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4 Tips To Getting Medicare Supplement Insurance In Cape Coral, Florida


Are you in need of Medicare supplement plan or Medicare Advantage plan coverage?  Do you live in the Cape Coral, Florida Region?  Well congratulations.  You found the perfect spot for acquiring a Medicare Supplement, or Medicare Advantage health plan - Newplanoptions.com.

Let's go over the basics of Medicare supplement coverage, as well as 4 important tips to acquiring a good Medicare supplement or Advantage plan in Cape Coral, Florida.

Before we leap to the task at hand, Let's quickly touch upon what Medicare Supplement and Medicare Advantage coverage is.   Simply put, these coverages are additional insurance to cover costs for portions of services that are not covered by Medicare.  In other words, these plans are designed to help pay medical costs that are not included in your original Medicare plan.

What does this mean for you?   Basically, it means that Medigap coverage can help bear medical costs in the following areas: insurance deductibles, copayments, coinsurance, and more.

It's important to know that while Medicare insurance is provided by the government, Medicare supplement plans are offered through private companies.   Keep in mind that Medicare Supplement plans are not the same as Medicare Advantage Plans.  While these two plans acheive the same goal, their benefit design is completely different.

Medicare is a federal health insurance program that pays for all manner of health care costs.  Normally, you become eligible for Medicare after you reach 65 years of age.   There are exceptions, however.

Medicare is available for people under 65 who are affected by certain serious disabilities.   These individuals must have received Social Security Disability benefits for 24 months, or have End Stage Renal Disease (ESRD) or Amyotropic Lateral Sclerosis (Lou Gehrig's disease).

Medicare is administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S.  Department of Health & Human Services (HHS).  Similar to Social Security, Medicare is an entitlement program.  Most U.S. citizens earn the right to enroll in Medicare by working and paying their taxes for a minimum required period.  Even if you didn't work long enough to be entitled to Medicare benefits, you may still be eligible to enroll, but you might have to pay more.

Cape Coral Hospital Cape Coral, FL health insurance
Cape Coral Hospital
636 Del Prado Blvd S
Cape Coral, FL 33990
Telephone: (239) 424-2000
Plus Code: J3R5+22 Cape Coral, Florida


Breaking Down Medicare Parts

There are four different parts to the Medicare program.  Parts A and B are often referred to as Original Medicare.  Medicare Part C, or Medicare Advantage, is private health insurance, while Medicare Part D provides for prescription drugs.
  • Part A provides inpatient/hospital coverage. 
  • Part B provides outpatient/medical coverage. 
  • Part C offers an alternate way to receive your Medicare benefits (see below for more information). 
  • Part D provides prescription drug coverage. 

Good to know:  Many plans don't provide drug benefits, or discounts, even on generics, until you reach your deductible, which is often in the thousands of dollars.  Instead of just accepting your insurance plan's lousy prescription drug benefit, try using websites such as Blinkhealth.com or Goodrx.com to shop around for the best price for your medication in your area.


Most beneficiaries choose to receive their Parts A and B benefits through Original Medicare, the traditional fee-for-service program offered directly through the federal government.  It is sometimes called Traditional Medicare or Fee-for-Service (FFS) Medicare.  Under Original Medicare, the government pays directly for the health care services you receive.  You can see any doctor and hospital that takes Medicare (and most do) anywhere in the country.

In Original Medicare:
You go directly to the doctor or hospital when you need care.  You do not need to get prior permission/authorization from Medicare or your primary care doctor.
You are responsible for a monthly premium for Part B.  Some also pay a premium for Part A.
You typically pay a coinsurance for each service you receive.
There are limits on the amounts that doctors and hospitals can charge for your care.
If you want prescription drug coverage with Original Medicare, in most cases you will need to actively choose and join a stand-alone Medicare private drug plan (PDP).

Who is eligible. 
To be eligible for a Medigap plan in Cape Coral, you must meet certain requirements.   For starters, you must be enrolled in Part A and Part B of Medicare.   If you are not enrolled, you will not be able to buy a supplement or advantage plan.
You qualify for full Medicare benefits at age 65 or older if:
You are a U. S.  citizen or a permanent legal resident who has lived in the United States for at least five years; and
You or your significant other has  been employed long enough to be eligible for Social Security Normally this means having earned 40 credits from about 10 years of work.

Or,

You or your spouse is a government employee who while has not paid into Social Security, has paid Medicare payroll taxes while working.  Note: If you have met the 40 credits threshold, you will not have to pay premiums for Part A benefits You do not need any work credits to qualify for Part B (mainly doctors' services and outpatient care) or for Part D (prescription drug coverage).   If you have not met the 40 credits threshold, it is possible to pay for the part A segment of Medicare insurance.  You can also qualify for premium-free Part A benefits off of your spouse's employment record if he or she is at least age 62 and you are at least age 65.   Due to the a recent Supreme Court ruling, people in same-sex marriages can  also qualify for Medicare on their spouse's work record You qualify for full Medicare benefits under age 65 if:  You have been entitled to Social Security disability benefits for at least 24 months.  Or, You have Lou Gehrig's disease (amyotrophic lateral sclerosis), which qualifies you immediately.

