Medicare Explained
Because there is so much information about Medicare on the internet, I have kept mine to a minimum. My goal is to offer you the basics that highlight each of the plans. What I can do for you further is weed through the information you don't need and present to you the information you do need. We can do this over the phone, my office, your home, or thru emails. My goal is to make this as convenient for you as possible! I have over 30 years insurance experience and clients are always welcome in my office. There are Medicare opportunities through several companies. I know them all — and I’ll find the one that can serve your needs best! One phone call or email is all it takes to get your one stop shop on the case for you. —Kent Kyle
Medicare Advantage Plans
Medicare Advantage plans are health plan options approved by Medicare and offered by insurance companies. These plans are part of Medicare and are often called Part "C." When you enroll in a Medicare Advantage plan, you still have all the benefits included in original Medicare. You are not leaving Medicare, but as long as you are in a Medicare Advantage plan, your claims to a provider will be paid by that insurance company and not Medicare. You may return to original Medicare or switch Medicare Advantage plans only at certain times of the year.
Medicare Advantage plans have low or no additional premiums to enroll. However, you must still pay your Part B Medicare premium.
The reason most people find Medicare Advantage plans appealing is that your out-of-pocket medical costs may be lower than original Medicare. Some plans offer additional benefits such as dental, vision, hearing and gym memberships. Also, most plans include prescription drug coverage. Details of each plan are described in a summary of benefits that Kent will provide to you.
To be eligible to enroll in a Medicare Advantage plan you must have Parts A and B of Medicare, live in a county served by that Advantage plan and not have end stage renal disease — that is the only health question that can be asked.
Kent is licensed to do business with several companies that offer Medicare Advantage and Prescription Drug plans. Please either email or call Kent at the number below. He can answer your questions. For a face-to-face appointment, Medicare requires a signed "Scope of Sales Appointment." This form makes it clear between parties that only Medicare Advantage or Prescription Drug plans will be discussed at the appointment. Kent will mail you the document prior to your appointment with him.
Medicare Supplement Plans
These are the traditional insurance policies that people have used for years to supplement their Medicare insurance. There are several options to choose from and each plan is the same regardless of the insurance company you select. The main difference is the premium and, of course, the service from that company. Plans are issued on a guaranteed basis when you are first eligible for Medicare, and you may move from company to company at your annual renewal without health questions. Otherwise, if you enroll at a time other than these two mentioned, you will need to answer new health questions and may be turned down.
Most people also need to enroll in a prescription drug plan when they have a Medicare supplement.
Premiums vary based on type of plan, age, sex and area in which you live.
Kent is happy to provide you with premium quotes on these plans. Please call (417) 881-3880 or send him an email.
Prescription Drug Plans
You have many different prescription drug plans available to select. You can either enroll in a plan by itself or your drug coverage may be included with your Medicare Advantage plan. All plans will vary in drug coverage, co-pays and premium costs. Each plan will have a formulary that shows what drugs will be covered and at what co-pay. One area where the plans are the same is the amount covered and when the "donut hole" starts. This changes yearly. For plan year 2023, the coverage gap begins after the total yearly drug cost reaches $4,660. After you enter the coverage gap, you pay 25% of the plan's cost for both covered brand name drugs and generic drugs until your costs total $7,400, which is the end of the coverage gap. You then enter the catastrophic stage until the end of the year, where you pay around 5% of the plans cost of the drugs.
Please be aware that there could be a late enrollment penalty from Medicare if you don't enroll when you are first eligible.