It’s Complicated: Coordinating Medicare with Employer Health Plans, or Other Types of Insurance
At Medicare Central we partner with Medical Groups, Employers, HR Administrators, and Retirement professionals to provide educational seminars and enrollment services that are designed to educate and prepare individuals for the Medicare program. Our portfolio of customized lecture series deliver up to date, inclusive details that are intended to meet the unique criteria of most eligibility situations.
Our Educational Seminars:
- Do not steer, or attempt to steer consumers toward a specific plan or limited number of plans
- Provide non-biased information about the Medicare Program
Reaching age 65 is an important turning point for Baby Boomers, and the Medicare Program can be confusing.
As a proven and trusted insurance agency who has worked closely with Scripps Health over the past several years, we can offer an easy solution to the problem. Attend or Reserve a personalized educational seminar that is designed to answer all of your questions. Currently presenting in Rancho Bernardo, Chula Vista, La Jolla, Mission Valley, Encinitas and Vista.
We can assist you in scheduling your seminar at a Scripps Health facility in your community, your business location, or a venue of your choice.
There are multiple lecture series to choose from and you get to choose the right one, or reserve them all. We can also customize your seminars to answer the most frequently asked questions.
Don’t spend hours surfing the internet or making dozens of phone calls when you can access the support of a licensed, certified and experienced professional. Contact us for more details and to schedule your seminar.
Seminars are Available in English and Spanish.
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Our agents have expertise in providing specialized consultations to individuals for a wide variety of Medicare enrollment situations.
* Turning 65 in the next 12 months
* Planning your retirement benefits
* Recently moved in or out of a different county or state
* Recently moved into, reside in, or moved out of a Skilled Nursing Facility (SNF), Nursing Facility (NF)
* Have the desire to switch physician(s) or medical group and need guidance
* You would like a “My Medicare” consultation to learn more about Part A, Part B, and Part C of Medicare.
* Have delayed Part B, but will be ready to enroll in the next 12 months
* Would like to consult on plan options if you are dual eligible (Medicaid eligibility and Medicare eligibility)
* Need eligibility and application guidance on enrolling in state and federal assistance programs including Medicare Savings Programs (MSP aka Medicaid), Low Income Subsidy (LIS aka extra help), and Pharmaceutical Assistance Programs
* Would like to consider a lower cost or zero premium plan option
All of the available plan options are designed to help cover some of the expenses not paid by original Medicare and help limit your annual spending for medical care and prescription drugs.
Original Medicare alone has substantial deductibles and copayments, and you can easily spend thousands of dollars each year for out-of-pocket medical expenses.
IDEAL CANDIDATE FOR A MEDICARE HEALTH PLAN
- Needs more benefits beyond what Original Medicare covers
- Wants more predictable costs than those offered by Original Medicare alone
- Wants both medical and prescription drug coverage
Finding a Medicare Plan that Meets Your Needs
We offer professional guidance to help you choose your best fit plan based on your service area, your preferred providers, your current medical needs and budget considerations.
During your consultation we will present options from an array of quality Medicare Advantage Plans, Medicare Supplement Insurance, and Part D Prescription Drug plans specially designed for Medicare-eligible persons.
Medicare Coverage Options
A Medicare Advantage Plan (like an HMO or PPO), sometimes called “Part C” or an “MA Plan” are offered by Medicare-approved private insurance companies that must follow the rules set by Medicare. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. You’ll generally get your services from a plan’s network of providers.
- Convenience of single plan
- Some include prescription drug coverage for no additional premium
- Some offer additional benefits not covered by Medicare (e.g., preventive care, vision, hearing aids, or transportation)
- If eligible for Medicare, you cannot be denied coverage (special rules apply to ESRD)
- If there is a premium, it is not affected by your age or health status
- In most plans, you receive your coverage in a service area - unless it's an emergency
- Your access to doctors and hospitals may be limited to a specified network of local providers
- Plan premiums and terms can change from year to year
There are limited time periods for enrollment or plan changes
Part D Stand Alone Prescription Drug Plan
Medicare Part D Prescription Drug Plans provide insurance coverage for your prescription drugs. Your Medicare prescription drug coverage can be provided by a "stand-alone" Medicare Part D plan (only prescription coverage) or a Medicare Advantage plan that includes prescription coverage (an MA-PD) that includes Medicare health and prescription drug coverage. If you join a Medicare Part D prescription drug plan, you will pay a monthly premium.
This is insurance coverage for both brand-name and generic prescription drugs at participating pharmacies in your area. It provides protection for people who have very high drug costs or unexpected changes in your drug needs.
Each Medicare Prescription Drug Plan has its own list of covered drugs called a formulary. Drug formularies can vary greatly from one prescription drug plan to the next, so it is key to ensure that your medications are covered by your chosen Medicare prescription drug plan before you enroll.
Medicare Supplement Insurance
A Medigap policy is health insurance sold by private insurance companies to fill the "gaps" in Original Medicare coverage. Medigap policies pay secondary to Original Medicare and help pay your share (coinsurance, copayments, or deductibles) of the costs of Medicare-covered services. Policies are “standardized” in most states by letters A through D, F through G, and K through N.
All policies offer the same basic benefits, but some offer additional benefits. The best time to buy a Medigap policy is during your Medigap “Open Enrollment Period”. This 6-month period begins on the first day of the month in which you’re 65 or older and enrolled in Part B. (Some states have additional Open Enrollment Periods.)
* Enjoy lower or zero co-pays and deductibles for Medicare A & B covered medical expenses
* You are guaranteed the right to buy a Medigap plan during your open enrollment period
* You can pick from various different policy options to get one that suits your needs best
* A standardized policy is guaranteed renewable, even if you have health problems
* Choose any doctor or hospital that accepts Medicare patients
* Plan premiums can change from year to year
* Older beneficiaries pay higher premiums because plans are age- rated and can go up every year. Premiums may also go up because of inflation and other factors.
* You must purchase a separate Medicare Part D prescription drug plan if you decide you would like to add drug coverage
* After your open enrollment period, insurers can refuse coverage or charge you a higher premium based on your health, or make you wait to get coverage for an illness you already have
Meet with one of our Medicare experts to find a plan that meets your needs
Contact us for a Personalized Medicare Consultation, a 1:1 Medicare Enrollment, or to schedule a Medicare Central Educational Seminar.