Welcome to Your Medvocate Quick Start Guide

Navigating Medicare can seem overwhelming, but don’t worry—we’re here to make it easy for you. Whether you're new to Medicare or looking to understand your current coverage better, this simple guide will break down the essentials of Medicare Parts A, B, C, and D. Let's dive in!

Medicare Part A: Your Hospital Insurance

What It Covers: Medicare Part A is all about covering the big-ticket items like:

• Inpatient hospital stays

• Skilled nursing facility care

• Hospice care

• Some home health care

Costs Involved: Most people don’t pay a monthly premium for Part A if they’ve paid Medicare taxes for a certain amount of time. However, there are costs when you use these services, like deductibles and coinsurance. For example, in 2024, the deductible for each benefit period is $1,632.

Why It’s Important: Part A helps cover the major expenses that can come with serious illnesses or hospital stays. It's a crucial part of your healthcare coverage.

Medicare Part B: Your Medical Insurance

What It Covers: Part B covers two types of services:

• Medically necessary services: like doctor visits, outpatient care, and durable medical equipment

• Preventive services: like flu shots, screenings, and annual wellness visits

Costs Involved: In 2025, the standard premium for Part B is projected to be approximately $185 per month, but it could be higher based on your income. In 2025, the Medicare Part B annual deductible is projected to be $250, after which you typically pay 20% of the Medicare-approved amount for most services.

Why It’s Important: Part B is essential for covering the day-to-day medical services and preventive care that keep you healthy.

Medicare Part C: Medicare Advantage Plans

What It Covers: Medicare Advantage Plans (Part C) are offered by private insurance companies and include all the benefits of Part A and Part B plus may also offer additional health and wellness benefits as well.

Costs Involved: Costs vary depending on the plan and provider. You still pay the Part B premium, and there might be additional premiums, copayments, and coinsurance.

Why It’s Important: Medicare Advantage Plans can be a great way to get extra benefits and bundled coverage. It’s important to compare different plans to find the one that fits your needs best.

Medicare Part D: Prescription Drug Coverage

What It Covers: Part D helps cover the cost of prescription drugs. Each plan has a list of covered drugs (formulary) and can vary in terms of what’s included.

Costs Involved: Part D costs vary by plan. In 2025, the average monthly premium for Medicare Part D is projected to be approximately $34.70.  There are also costs like copayments, coinsurance, and possibly a coverage gap (donut hole), but recent changes have reduced this gap significantly.

Why It’s Important: If you take prescription medications, Part D is crucial for helping manage those costs.

Conclusion

Understanding Medicare can seem complex, but with the right information, you can make confident decisions about your healthcare. Whether you’re just starting with Medicare or looking to optimize your current coverage, we’re committed to helping you find the best options to meet your needs.

Stay informed, stay healthy, and never hesitate to reach out with any questions. Here’s to navigating Medicare together!

Choosing the Right Combination

Now that you know what each part covers, how do you choose the right combination? Here are some tips:

1. Assess Your Healthcare Needs

• Consider your current health, doctors, and medications.

• Think about what services you use most frequently.

2. Consider Your Budget

• Look at the total costs, including premiums, deductibles, and out-of-pocket expenses.

• Balance between what you can afford monthly and potential high costs in the event of major health issues.

3. Plan

• While you might be healthy now, it’s wise to plan for future healthcare needs.

• Consider options like Medicare Advantage for extra benefits or Medigap for additional coverage.

4. Use Available Resources

• Utilize tools like the Medicare Plan Finder on the official Medicare website.

• Don’t hesitate to ask questions and seek advice from professionals.

Navigating Medicare can be complex, especially when it comes to managing out-of-pocket costs. One great way to enhance your Medicare coverage and reduce your healthcare expenses is through Medigap, also known as Medicare Supplement Insurance. In this blog, we’ll break down what Medigap plans are, how they work with Original Medicare, and provide tips for choosing the best plan to meet your needs. Let’s get started!

What is Medigap?

Medigap, or Medicare Supplement Insurance, is a type of health insurance policy sold by private insurance companies. It’s designed to cover some of the costs that Original Medicare (Part A and Part B) doesn’t cover, such as copayments, coinsurance, and deductibles. There are 10 standardized Medigap plans available in most states, labeled Plan A through Plan N, each offering a different combination of benefits.

How Does Medigap Work with Original Medicare?

