FAQs Medicare

Q: What is the difference between Original Medicare and Medicare Advantage Plans?

A: Medicare Advantage plans are insurance plans offered by private companies who have contracted with Medicare to provide your healthcare benefits.  Most of these plans will cover your Part A premiums and have a very low monthly premium. They are structured so that most preventative services are free and all other benefits are a co-pay.  Some even have prescription drug benefits. Original Medicare pays 80% and you pay 20% of your covered benefits plus you pay for your Part A & Part B premiums.

Q: Since I can contact the insurance companies myself or call the Center for Medicare & Medicaid to enroll, why would I contact you instead?

A: I have access to many different plans and together we can decide which one best fits your needs.  Insurance companies will only sell you their plans, not help you shop around.

Q: Do the benefits vary a lot by insurance provider versus original medicare?

A: The benefits do not vary much.  By law all plans are required to offer the same level of coverage as medicare.  Many times the private insurance companies will offer extra benefits that medicare doesn’t.

Q: Can I go to any doctor I want?

A: Most insurance carriers require you to select a primary care physician and stay within their network of contracted doctors.  If you choose to go outside that network your pay for most, if not all, of your care.  There are some plans that will allow you to go outside of the network and still over coverage but you will still pay a higher co-pay or co-insurance than staying within the network. Before enrolling in a plan be sure to double check the doctors in that plans network.