Or,

You have permanent kidney failure requiring regular dialysis or a kidney transplant — and you or your spouse has paid Social Security taxes for a certain length of time, depending on your age.  Now, lets review our tips.

Interesting Fact:  One of the factors contributing to high health insurance costs in the U.S. is fraud.  Fraud costs the medical and health insurance industry as much as $200 billion a year.  This includes abuse of prescription painkillers.  The U.S. Center for Disease Control estimates that 12 million adults used prescription drugs for nonmedical reasons in 2010.  Of these, there were 170,000 seniors who "doctor shopped," getting prescriptions from at least five doctors for controlled substances.


Tip #1.  Start searching immediately. 
When it comes to Medicare supplement, or Medicare Advantage coverage, (sometimes referred to as Medigap Plans), the sooner you can begin researching your options, the better.   The first thing you will want to do is to make certain that you are eligible to purchase a Medicare Supplement, or Medicare Advantage Plan.   To be eligible, you will need to be enrolled in both Part A, and Part B of Medicare.   If you are eligible, there is an initial enrollment period of seven months.   This enrollment period begins three months before your 65th birthday.   This is the time to get your Medicare Supplement or Advantage plan policy in place.   If you miss this deadline, you can still enroll, however, enrollment headaches, and even premium amounts can rise significantly.

Tip #2.  Review plan options. 
In Cape Coral, there are 10 general Medicare Supplement plan types to choose from.   These plans are designated by letters of the alphabet (A-N).   Each option provides coverage for a distinct level of medical fees that are not covered by Medicare.   Please review the different Medicare plan types and their associated benefits below.   If you have questions, be sure to call.
 

Medicare Supplement Plan Comparison

Benefits Medicare Supplement Plans
  A B C D F* G K L M N
                     
Medicare Part A Deductible No 100% 100% 100% 100% 100% 50% 75% 50% 100%
Medicare Part B Deductible No No 100% No 100% No No No No No
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%**
First three pints of blood 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part A hospice coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled Nursing Facility (SNF) coinsurance No No 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part B Excess Charges No No No No 100% 100% No No No No
Foreign Travel Emergency (Up to Plan Limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-Pocket Limit*** None None None None None None $5,240 $2,620 None None

*Plan F is also has a high-deductible option.  The F high deductible plan pays for all Medicare-covered expenses after you meet a $2240 annual deductible.
**Office copay exceptions: Some office visits may require a copayment of up to $20.  Emergency room visits may require a copayment of up to $50.
***Plan pays 100% of covered Medicare costs for the remainder of the calendar year once the out-of-Pocket limit is reached.

Good to know:  Tell the Truth on your application: Did you know that in some circumstances, health plan companies are not legally obligated to honor your policy and pay claims if you knowingly misrepresented the truth on your application?  Getting your application accepted, or getting a cheaper premium, is not worth the risk of the company canceling your policy because you misrepresented the truth.



Tip# 3.  Know your budget. 
When you purchase any insurance plan you have to thoroughly review costs.   The costs now, and the costs in the foreseeable future.
First you need to consider the monthly premium of the Medicare Supplement plan you are choosing.   It will have to fit into your budget not just for now, but realistically, for the rest of your life.   Do not buy a plan that pushes you to the ceiling of what you can afford.   You need to expect and make room for modest premium increases as you grow older.   Two factors that affect premiums, are increases in inflation, and increases in health care costs.   As the overall cost of health care rises, the insurance to cover the costs will also rise.  It's not possible to know the exact premium increase amount to expect as time goes by.   However, over the last several years, Medicare supplement premiums have risen at a rate of approximately 4.1 percent.   This percentage should be a reasonable guideline by which to gauge your plan choice in relation to your long-term budget.

Secondly, you will need to understand the cost that could incur should you become ill.   The key item here, is the plan deductible.   Second to that, is the percentage of the medical bill that you are responsible for before you reach your maximum-out-of-pocket amount.   Take these two items into consideration when deciding upon a plan.

Tip #4.  Speak to a Medicare insurance plan specialist. 
Contacting a Medicare Supplement Plan specialist is usually the best way to find out about the plan options that are available to you.   Newplanoptions. com a brokerage that has extensive experience concerning all things Medicare.   We are licensed with all the major insurance carriers that offer Medicare plans in Cape Coral, Florida.   Insurance carriers we work with include: Blue Cross Blue Shield, Cigna, Humana, Mutual of Omaha, AARP, and more. 



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5 Important Steps For Getting Health Insurance In Florida.
Find Affordable Health Insurance in Cape Coral, Florida
The First 3 Steps in Acquiring Medicare Supplement Insurance Coverage in Florida
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