Health Insurance

If you are looking for Individual Medical Health Plans. We can assist you with ACA plans AKA as Obama Care. Or Individual Insurance Plans. Or other options for you.

Introduction to health insurance

Health insurance (sometimes called health coverage) pays for some or all of the cost of the health services you receive, like doctors’ visits, hospital stays, and visits to the emergency room. It helps keep your health care costs predictable and affordable. You may have to pay several different amounts for health insurance:

If you are looking for Individual Medical Health Plans. We can assist you with ACA plans AKA as Obama Care. Or Individual Insurance Plans. Or other options for you.

  1. You will generally pay a premium, a monthly fixed payment to the insurance company.
  2. You may have to pay a deductible. This is a fixed amount that you pay out of pocket before your health insurance begins to pay for your health services.
  3. After you have met the deductible, you and your insurance company typically share the cost of covered health services. Your insurance pays most of the cost first, and then you pay the remaining cost. The amount that you pay is either a copayment (a fixed amount) or a coinsurance (a percentage of the cost of the service).

Medicare is a type of health insurance administered by the federal government.

Medicare cards

Everyone who enrolls in Medicare receives a red, white, and blue Medicare card. This card lists your name and the dates that your Original Medicare hospital insurance (Part A) and medical insurance (Part B) began. It will also show your Medicare number, which serves as an identification number in the Medicare system. (If you get Medicare through the Railroad Retirement Board, your card will say Railroad Retirement Board at the bottom.)

If you have Original Medicare, make sure you always bring this card with you when you visit doctors and hospitals so that they can submit bills to Medicare for payment. If you have a supplemental insurance plan, like a Medigap, retiree, or union plan, make sure to show that plan’s card to your doctor or hospital, too, so that they can bill the plan for your out-of-pocket costs.

Note: Medicare has finished mailing new Medicare cards to all beneficiaries. You can still use your old card to get your care covered until January 1, 2020. However, if you have not received your new card, you should call 1-800-MEDICARE (633-4227) and speak to a representative.

If you are enrolled in a Part D plan (Medicare prescription drug benefit), you will use the Part D plan’s card at the pharmacy.

If you are enrolled in a Medicare Advantage Plan (like an HMO, PPO, or PFFS), you will not use the red, white, and blue card when you go to the doctor or hospital. Instead, you will use your Medicare Advantage Plan card, which you should receive in the mail. You will also use this card at the pharmacy if your plan serves as your Part D coverage. If you have a supplemental insurance plan, like a retiree or union plan, make sure to show that plan’s card to your doctor or hospital, too, so that they can bill the plan for your out-of-pocket costs.

Your Medicare card, Social Security card, and other health insurance cards are very important documents. Make sure to keep a photocopy of your important identification and insurance cards, write down any important numbers (like your Medicare number), and keep everything in a safe place so that you have a record for future reference if anything gets lost. If your card is ever lost, stolen, or damaged, you can get a replacement card by calling 1-800-MEDICARE (633-4227). You can also order or print a card by logging in to your mymedicare.gov account.

Remember: Do not give your Medicare or Social Security numbers or personal data to strangers. Medicare will never ask for this information over the phone. If you believe you have been the target of Medicare marketing or billing fraud, contact your local Senior Medicare Patrol.

Differences between Medicare and Medicaid

Medicare and Medicaid are two separate, government-run programs. They are operated and funded by different parts of the government and primarily serve different groups.

  • Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income.
  • Medicaid is a state and federal program that provides health coverage if you have a very low income.
  • If you are eligible for both Medicare and Medicaid (dually eligible), you can have both. They will work together to provide you with health coverage and lower your costs.

Also know that while Medicare and Medicaid are both health insurance programs administered by the government, there are differences in covered services and cost-sharing. Make sure to call 1-800-MEDICARE or contact your local Medicaid office to learn more about Medicare and Medicaid costs and coverage, especially if you are a dual-eligible.

Questions to ask when new to Medicare

If you are new to Medicare, there are several questions you should consider while approaching or within your Initial Enrollment Period (IEP) or a Special Enrollment Period (SEP). Use this guide to consider your options when preparing to enroll in Medicare or after you have already enrolled.

  1. What are the basics? Medicare is a complex program and can sometimes be confusing. The best place to start when you are new to Medicare is by familiarizing yourself with the differences between it and the health insurance you have now. Learn what makes a person Medicare-eligible, the different parts of Medicare insurance and what those parts cover, times to enroll in Medicare, and how putting off enrollment can result in penalties. These initial steps will help smooth the transition from your current insurance to Medicare once you are eligible.
  2. What are your coverage options? Everyone has different health care needs, meaning the coverage that is right for your friends or family may not be right for you. Will you enroll in Original Medicare or would you prefer a Medicare Advantage Plan that may limit your provider networks or have different costs but that offers additional coverage? If you have current employer insurance, you may decide not to enroll in Medicare until you have retired. If you are already retired, you might find that Original Medicare plus retiree insurance works better for you than Original Medicare plus a Medigap (or vice versa). Find out the full range of your coverage options.
  3. Should you enroll in Part D? While you should make sure you enroll in Part D prescription drug coverage when you become Medicare-eligible (assuming you do not have other creditable drug coverage), there are many Part D options for you to explore. Keep in mind, too, that sometimes retiree insurance offers prescription drug coverage that is as good as or better than Medicare Part D. If that is the case, you might decide not to take Part D because you are already covered. Finally, if you have difficulty affording your drug costs, you may want to consider applying for programs that can help pay these costs.
  4. Are you eligible for programs that help lower Medicare costs? There are several programs for people with low incomes that help pay for Medicare-related costs, such as premiums and copays. Some of these programs are federal while others are state-specific. Find out whether you meet the eligibility requirements and take full advantage.
  5. What resources exist to help you navigate Medicare? Medicare is a complex and beneficial program, and a variety of trusted sources can help you navigate your rights and options. A few are listed here:

What is Medicare

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