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Choosing Medicare Options That Are Right for You

Nearly 4.8 million Floridians are enrolled in Medicare, the U.S. health care program for people over 65. If you’re one of them, you probably know that during the Annual Enrollment Period, from now until December 7, you have the opportunity to change how you receive your Medicare benefits. Changes you make now will take effect beginning Jan. 1, 2023.

Original Medicare or Medicare Advantage

You can receive Medicare benefits in one of two main ways: Original Medicare, which is a fee-for-service health plan with two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Once you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share. If you need drug coverage, you can add a separate Medicare drug plan (Part D).

The second option for receiving Medicare benefits is Medicare Advantage, also known as Medicare Part C. Medicare Advantage is provided by private insurance companies that contract with Medicare. Plans include part A, Part B and usually Part D. They may also offer extra benefits that Original Medicare doesn’t offer, such as vision or dental. The number of Medicare Advantage plan choices continues to increase—according to the Tampa Bay Times, “Floridians enrolled in Medicare will be able to choose from 627 Medicare Advantage plans compared to 583 plans in 2022.”

Considering your options

So how do you choose?

Coverage is very similar. Both options cover most medically necessary services and supplies related to care in the hospital, your doctor’s office, and other healthcare facilities. Main differences include things like doctor and hospital choice (with Medicare Advantage, you need to stay in the plan’s network for non-emergency care), whether or not you need a referral to see a specialist, and as mentioned above, whether or not some routine exams—vision, dental, hearing—are covered. Medicare Advantage plans are increasing in popularity among Medicare-eligible seniors, largely because of the added benefits available as well as the cap on out-of-pocket costs, something Original Medicare doesn’t have.

As you consider your options, think about what type of healthcare needs you’ll have over the coming year. Of course, unexpected things happen, but you may already know you’ll need to see a specific doctor, or you’ll need certain prescription drugs over the course of the year. Once you have this figured out, you can compare plans to see which one is right for you. It pays to spend some time comparing the total you’ll pay for medical care, including premiums, co-pays, and deductibles for each option.

For more in-depth information on how Medicare Advantage and Original Medicare plans compare with each other, click here.

How L & M Insurance Group can help

Sound confusing? If you’re interested in finding out more about Medicare Advantage plans, L & M Insurance Group can help. In addition, we can also help if you want to stay with Original Medicare, but you want a supplemental policy (“Medigap”) to help cover your deductibles and coinsurance costs. A supplemental policy may be cheaper for you than covering all the out-of-pocket costs on your own, especially in the event of a catastrophic illness. We represent companies that offer Medicare Advantage, Medigap, and Medicare Prescription Drug plans, including UnitedHealthcare and Aetna. We’ll be happy to help you decide if one of these plans makes sense for you. Please call us at 813-672-4100, or click here to contact us online.

For additional information on Medicare benefits and plans, please see  https://www.medicare.gov/

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How We Can Help With Medicare Coverage

Be Ready For Medicare Annual Election Period

Once you become eligible for Medicare at age 65, you have some decisions to make. Will original Medicare Part A and Part B be sufficient for your health insurance needs? What about Medicare Advantage (also known as “Medicare Part C”), prescription drug coverage (“Part D”), or Medicare Supplement (Medigap) insurance?

Now is the time to evaluation your Medicare coverage to see if it meets your needs, since we’re about to enter an annual election period (AEP). Between Oct. 15 and Dec. 7, eligible people may sign up for Medicare Advantage or make other changes to their Medicare coverage.  Once this period is past, you’re more limited in the changes you can make in your health insurance plans. 

Medicare Advantage and Medicare Supplement Plans

L & M Insurance Group offers both Medicare Advantage and Medicare Supplement plans. We represent Aetna, UnitedHealthcare, and other companies.

Medicare Advantage, or Medicare Part C, is a different way to receive your Medicare benefits. Under original Medicare, the government pays for your benefits when you get them. Medicare Advantage plans are offered by private insurance companies approved by Medicare. The government pays these companies to cover your Medicare benefits. There are different types of Medicare Advantage plans, including those operating as Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). Some Medicare Advantage plans offer benefits original Medicare doesn’t, such as vision or dental. Plan benefits can change from year to year.

As with any type of insurance, there are advantages and disadvantages to choosing a Medicare Advantage plan over original Medicare. Please call our office at 813-672-4100 to speak to an agent who will help you decide if a Medicare Advantage plan is right for you, and which plan offers the best coverage for the best price.

Medicare Supplement, or Medigap, insurance helps pay certain out-of-pocket costs not covered by your original Medicare benefits, such as co-payments, coinsurance, or deductibles. Medigap policies are standardized and must offer the same basic benefits, but some policies offer more benefits than others. These policies can only be purchased by people who have original Medicare.

Helping You find the Right Medicare Coverage

When deciding on health insurance for your retirement, you’ll want to think about what your healthcare needs will likely be, and compare premiums, deductibles, and co-payment requirements in order to decide which plan offers the best coverage at the lowest price.  L & M Insurance Group can help you find the best Medicare Advantage or Medicare Supplement plan to suit your needs. Just give us a call at 813-672-4100. For more information on Medicare benefits and plans, please see https://www.medicare.gov/