KMQ Medicare Planning

Are you feeling confused and overwhelmed about your Medicare options? We can educate you on your choices!

Medicare is truly a maze! People who are new to Medicare often have a hard time sorting things out initially. There are all these parts and plans with similar letters, making it hard to figure out what is what. We are here to educate you on your options!

“I realized that I don’t have to be perfect. All I have to do is show up and enjoy the messy, imperfect, and beautiful journey of my life.” — Kerry Washington

Every Medicare Supplement has to follow the guidelines created by Medicare itself when it standardized all plans in 1990. Each standardized plan is identified by a letter. Medicare calls them plans. There is Medigap Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M and Plan N. Each one of these lettered policies provides the same set of benefits from company to company.

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Fast Fact: Medicare Part D plans all follow federal guidelines. Each insurance carrier must submit its plan outline to the Centers for Medicare and Medicaid Services annually for approval.

Medicare Supplements only pay after Medicare has first paid its share. If Medicare approves a claim and pays the part that Medicare owes, it will forward the remainder of the bill to your Medicare Supplement.

Long Term Care are services that include medical and non-medical care provided to people who are unable to perform basic activities of daily living such as dressing or bathing. Long-term supports and services can be provided at home, in the community, in assisted living or in nursing homes. Individuals may need long-term supports and services at any age. Medicare and most health insurance plans don’t pay for long-term care.

In-network coinsurance is the percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or plan. In-network coinsurance usually costs you less than out-of-network coinsurance.

A HIPAA eligible individual is your status once you have had 18 months of continuous creditable health coverage. To be HIPAA (Health Insurance Portability and Accountability Act) eligible, at least the last day of your creditable coverage must have been under a group health plan; you also must have used up any COBRA or state continuation coverage; you must not be eligible for Medicare or Medicaid; you must not have other health insurance; and you must apply for individual health insurance within 63 days of losing your prior creditable coverage.

Getting “Preauthorized” means a decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.

A Medicare Special Needs Plan is a Medicare Advantage plan that include all Medicare Part A, Part B and Part D benefits and may include additional benefits, such as support for a chronic condition or services that may be helpful to someone who has both Medicare and Medicaid.

Fast Fact: AEP begins October 15 and ends December 7 each year. During AEP, you can enroll in, disenroll from or change your Medicare Advantage plan or your prescription drug plan. You can also return to Original Medicare. Elections made during AEP are effective January 1 of the following year.

Medicare Part C 101: These plans are offered by private insurers approved by Medicare. By law, Medicare Advantage plans must offer, at minimum, the same benefits as Original Medicare Part A and Part B. Most Medicare Advantage plans also include coverage for prescription drugs, and many include some coverage for dental, vision and hearing care, as well.

Medicare Part B is part of Original Medicare, Medicare Part B helps cover certain doctors' and preventive services, outpatient care and medical supplies.

"Never bend your head. Always hold it high. Look the world straight in the eye." - Helen Keller

Feeling stressed out about your upcoming Medicare choices? Let us educate you on your options. Request a no cost consultation today!

Fast Fact: Final expense insurance helps families cope with the loss of a loved one by guaranteeing all funeral and burial expenses will be paid for.

Medicare Part D 101: The monthly premiums for Part D drug plans vary depending on the specific plan that you choose. Each insurance company sets its own rates.

Hospital indemnity insurance is a type of plan that pays a set amount – per day, per week, per month, or per visit – if you’re confined in a hospital. The Hospital Plan is a hospital indemnity insurance plan.

It is important to note that Medicare Supplement Insurance Plans do NOT include Prescription Drug Coverage (Part D, PDP) and for those that do not get a PDP when first eligible there will be a penalty when they do get a PDP.

Overwhelmed by your Medicare choices? Let us educate you on your options. Request a no cost consultation today!

Original Medicare, also called Traditional Medicare, Original Medicare consists of Medicare Part A (hospital) and Part B (medical) coverage. It is offered directly by the federal government.

Many people new to Medicare feel surprised to find that Medicare covers only 80% of your Part B expenses. The other 20% can be devastating to you financially if a serious illness arises. You can choose a Medicare Supplement that will pay some or all of that 20% for you, among other things.

Medicare Part B (Medical Insurance) helps cover medically necessary doctor’s services, outpatient care, home health services, durable medical equipment, mental health services, and other medical services.

Fast Fact: A Medigap policy only covers one person. Spouses must buy separate coverage.

Medicare 101: Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Long Term Care are services that include medical and non-medical care provided to people who are unable to perform basic activities of daily living, like dressing or bathing. Long-term supports and services can be provided at home, in the community, in assisted living, or in nursing homes. Individuals may need long-term supports and services at any age. Medicare and most health insurance plans don’t pay for long-term care.

Fast Fact: Lifetime reserve days are in Original Medicare, these are additional days that Medicare will pay for when you're in a hospital for more than 90 days. You have a total of 60 reserve days that can be used during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance.