Simply Covered

Medicare is health insurance for people who are age 65 or older or people under age 65 with certain disabilities. Medicare is also available to anyone with end-stage renal disease, regardless of age. There are several “parts” to Medicare. Each part provides coverage for specific services or items. Part A and Part B are often… [Read more…]

Medicare Part A and Part B are often called “Original Medicare.” This coverage is managed by the federal government, and generally, there is a cost for each service. Part A – Hospital Insurance Medicare Part A helps cover inpatient care in hospitals, as well as some home health care, stays in skilled nursing facilities, and… [Read more…]

Medicare Advantage Plans include the standard benefits available through Medicare Part A and Part B, along with additional benefits. Most Medicare Advantage Plans cover Medicare Part D prescription drug coverage. You can enroll in a Medicare Advantage Plan as an alternative to Original Medicare. Medicare Advantage Plans are similar to HMOs and PPOs. These plans… [Read more…]

Medicare Part D helps cover the cost of prescription drugs and is available to everyone who is eligible for Medicare. Part D coverage may help lower your prescription drug costs and help protect against higher costs in the future. To get this coverage, you must purchase a plan offered by an insurance company or other… [Read more…]

A Medigap policy (also known as “Medicare Supplemental Insurance”) is private health insurance that supplements Original Medicare. A Medigap policy helps pay some of the health care costs that Medicare doesn’t cover (known as “gaps”). These are costs like co-payments, co-insurance, and deductibles. If you have Original Medicare and a Medigap policy, Medicare will pay… [Read more…]

When the Affordable Care Act was passed in 2010, Medicare was strengthened. People age 65 and older now have access to many preventive health services with no out-of-pocket costs. The law also gives seniors discounts on drugs when individuals are in the coverage gap known as the “donut hole.” Plus, the law helps protect seniors… [Read more…]

Each year, Medicare publishes a list of the amounts it will pay for hospital and medical services. This is known as “Medicare assignment.” Doctors that accept Medicare assignment will charge you only the Medicare-approved amount, once you have met the yearly deductible. There is no yearly limit for what you pay out of pocket. You… [Read more…]

Knowing when to sign up for Medicare is very important. If you miss certain enrollment periods, you may have to pay more for coverage and your start date can be delayed. We’re here to help if you need trusted advice about Medicare enrollment. If you are already receiving benefits from Social Security or the Railroad… [Read more…]

You can get coverage through Original Medicare, combine Original Medicare and a Medigap policy, or by purchasing a Medicare Advantage Plan. Decide which option is best for you in three quick steps. We’re Here to Help We know that your health care is critically important to you and your family. We also understand that switching to… [Read more…]

Advance Coverage Decision. A notice you get from a Medicare Advantage Plan letting you know in advance whether it will cover a particular service. Appeal. The action you can take if you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan. Assignment. An agreement… [Read more…]