Tim Vendt
Financial Security
"Securing Your Future" 

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Medicare

The information provided here is meant to give you a basic understanding of Medicare.  The Information is not all-inclusive.  Some of the information contained hear only pertains to Missouri and Arkansas residents.

Medicare is a federal health insurance program for people age 65 and older, certain disabled Social Security and Railroad Retirement beneficiaries who are under 65, and people of any age with end-stage renal disease (kidney failure requiring dialysis or transplant).

Medicare has four primary parts.  They are “Part A”, “Part B”, “Part C”, and “Part D”

Part A:  Medicare Part A is designed to help with costs associated with confinement in a hospital or skilled nursing facility, as well as, hospice care, and some home-health care if you meet certain conditions.  Most (not all) Medicare beneficiaries receive Part A benefits without ongoing cost.

Part B:  Medicare Part B is designed to help with costs associated with physician’s services, outpatient care, durable medical equipment, some home-health care, physical and occupational therapists, clinical laboratory services, some preventive services, and other medical services not covered under Part A.  Part B requires an ongoing premium to be paid by Medicare beneficiaries.  Enrolling in Part B is your choice.  If you wait to enroll in Part B there can be consequences.  The cost of Part B may be more if you could have had Part B, but did not sign up for it. If that happens to you, you will have to pay the extra cost for the rest of your life.
 
(Note:  Part A and Part B are often times referred to as “Original Medicare”.)

Part C:  Medicare Part C, also know as “Medicare Advantage”, are plans offered by private insurance companies as an alternative to Original Medicare (Part A & Part B).  In another words with Medicare Advantage plans private insurance companies provide the benefits instead of Medicare.  However, Medicare Advantage plans are government subsidized and regulated.  I am not a fan of Medicare Advantage.  While I can see the Advantages for insurance companies, agents, and maybe someday our government… I simply do not see enough “Advantages” for Medicare beneficiaries.  Instead I worry that beneficiaries won’t have the necessary coverage when they need it the most.  Enrollment in a Medicare Advantage plan is optional and can only be done during certain “election periods”.  Once enrolled you will be “locked in” to the plan for a period of time, unless you meet one of the exceptions.  Medicare beneficiaries who choose this type of coverage still must pay their Part B premium.

Part D:  Medicare Part D is Prescription Drug Plans (PDP) provided by private insurance companies.  These plans are government subsidized and regulated.  Medicare beneficiaries pay an ongoing premium to have one of these plans.  Enrolling in Part D is optional and can only be done during certain “election periods”.  If you wait or hold-off on enrolling in Part D there can be consequences.  If a Medicare beneficiary does not sign up for a Part D plan when they first become eligible, and they do not have other “creditable coverage”, then later decide to enroll in a plan they could have to pay a life-long penalty that will stay with them as long as they have a Part D plan.

Medicare Supplement/Medigap policies:  Original Medicare was designed with “holes” or “gaps” in it.  So many people choose to supplement Part A and Part B with a Medicare Supplement policy provided by a private insurance company.  Medicare Supplement policies are available in “Standardized Plans.  It is important to understand that a “Standardized Plan” is just that… for example a “Plan F” with one company has exactly the same benefits as a “Plan F” with another company.  The only difference is how much you have to pay for it. 

Arkansas has a Medicare Supplement pricing requirement that can be beneficial for some residents.  In Arkansas Medicare Supplement policies are priced by a method Know as "Community Rated".  This means insurance companies have to price their policies based on geographic location and cannot base pricing on age or gender.

Open Enrollment &/or Guaranteed Issue:  With regard to Medicare Supplement policies the terms “Open Enrollment” and “Guaranteed Issue” describe when you have the right to purchase a policy without having to provide any medical information to the insurance company.  There are several circumstances that can create these “Guaranteed Issue” opportunities.  That said… being new to Medicare or loosing coverage through no fault of your own will usually create a “Guaranteed Issue” opportunity.  Outside of these Open Enrollment” and “Guaranteed Issue” opportunities Medicare Supplement polices are medically underwritten.

Missouri residents have a rather unique “Open Enrollment”/ “Guaranteed Issue” opportunity when it comes to Medicare Supplement policies.  It works like this...  Once a Missouri Medicare beneficiary has one of the standardized Medicare Supplement policies in place, each year based on the original issue date of their current policy the beneficiary can switch from a like plan to a like plan (example: “Plan F” to “Plan F”) without having to answer any medical questions.  The window for this opportunity lasts from 30 days before the issue date of the beneficiary’s current policy until 30 days after that issue date.  By using this provision when a Missouri Medicare beneficiary gets a price increase from their insurance company they may be able to find the same plan at a lower price, and not have to worry about being medically underwritten to make the switch.

Medicare missteps:  There are some areas in which Medicare may let you down.  For instance Medicare only covers medically necessary procedures.  Medicare does not cover elective procedures.  While on a limited basis Medicare provides some coverage for “skilled” nursing care, Medicare does little for intermediate care or custodial care, the types of nursing care most patients receive.  Amongst other items, many dental, hearing, and vision procedures are not covered by Medicare. 

Tim’s Recommendation:  Once eligible for Medicare I believe the best course of action for most people (those that do not have employer continuation coverage) is a combination of Original Medicare (Part A & Part B), a Medicare Supplement policy (Standardized Plans), and a Part D Prescription Drug Plan.

Remember, the information I am providing on this website is designed to help you understand the basics, not answer every possible question.

To best serve my clientele I am constantly searching for the most competitive Medicare Supplement policies in Missouri and Arkansas.  For Part D coverage, rather than favoring one plan over another, I prefer to use a tool on the official Medicare website to figure out which plan is best for a particular individual.  If you live in Missouri or Arkansas and would like a Medicare Supplement quote, need more information, or would just like to understand your options, just fill out the "I Want Information About Medicare" form, call, or email me.

Important Money Saving Note

To figure out which company has the best priced Medicare Supplement plan for you I have created a pricing tool.  After entering some basic information, the tool will instantly show me which company has the best deal for your situation.   In other words, we do the shopping for you to save you time and money.


I Want Information
About Medicare

Enter your contact information and indicate what you are looking for. Tim Vendt will contact you as soon as possible. If you want to reach Tim right away, you can call him at the office: (417)732-4306, toll free (866)465-7317, or on his cell (417)839-7193.

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Note:  To select more than one "Plan" hold down the Ctrl key while clicking on the plans.
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If you are new to Medicare or would just like to know more… a couple of great sources of information are the following government publications or the governments official Medicare website.

Medicare and You

Choosing A Medigap Policy:  A Guide to Health Insurance for people with Medicare

Official Medicare Website

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