Medicare
407-852-7442
What is Medicare Health Insurance?
Medicare is our nation’s health insurance program for people 65 years of age or older. Certain people under age 65 may also qualify for Medicare, including people with disabilities and those with permanent kidney failure, so contact us to discuss alternatives. Our address is: 108 Buenaventura Blvd, Kissimmee, FL,
The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care. You have options on how to get coverage. If you choose to have Original Medicare coverage (Part A and Part B), you can buy a supplemental insurance policy (Medigap).
Medicare is as simple as Parts A, B, C, and D
The Centers for Medicare and Medicaid Services (CMS) helps you apply for and understand the benefits offered by this health plan, also known as Medicare Part A and Part B. However, there are many people who need more coverage than the original plan provides. For example, you may want dental, vision, and hearing insurance, as well as prescription drug coverage. That’s where Medicare Part C and Part D come in.
After you sign up for Original Medicare Parts A and B, you can sign up for Part C, which includes Part D coverage. CMS doesn’t offer Part C or Medicare Part D plans.
Medicare supplement insurance is sold by private companies. Sometimes called “Medigap,” it can help you pay for out-of-pocket health care expenses that Medicare doesn’t cover, such as deductibles, coinsurance, copayments, or outpatient services.
Helps reduce your out-of-pocket expenses
Provides permanent coverage, even if you develop health problems.
Provides coverage to those who travel with you
It allows you to keep your doctor and visit any hospital, without networks, without the need for referrals.
Medicare Enrollment Period:
When you first become eligible for Medicare, you will typically be given an Initial Enrollment Period (IEP). This period begins three months before you turn 65, includes your birthday month, and continues for three additional months. If you have just turned 65, we can help you learn more about applying for Medicare and Medicaid in Kissimmee, Florida.
How do Advantage plans work in Florida?
Medicare Advantage is another way to get your Medicare Part A and Part B coverage. These plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare that must follow rules set by Medicare. If you join a Medicare Advantage plan, you will still have Medicare, but you will get most of your Part A and Part B coverage from your Medicare Advantage plan, not from Original Medicare.
This “bundle” of plans includes Medicare Part A and Part B and usually Medicare drug coverage (Part D).
Ask us if you qualify for Medicare Advantage Benefits
FREQUENTLY ASKED QUESTIONS ABOUT MEDICARE & MEDICAID
What is medicare?
Medicare is a federal health insurance program for people who are:
- 65 years or older.
- Under age 65 with disabilities.
- Any age with end-stage renal disease (ESRD), a type of permanent kidney failure that requires dialysis or a kidney transplant.
Medicare has helped millions of Americans pay for the health care services they need. You’ve likely contributed to the program through Social Security taxes deducted from your paycheck.
What does Medicare Part A cover?
Medicare Part A generally covers:
- Hospital care
- Skilled nursing facility care
- Nursing home care when you need more than custodial care
- Hospice care
- Home health services
Even when Medicare pays the cost of a service or item, you generally have to pay your own share, in the form of deductibles, coinsurance and copayments.
What does Medicare Part B cover?
Medicare Part B covers two types of services:
Medically necessary services are needed to diagnose or treat your medical condition and must meet accepted standards of medical practice.
Preventive services are meant to prevent illnesses like the flu and detect serious conditions at an early stage, when treatment has the greatest chance of success.
Medicare Part B covers health care costs like:
- Clinical trials
- Ambulances
- Durable medical equipment
- Mental health
- Inpatient hospital stays
- Outpatient care
- Getting a second opinion before surgery
- Some outpatient prescription drugs
Even when Medicare covers a service or item, you generally have to pay your own share, in the form of deductibles, coinsurance and copayments.
What Medicare Part C (Medicare Advantage) Covers
Part C (Medicare Advantage) was originally added to the Medicare program by Congress to give Medicare beneficiaries more coverage options. Medicare Advantage plans include all of the coverage that Medicare Parts A and B provide, as well as additional benefits.
Additional benefits provided by Medicare Advantage plans may include, but are not limited to:
- Prescription drug coverage
- Dental services
- Vision services
- Hearing services
- Gym or fitness center membership
- Health and wellness programs
- Nurse help line
However, Medicare Advantage plans are not all the same. They can vary in the health benefits they cover, depending on the plan provider and where you live. We recommend that before you choose a plan, you make sure to review what each available plan offers and whether it fits your health and lifestyle needs.
Is there anything that is not covered by Medicare Parts A and B?
Medicare does not cover all items and services. Some of these are:
- Long-term care
- Custodial care
- Most forms of dental care
- Eye exams to prescribe glasses
- Dentures
- Cosmetic surgery
- Acupuncture
- Hearing aids and fitting exams
- Routine foot care
What is a Dual Special Needs Plan (D-SNP)?
Dual special needs plans (or dual eligible health plans) are a type of health insurance plan for people who receive both Medicaid and Medicare. These people are “dual eligible” because they are eligible to receive benefits from both Medicaid and Medicare programs.
Dual special needs plans provide extra assistance to those who need it. This can be due to income, disability, age, or illness. A dual special needs plan works alongside your Medicaid health plan. You will keep all of your Medicaid benefits. Most dual health plans also give you more benefits and features than Original Medicare. All with a plan premium of just $0.
Why should I purchase a Medicare supplement insurance policy?
Medicare Supplement insurance offers a number of advantages:
- You get help paying out-of-pocket medical expenses, such as co-pays and deductibles, making it easier to manage your healthcare budget.
- Your Medicare Supplement coverage is valid throughout the United States.
- You can visit any specialist, without a referral, as long as the provider accepts Medicare patients.
- You can choose any doctor or hospital that accepts Medicare patients.
- You can choose from a variety of plan types to help meet your needs now and in the future.
When is the best time to buy Medicare supplement insurance?
The best time to purchase Medicare supplement insurance is during the six-month Medigap open enrollment period. During this time, you can purchase any Medicare supplement policy sold in Florida, regardless of any pre-existing conditions. You will not be asked to answer any medical questions during this time.
How do I apply for Medicare Supplement Insurance?
The first step to obtaining Medicare Supplement insurance is to complete an application. If you are not in your open enrollment period or if you qualify for guarantee issuance, you will need to answer a few medical questions. Our underwriters will review your medical history to determine if your application is acceptable and identify your risk classification. The amount of your premium will be determined in part by the amount of insurance coverage you apply for.
Can You Have Both Medicare and Medicaid?
Yes, some people can have both Medicare and Medicaid. People who qualify for both Medicare and Medicaid are “dual eligible.” If you qualify and choose to enroll in both programs, they can work together to help you cover most of your health care costs. You may also qualify for a special kind of Medicare Advantage plan, called a Dual Eligible Special Needs Plan.
Services covered by Medicare Advantage plans
With a Medicare Advantage plan, you may have coverage for things that Original Medicare doesn’t cover, such as fitness programs (gym memberships or discounts) and some vision, hearing, and dental services (such as routine checkups or cleanings). Plans may also choose to cover even more benefits. For example, some plans may offer coverage for services such as transportation to doctor visits, over-the-counter medications, and services that promote your health and wellness. Plans may also tailor their benefit packages to offer these benefits to certain members with some chronic conditions. These packages will provide customized benefits to address specific conditions. Check with the plan before you enroll to see what benefits it offers, whether you may qualify, and if there are any limitations.