Jim Cooper Medicare Advisor

Fast Fact: “Minimum and Essential Coverage” is Health coverage that will meet the individual responsibility requirement. Minimum essential coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP, TRICARE, and certain other coverage.

Point of Service (POS) plan is a type of Medicare Advantage HMO plan that allows members the ability to visit doctors and hospitals outside their network for some covered services, usually for a higher copayment or coinsurance. Some POS plans do not require referrals for specialty services.

Confused About Medicare? It is not unusual for a client to bring in a whole bag of mail that he has received at home and ask for our help to identify which things should be kept or tossed out.

Medicare Advantage plans work differently from Medigap plans, so make sure you understand all the differences between the two before signing up for an Advantage plan.

Medicare Part C Advantage plans have different networks, premiums, and cost-sharing. Working with an insurance agent that specializes in these plans is a great way to ensure that you consider all the variables before choosing your insurance company.

Medigap plans are standardized, meaning each plan offers the same benefits no matter the carrier you choose. However, the monthly premium you will pay depends on different factors like your age, gender, to***co use, zip code, and more.

Medigap plans and Medicare supplement insurance plans are the same things, just two different terms.

A Medicare Summary Notice (MSN) is a quarterly explanation of benefits statement that Medicare provides to show you the healthcare services received and what Medicare paid toward them. You should review your MSN to determine if you owe any balances that are due.

Also known as Medicare Advantage, the Part C program is a form of managed care that allows Medicare beneficiaries to get their Parts A and B benefits through a private insurance plan and its network of providers. Many Part C plans offer a built-in Part D drug plan.

Part A (Hospital Insurance): Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

Critical Illness Insurance provides benefits when a covered person is diagnosed with an eligible condition like heart attack, stroke, major organ transplant, end stage renal failure or coronary artery bypass surgery.

Medicare Supplement and Advantage plans differ significantly as Supplement plans are secondary plans, and Advantage plans replace your Original Medicare.

Are you starting to get a lot of phone calls and things in your mail about Medicare Insurance Plans? Contact us today for a no cost consultation. We can educate you on your options.

Quick Tip: Plan C covers all the gaps in your Medicare coverage, except Medicare Part B excess charges.

Many people confuse their Medicare Eligibility date with their Social Security retirement age. They are different. A person can apply for full retirement income benefits at around age 67. This is considered their retirement age. However, this does not affect the age at which they qualify for Medicare.

Fast Fact: Most people become eligible and sign up for Medicare around age 65 during their 7-month Initial Enrollment Period.

Quick Tip: Medicare Advantage plans work differently from Medigap plans, so make sure you understand all the differences between the two before signing up for an Advantage plan.

Turning 65 soon? Starting to feel overwhelmed by your Medicare choices? Contact us today to request a no obligation consultation.

Medicare Supplement plans cover 10 million Medicare beneficiaries. Also referred to as Medigap plans, these policies help pay for your share of Medicare expenses, such as your deductibles and co-insurance.

Fast Fact: You must be enrolled in Medicare Part A and B to purchase a Medicare Supplement Insurance plan.

Original Medicare with a Medigap plan gives you very comprehensive coverage. The primary differences are that with Medigap plans, you can see any doctor that accepts Medicare. You don’t have to ask your doctors if they take your specific Medigap insurance company. The network is Medicare, which has over 1 million contracted providers across the nation.

Fast fact: You are still required to pay the Medicare Part B premium even if you have an Advantage plan.

The Medicare program has four different parts: Part A, B, C, and D. Part C, D, and Medigap plans are sold through private insurance carriers, not the federal government.

Turning 65 soon? Confused about Medicare? Let us educate you on your options. Request a no cost consultation today!

In July of 1965, President Lyndon B. Johnson signed a Medicare bill into law so that people 65 and older could get the healthcare coverage they needed from a national program. Initially, the only coverage options were Part A and Part B.

A common question around here is how is Medicare different than Medicaid? By definition, Medicare is a health insurance program for the elderly. Medicaid, on the other hand, is financial and/or healthcare assistance for low-income individuals. Some people 65 and older can qualify for both. In that scenario, Medicare is primary and Medicaid is secondary.

Fast Fact: There are different times to enroll in an Advantage plan throughout the year, including your Initial Enrollment period, the Annual Election period, and more.

Medicare 101: A "Deductible is an amount you could owe during a coverage period (usually one year) for covered health care services before your plan begins to pay. An overall deductible applies to all or almost all covered items and services.

Quick Tip: A "Copayment" is a fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.

Lost in the Medicare plan maze? Let us educate you on your options. Request a no cost consultation today!