Maximize Your Medicare Benefits

Welcome to Medicare Coverage Pro, LLC. If you are approaching 65, you may have received pamphlets in the mail from many different insurance carriers and Medicare, which can be very overwhelming to say the least. Our mission is to simplify the Medicare process and put it in terms you can understand. Providing superior customer service and thoroughly supporting your healthcare insurance needs is of the utmost importance to us.

This website is designed to provide you with information to help you sort through the Medicare maze. We offer ONE-ON-ONE consultations to help you decipher all of the Medicare jargon and find the plan that best suits your specific needs.

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CALL NOW (770-514-0589) for your complimentary ONE-ON-ONE consultation and let us customize a plan for you TODAY!

What is Medicare

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

The different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Part C (Medicare Advantage Plans)
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Part D (Prescription Drug Coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Let us customize a plan for you. Call us today (770-514-0589) for a ONE-ON-ONE consultation.

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What Are My Choices

On Medicare, you basically have two options:

Option One – Medicare Supplement Plan

  • Stay on Original Medicare and purchase a Medicare Supplement Plan as well as a stand alone Prescription Drug Plan (Part D). The most comprehensive Medicare supplemental coverage this year is the “Plan F”.

  • Medicare Supplement Plans usually run approximately $165 and Part D usually runs $30-$45 a month.  These are amounts in addition to your monthly Part B premium which is $104.90 (2014).  Once you pay the afore-mentioned monthly supplement premium, you don’t pay anymore out of pocket for medical services.

  • This option allows you to go to any Medicare doctor.

  • You would, however, continue to pay the co-payment for the medications you take; the amount depends on whether they are generic, brand, non-preferred brand, etc. If you reach the Medicare doughnut hole, your out of pocket expenses will increase. Either way, the generic drugs are always the most cost effective way to go.

Option Two – Medicare Advantage Plan

  • Enroll in a Medicare Advantage Plan, which is usually a $0 monthly premium in addition to your Part B premium depending on the county/state you reside in. You must have both Parts A and B to qualify to enroll in one of these plans.

  • Medicare Advantage plans are all-in-one plans that include prescription drug coverage and other non-Medicare covered benefits such as vision, preventative dental, fitness club membership, etc. 

  • This option usually works within a network of doctors.

  • Medicare Advantage Plans are run by private insurance companies and are governed by Medicare.  The government pays them a set amount of money every month to cover your entire healthcare costs whether you use the plan or not.  Getting this money from the government, they are able to offer coverage to you at a $0 monthly premium. 

  • In turn, you pay co-payments and/or co-insurance similar to your group/employer insurance, i.e., $15 at a primary care doctor, etc. 

  • Additionally, there is a limit on the amount out of pocket expense you would pay in a worse case scenario, i.e., if you run medical bills up to $100,000 or more, the maximum out of pocket you could pay may be between $3400- $6700, depending on the insurance company and plan you select.

Let us customize a plan for you. Call us today (770-514-0589) for a ONE-ON-ONE consultation.

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Medicare Advantage Plan

A Medicare Advantage Plan (sometimes called “Part C”) is a type of Medicare health plan offered by private insurance companies who contract with Medicare. Medicare Advantage Plans must include Part A (Hospital Insurance) and Part B (Medical Insurance) covered by Original Medicare.  Oftentimes, they provide additional benefits such as vision or dental care, hearing aids, eyeglasses, and much more. If you join a Medicare Advantage Plan, you are still in the Medicare program. Most Medicare Advantage Plans offer prescription drug coverage.

Who Can Join a Medicare Advantage Plan?

You can generally join if you meet all of the following conditions:

  • You live in the service area of the plan you want to join. The plan can give you more information about its service area. If you live in another state for part of the year, check to see if the plan will cover you there.

  • You have Medicare Part A and Part B.

  • You don’t have End-Stage Renal Disease (ESRD).

Drug Coverage in Medicare Advantage Plans

You usually get prescription drug coverage (Part D) through the plan. In some types of plans that don’t offer drug coverage, you can join a Medicare Prescription Drug Plan.

You can’t have prescription drug coverage through both a Medicare Advantage Plan and a Medicare Prescription Drug Plan. If you’re in a Medicare Advantage Plan that includes drug coverage and you join a Medicare Prescription Drug Plan, you’ll be dis-enrolled from your Medicare Advantage Plan and returned to Original Medicare.

Let us customize a plan for you. Call us today (770-514-0589) for a ONE-ON-ONE consultation.

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Medicare Supplement Plan

A Medicare Supplement Plan (also known as Medigap) is different from a Medicare Advantage Plan. A Medicare Supplement Plan supplements your Original Medicare benefits. It can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles.

7 Things You Need to Know About Medicare Supplement Plans

  1. You must have Medicare Part A and Part B.

  2. If you have a Medicare Advantage Plan, you can apply for a Medicare Supplement Plan, but make sure you can leave the Medicare Advantage Plan before your Medicare Supplement Plan begins.

  3. You pay the private insurance company a monthly premium for your Medicare Supplement Plan in addition to the monthly Part B premium that you pay to Medicare.

  4. A Medicare Supplement Plan only covers one person. If you and your spouse both want Medicare Supplement Plan coverage, you’ll each have to buy separate policies.

  5. Any standardized Medicare Supplement Plan is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medicare Supplement Plan as long as you pay the premium.

  6. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).

  7. Medicare Supplement Plans don’t cover everything. They don’t cover long term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

Let us customize a plan for you. Call us today (770-514-0589) for a ONE-ON-ONE consultation.

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Medicare Prescription Drug

A Medicare Prescription Drug Plan (Part D) adds drug coverage to Original Medicare. Medicare Advantage Plans may also offer Part D. Each plan can vary in cost and drugs covered.

Let us customize a plan for you. Call us today (770-514-0589) for a ONE-ON-ONE consultation.

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