What kind of Medicare Plan do you Need?
It Depends
Everyone’s health is different. We are all unique individuals. We sit down with you during a free no-obligation meeting to discuss what you and your body needs. You could get a Medicare Advantage Plan or a Medicare Supplement together with a Part D. Prescription Drug Plan. We can review 10 Medicare Company Plans!
Do you need help figuring out Which
Medicare Plan is Right For You?
We are an independent licensed insurance broker that works with the majority of companies that provide Medicare in the State of Nevada.
We won’t know which plan is right for you until we enter your:
- doctors you want to see
- the prescription(s) you want to take
- the pharmacy you wish to use into our program.
Then we can determine which pharmacy will charge you the least for prescription(s).
If you would rather we help you to make sure you do the right thing, give us a call. We will meet with you and help you personally!
4 parts to Medicare
Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B (Medical Insurance) Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Medicare Part C (Medicare Advantage HMO or PPO) Medicare Part C is a health coverage choice for Medicare beneficiaries. Medicare Advantage Plans are offered by private companies approved by Medicare. The plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. In all plan types, you are always covered for emergency and urgent care. Medicare Advantage Plans Must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you are in a Medicare Advantage Plan. Medicare Advantage Plans are not considered supplemental coverage. Most include Medicare prescription drug coverage. In addition to your Part B premium, you usually pay a cost for services provided.
Medicare Part D (prescription drug coverage) Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
THERE ARE 3 WAYS TO GET MEDICARE
1. Original Medicare with Prescription Drug Coverage
2. Medicare Advantage
3. Medicare Supplement
3 WAYS TO QUALIFY FOR MEDICARE
- If you have worked for 40 quarters in your lifetime and have turned 65 years old or older
- Certain younger people with disability for at least 2 years
- people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes call ESRD)
Do you have specific questions about Medicare insurance or need help finding the right coverage?
Get Help With Insurance, Inc. can quote your insurance with several carriers that that provide insurance coverage meet your medical and health needs. We provide UN-BIASED opinions. Contact us today.
MEDICARE STARTS WITH ORIGINAL MEDICARE
Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you receive them. When you get services, you’ll pay a deductible at the start of each year, and you usually pay 20% of the cost of the Medicare-approved service, called coinsurance.
If you want drug coverage, you can add a separate drug plan (Part D). Original Medicare pays for much, but not all, of the cost for covered health care services and supplies.
You can go to any doctor, health care provider, hospital, or facility that is enrolled in Medicare and accepting new Medicare patients.
With a few exceptions, most prescriptions aren’t covered in Original Medicare.
You can add drug coverage by joining a Medicare drug plan (Part D).
Hospital stays– The amount covered depends on how long you’re in the hospital. In 2023, for the first 60 days, you pay a deductible of $1,600 for each benefit period and Medicare pays the rest. After that, the longer you stay, the more you pay. You’ll pay $400 per day for days 61 through 90.
Original Medicare covers up to 90 days in a hospital per benefit period and offers an additional 60 days of coverage with a high coinsurance. These 60 reserve days are available to you only once during your lifetime. However, you can apply the days toward different hospital stays. For days 91 and beyond in the hospital, you will pay $800 per each “lifetime reserve day” until the 60 days over your lifetime. Then, you pay all the costs. Skilled nursing facility care. This is to allow you to recover and rehabilitate after a stay in the hospital; Medicare does not pay for long stays in a nursing facility. Medicare will cover the cost of skilled nursing care for a maximum of 100 days. Medicare pays in full for the first 20 days. From the 21st to 100th day, you pay a co-pay of $200.00 per day in 2023. After that, you pay all the costs of your stay in a skilled nursing facility.
MEDICARE STAR RATINGS
Each year the Centers for Medicare and Medicaid Services (CMS) measures the quality and value of certified health plans. Medicare certified health plans, both Part C (Medicare Advantage) and Part D (Prescription Drug), are rated on a star scale. The scale ranges from one to five stars, with five stars representing the highest quality. Scores are based on more than 37 care and service quality measures across several categories. Some examples of the categories include:
Staying Healthy
How well the plan covers and helps its members receive recommended health screenings, vaccinations, and other check-ups, including programs that encourage wellness and help members stay healthy.
Managing chronic (long-term) conditions
How often members with different chronic conditions receive certain tests and treatments that help them manage their condition.
Member experience
How members rate their satisfaction with plan benefits (e.g., coverage, copays, and customer service).
Member complaints and plan performance
How often Medicare found problems with the plan and how often members had problems with the plan, including how well the plan handles member appeals and new enrollment request.
Why do Star Ratings Matter?
What information does Medicare use to determine Star Ratings?
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- Reviews of claims and other info submitted by health plans.
- Monitoring and auditing performed by Medicare
- Member satisfaction, plan, and provider surveys
Medicare rewards plans that achieve four- and five-Star Ratings with extra money that must be reinvested back into the health plan’s programs and benefits. This means, the better the plans serve you, the better your benefits for you can be in the future.
Do you have specific questions about Medicare insurance or need help finding the right coverage?
Get Help With Insurance, Inc. can quote your insurance with several carriers that that provide insurance coverage for Medicare Advantage of Medicare Supplement plan, and much more.
We do not offer every plan available in our area. Currently we represent 10 organizations which offer 91 Medicare Advantage plans in Nevada. Please contact Medicare.gov, 1-800-MEDICARE, or your local Nevada Health Link at https://www.nevadahealthlink.com.