Medicare Services

Medicare Enrollment is upon us and this may be your only chance  to change your current plan or to newly enroll.  We want to help YOU find the BEST and AFFORDABLE Medicare Health Plan to fit your individual health needs. Choosing the right health plan is one of the most important decisions you can make. There are many plans available in our area, so why not do what hundreds of your friends and neighbors are doing,  let a Local Dan Burghardt licensed professional help YOU chose the right plan to enroll in. We represent  and offer  ALL of the A+ Major companies . Why spend hours on the phone with multiple agents when your Local Independent agent who can SHOP all these carriers with just  one phone call.

Medicare is a federal program that provides individuals 65 years or older healthcare coverage at a small cost. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays while Part B covers outpatient or medical care.

Together, Part A and B cover about 80% of the typical healthcare costs seniors face—leaving a few significant gaps in coverage. Medicare Supplement (Medigap) plans are supplemental policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind at all times.

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans.

• Health Maintenance Organization (HMO) plans: These plans offer a network of doctors and hospitals that members are generally required to use to be covered. Because of this, HMOs tend to have strict guidelines, meaning that any visits and prescriptions are subject to the plan approval. If you use providers outside of the plan network, you may need to pay the full cost out of pocket (with the exception of emergency or urgent care). You generally need to get a referral from your primary care doctor to see a specialist.
• Preferred Provider Organization (PPO) plans: Medicare Advantage PPO plans offer a network of doctors and hospitals for beneficiaries to choose from. Unlike an HMO, you have the option to receive care from health-care providers outside of the plan’s network, but you’ll pay higher out-of-pocket costs. Medicare Advantage PPOs don’t require you to have a primary care doctor, and you don’t need referrals for specialist care.
• Private Fee-for-Service (PFFS) plans: This type of plan allows visits to any Medicare-approved doctor or hospital, as long as the plan’s terms and conditions of payment are accepted by the provider. Keep in mind that you’ll need to find providers that contract with the plan each time you are receiving treatment.
• Special Needs Plans (SNPs): These plans limit enrollment to beneficiaries who have certain chronic conditions, are institutionalized, or qualify for both Medicare and state Medicaid (also known as dual eligibles). Benefits, provider options, and prescription drugs are tailored to meet the needs of the plan’s enrollees.
• Medicare Medical Savings Account (MSA) plans: These plans combine a high-deductible Medicare Advantage plan with a medical savings account. Every year, your MSA plan deposits money into a savings account that you can use to pay for medical expenses before you’ve reach the deductible. After your reach the deductible, your plan will begin to pay for Medicare-covered services. These plans don’t cover prescription drugs; if you want Medicare Part D coverage, you may enroll in a stand-alone Medicare Prescription Drug Plan.

Other less common types of Medicare Advantage Plans that may be available include HMO Point of Service (HMOPOS) Plans and a Medicare Medical Savings Account (MSA) Plan.

With some Medicare Advantage Plans there are multiple Benefit Options available far Beyond the Original Medicare has to offer:

• Part B Give Back – $100 or more Credit back to your Social Security check for the cost of your Part B (Approx. $140.00 per month)
• $0 Dollar Deductible copay for Dental – Vision – Hearing Benefits
• $0 Dollar Deductible copay for Preventive and Screening Benefits
• Part B Prescription Drug coverage with $0 dollar deductible for Part B Tier 1 and 2 Prescriptions Drugs
• Lower Prescription Drug Cost – Free Home Delivery
• Monthly Over-the-counter Allowances for Health and Wellness items (Vitamins, Toothpaste, Pain Relievers and more)
• Free Fitness Center/Health Club Membership (Now with online classes)
• Free Transportation to Doctor or Pharmacy
• Grocery Pick-up Services
• Worldwide Emergency and Urgent Care
• Online Doctor Visits from Home
• 24/4 Nurse Hotline (Telehealth)
• Home Delivered Meals

Medicare Supplement (Medigap) plans work alongside your Original Medicare plan to help fill coverage gaps, such as traveling abroad and deductibles. Because it is used with your federal Medicare coverage, it is also accepted at any hospital that accepts Original Medicare.

Medicare Supplement plans offer the advantage of flexibility; unlike some other senior healthcare options, you have the freedom to enroll in or change your Medicare Supplement policy at any time throughout the year. And because Medicare Supplement policies are guaranteed renewable, you cannot lose coverage if you develop a health condition or concern—meaning you’re protected year over year, no matter what.

For more information or a quick quote, contact one of our Health Insurance Specialists at (504) 441-7283 or complete the Online Quote Request form and you will be contacted immediately.