Medicare 101

Medicare Help and Enrollment Strategies

GolferOCMedicare helps you make the best decision when choosing your Orange County Medicare Insurance.  We bring ease to the Medicare Insurance process, allowing you to understand how Medicare works and helping you find the Medicare Insurance plan that’s right for you.

We provide free assistance so you don’t have to learn it all yourself.  We sit down with you, either in person, on the phone or via email and show you how the whole system works.

It will all become crystal clear once you sit down with us and we talk with you personally about your particular situation.

Medicare has four distinct parts

Medicare Part A

Medicare Part A covers you if you are admitted, as an “In-patient”, to a hospital, skilled nursing facility or institution.  Part A is free for most people and you are entitled to Part A if you are a US citizen and you’ve worked 40 or more quarters (your spouses working quarters apply to you if you have not worked).  Part A has a deductible and, once you’ve reached your deductible it covers you at 80%.  You are responsible for the 20%, which is why you’ll want to consider obtaining Medicare Insurance (which typically takes care of your deductibles and the 20%).

Medicare Part B

Medicare Part B is NOT free.  Most citizens pay a monthly premium of $144.60 for Part B.  But, if you make more money you may need to pay more for your Part B.

Medicare Part B covers you for all services performed outside of a hospital setting.  Think “out-patient”.  Everything from a routine MD Office Visit, Lab work, Physical Therapy, CT Scans, MRI’s, etc, etc, etc.  Part B has a deductible as well, and covers you at 80%.  You are responsible for 20%, which, again, is why you’ll want to consider obtaining Medicare Insurance.

Medicare Part C

Medicare Part C is also known as the Medicare Advantage program.  Most HMO’s you see advertised on TV are a part of the Medicare Advantage program.  Think SCAN, Blue Shield’s 65+, AARP’s Medicare Complete, etc.  These Medicare HMO’s often have ZERO premium but require that you make co-payments for certain services.  You also MUST use your Primary Care Physician for all services and he/she will give you a referral to a specialist should you need one.

Medicare Part C is NOT a requirement.  It is just a Medicare Insurance option for you to consider that will help offset the Medicare deductibles and the 20% that you would be responsible for if you did not have a Medicare Insurance plan in place.

Medicare Part D

Medicare Part D, or the Prescription Drug program, is just that.  You must obtain a prescription drug plan whether you are currently on medications or not.  The Federal Government requires all Medicare beneficiaries to obtain a Part D drug plan, otherwise you will be responsible for a “late enrollment penalty” if you fail to get a Part D plan and decide to activate one later.

There are some things to consider when deciding which plans you’ll need and which plans you won’t need.  For instance, if you are still working and your employer provides “creditable coverage” you may NOT need to get Medicare Part B OR Medicare Part D.  These are things that we can help you determine so please feel free to contact us to review your particular situation.

Medicare Supplement Insurance plans

Another insurance option to consider is a Medicare Supplement Insurance plan (rather than a Part C Medicare Advantage Plan).  A Medicare Supplement plan will often pay for most, if not all, of the balance that Medicare does not pay.  There are NO co-pays or deductibles and you can use ANY doctor in the USA, as long as that doctor accepts Medicare.

It’s hard to understand all the intricate details of Medicare and the insurances available by reading about it, which is why we offer free advise and provide Medicare education to you without obligation.  Please take advantage of our free service and schedule an appointment today.

Don’t try and tackle Medicare alone!

Contact us and let us be your guide. We provide a no obligation free consultation! We’ve been helping people just like you for over 30 years and feel confident that we can help you make the best decision for yourself regarding your Medicare Insurance needs.

Call today at (714) 729-3161.

Medicare 101: Medicare For Beginners

I think everyone could use a Medicare for beginners article. Especially after all the changes that have taken plan the last few years. If you are an American citizen or permanent resident, you are going to want to be familiar with the many benefits that are available to you. One of the greatest things about this country are all of the many services and benefits available to the citizens of this … [Read more...]

Medicare Insurance Is Now A Reality For Baby Boomers

The first wave of Baby Boomers begin turning 65 in January 2011. This means that if you are one of these Baby Boomers you will be signing up for Medicare insurance for the first time. It can be a complex and frustrating process that could cost you time and money, if you make mistakes or wrong choices. Medicare Insurance has four parts: A, B, C and D. Part A covers in-hospital stays and has … [Read more...]

Medicare help: How To File A Medicare Claim

When filing a Medicare claim it has to be filed within one calendar year following the year that the services were provided for the claim. This means, one year after you have the treatment for the health condition, you have to file a claim before that calendar year is up. For example, if you have made a physician's visit on the month of March 2009, a Medicare claim can be filed before 31st … [Read more...]

Changing Residences Can Impact You With the Medicare Advantage Program

It is essential that anyone with the Medicare Advantage Program makes sure to document any move, temporary or permanent. The subject of Medicare for U.S. residents can be complicated at the best of times and with the changes recently made to the health-care laws, people may find themselves either paying more or even without coverage if they are not well informed. With the increasingly aging … [Read more...]

Medicare 101: How To Qualify for Medicare

Learning about medicare for the first time you could be asking yourself "How do I qualify for Medicare"? Medicare is an American healthcare system for people of the age 65 or older. It is primarily funded by employees and employers through payroll taxes, as well as, monthly premium deductions from social security checks. If you would like to know how to qualify please read the following … [Read more...]

Five Things To Know About the Medicare Donut Hole

The gap in coverage faced my many is commonly referred to as the “Medicare Donut Hole”. In recent years, options for seniors who are Medicare beneficiaries can be quite confusing, especially when it comes to supplemental coverage such as Part D, which is designed to cover prescription drugs costs.  Here is a list of five things you and your family should consider when choosing the most effective … [Read more...]

Medicare Help: What you should know about Medicare for 2011

It's almost time for Medicare's open enrollment period for 2011 and any of you may be looking for medicare help. It will run from November 15 through the end of the year. If you have a Medicare Advantage policy or are considering Medicare Advantage, you will want to learn more about the upcoming changes. According to a Medicare help spokesperson, the information you will need to make an informed … [Read more...]

Medicare Advice: Learn About Medicare Fraud

Are you tired of rising health care costs? One contributing factor is Medicare fraud. Most health care professionals who work with Medicare are honest. Unfortunately, a handful of dishonest providers and individuals cost the Medicare system millions of dollars every year. These costs are passed on to you in the form of higher co-payments and health care costs. What You Don't Know About Medicare … [Read more...]