in the plan network. Make sure all your medications are covered under the plan you want. Drug lists vary from company to company.
Q. What are the top concern seniors have about Medicare?
A. Seniors can get overwhelmed with all the options. Everyone wants to make the right choice, but the research is tedious and time-consuming. Although Medicare is a national program, there are state-specific regulations that are difficult to obtain if you are not licensed. We provide the tools and guidance to alleviate that stress so you make an informed decision quickly.
Q. What are the range of programs?
A. There are 39 Medicare Medical Plans approved by the State of Connecticut Insurance Commission and 25 Prescription Drug Plans.
Q. Once you pick a plan, why is it important to have a 'tune-up' every year?
A. The plans are approved annually and insurance companies can make changes each year. As we age, our healthcare needs change, making switching plans advantageous.You can re-evaluate your choices each year and select a new plan. You might also be able to switch plans through special enrollments throughout the year.