We've been in this industry for over 26 years. We know a thing or two about Medicare.
Medicare doesn't have to be confusing...
Medicare provides health coverage to over 49 million people who are age 65 and older, under age 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD). Your clients enroll in Medicare by calling Social Security (800.772.1213), by visiting ssa.gov or their local Social Security office. If they don't enroll on time, they may pay late enrollment penalties and their healthcare expenses may not be covered.
There are two ways to get Medicare >
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Current Medicare Beneficiaries in 2018
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Projected Medicare Beneficiaries in 2025
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When Should Clients Enroll in Medicare?
Have your clients sign up early to avoid a delay in getting coverage for Part B services. To get Part B coverage the month your clients turn 65, they must sign up during the first three months before they turn 65.
If they wait until the last four months of their Initial Enrollment Period to sign up for Part B, their start date for coverage will be delayed.
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$10,000 National health spending will average upwards of this figure per person for 2018 - 2025 +5.6% National health spending is projected to grow at an average rate for 2018 - 2025 |
+7.1% Medicare spending is projected to grow an average rate per year. 1 in 5 Americans will be on Medicare in 2025 |
Differences between Medicare Supplement plans and Medicare Advantage plans:
Medicare Supplement |
Medicare Advantage |
Choice of doctors
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Any doctor who accepts Medicare.
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Doctors who participate in the plan's network.
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referrals
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Your client may see specialists without a referral.
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Your client may need a referral and may be limited to specialists in the plan's network.
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Coverage while travelling
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Your clients are covered when travelling domestically, and may see any doctor who accepts Medicare.
Plans F, G and N cover travel abroad. |
Only emergency and urgent services are covered. Routine care is not covered.
Only emergency services are covered abroad. |
prescriptions
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Prescription drug plans are separate and compliment a Medicare Supplement plan.
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Many plans include drug coverage, but not all drugs are covered.
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Dental & vision
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Separate Dental, Vision and Hearing plans provide optional coverage.
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Most plans include dental and vision.
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plan cancellation
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Plans cannot be cancelled as long as your client pays their premiums.
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Plans can be cancelled at the end of every calendar year. Most renew, but not always.
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co-pays & co-insurance
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Co-pays and co-insurance depend upon the plan.
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There are co-pays and co-insurance with Medicare Advantage plans.
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premiums
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Your client will have to pay a monthly premium in addition to their Part B premium.
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Most plans have a low or $0 monthly premium. Your client will also need to pay their Part B premium.
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benefits
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Some plans offer additional benefits. Medicare Supplement benefits will always remain the same though.
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Fitness memberships, transportation and even hearing are often included. Benefits may change from year to year though.
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Deductible and Co-insurance Amounts for 2018 & 2019
Type of Cost Sharing |
2018 |
2019 |
Part A Hospital Inpatient Deductible for each benefit period |
$1340 |
$1364 |
Hospitalization Days 61 - 90 Co-insurance per day of each benefit period |
$335 |
$341 |
Hospitalization Days 91 and beyond Co-insurance per each "lifetime reserve" day after day 90 for each benefit period (up to 60 days over your lifetime) |
$670 |
$682 |
Skilled Nursing Facility Care Co-insurance per day of each benefit period (21 - 100 days) |
$167.50 |
$170.50 |
Part B Deductible Calendar year deductible for Medicare approved amounts for covered services |
$183 |
$185 |
Standard Monthly premium for Medicare Part B enrollees |
$134 |
$135.50 |
Annual deductible for all Medicare Part B beneficiaries |
$183 |
$185 |
Source: CMS.gov
Your Role as an Advisor
Advising your clients and showing them the differences between the Medicare Advantage and Medicare Supplement product, and then recommending the best solution(s) for them, while advising and helping them navigate the complexities of the Medicare program is what they need and expect.
Our Senior Solutions Managers can offer you guidance with which plans are best for your clients' needs. They can assist you with using our quote tool to determine the best plan, depending on your clients' location, health and budget.
Expanding Your Portfolio
Providing complete solutions for your clients is crucial.
Questions? Call us 800.928.4998 or chat with us.