When you have Original Medicare and a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered healthcare costs first. Then, your Medigap policy pays its share. Here’s how it works:

1. Medicare Part A (Hospital Insurance)

1. • Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.

   • Medigap helps cover the Part A deductible and coinsurance.

2. Medicare Part B (Medical Insurance)

1. • Covers certain doctors' services, outpatient care, medical supplies, and preventive services.

   • Depending on your plan, Medigap may help cover the Part B deductible, coinsurance, and excess charges.

Benefits of Medigap Plans

Standardized Coverage: Each Medigap plan of the same letter offers the same benefits, regardless of which insurance company sells it. This makes comparing plans easier.

Predictable Costs: Medigap plans help manage and predict your out-of-pocket costs, making your healthcare expenses more predictable.

Nationwide Acceptance: Medigap plans are accepted by any healthcare provider that accepts Medicare, giving you broad access to medical care.

What is the Annual Enrollment Period (AEP)?

The Annual Enrollment Period runs from October 15 to December 7 each year. During this time, you can:

• Enroll in a Medicare Advantage Plan (Part C)

• Switch from one Medicare Advantage Plan to another

• Drop your Medicare Advantage Plan and return to Original Medicare (Part A and Part B)

• Enroll in a Medicare Prescription Drug Plan (Part D)

• Switch from one Part D plan to another

• Drop your Part D coverage

Why is AEP Important?

AEP is your opportunity to review and adjust your Medicare coverage based on your current health needs, budget, and any changes in plan offerings. Making informed decisions during this period can help you save money and ensure you have the coverage that best suits your needs.

Medicare offers a variety of benefits designed to keep you healthy and ensure you receive the care you need. Whether you're new to Medicare or have been enrolled for years, it’s essential to know how to make the most of these benefits. Let’s explore some tips and strategies to help you maximize your Medicare coverage, including preventive services, wellness visits, and other covered services.

Take Advantage of Preventive Services

Medicare covers many preventive services to help you stay healthy and detect any health issues early. These services are often provided at no additional cost to you. Some key preventive services include:

• Annual Wellness Visit: This visit is designed to create or update a personalized prevention plan based on your current health and risk factors. It’s a great opportunity to discuss any health concerns with your doctor and set health goals for the year.

• Screenings and Vaccinations: Medicare covers screenings for various conditions such as cardiovascular disease, cancer, diabetes, and osteoporosis. Additionally, vaccinations like the flu shot, pneumococcal shot, and hepatitis B shot are also covered.

Regular Check-Ups and Wellness Visits

Medicare provides coverage for regular check-ups and wellness visits, which are vital for maintaining good health. Here’s what you need to know:

• Welcome to Medicare Visit: If you’re new to Medicare, you can schedule a “Welcome to Medicare” preventive visit within the first 12 months of enrolling. This visit includes a review of your medical history and a discussion of preventive services.

• Annual Wellness Visit: After your first year, you can schedule an annual wellness visit. This visit focuses on developing or updating a personalized prevention plan to keep you healthy.

Utilize Telehealth Services

Medicare has expanded coverage for telehealth services, especially in response to the COVID-19 pandemic. Telehealth allows you to consult with healthcare providers from the comfort of your home. This can be particularly useful for routine check-ups, follow-up visits, and managing chronic conditions.

Manage Chronic Conditions

If you have a chronic condition, Medicare offers programs to help you manage your health effectively:

• Chronic Care Management (CCM): This program provides coordinated care for those with multiple chronic conditions. It includes regular check-ins and personalized care plans to manage your health.

• Disease Management Programs: Medicare Advantage Plans often offer disease management programs tailored to specific conditions like diabetes, heart disease, and asthma.

Take Advantage of Additional Benefits with Medicare Advantage

Medicare Advantage Plans (Part C) may provide additional benefits beyond Original Medicare (Parts A and B).

Review Your Plan Annually

Medicare plans can change annually, and so can your health needs. It’s important to review your Medicare plan every year to ensure it still meets your needs. During the Annual Enrollment Period (October 15 to December 7), compare your current plan with other available options to see if there’s a plan that better suits your needs and budget.

Get Help from a Local and Licensed Health Insurance Agent

Navigating Medicare can be complex, but you don’t have to do it alone. A local and licensed health insurance Agent can provide personalized advice, help you understand your options, and ensure you’re getting the most out of your Medicare benefits. Don’t hesitate to reach out for assistance.