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Equity Health & Life Insurance Solutions
Understanding Medicare Plans
Contact one of our agents to explore Medicare Insurance solutions and determine which plan is best for you. A comprehensive review of your needs can minimize your costs and maximize your coverage.
What's Medicare?
Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have End-Stage Renal Disease (ESRD).
You can receive health coverage directly through the Federal Government (Original Medicare) or through a private company (Medicare Advantage).
Original Medicare is generally a fee-for-service health insurance program. This program is offered through the Federal Government, which pays providers for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare.
While many people with Medicare get their health coverage from Original Medicare, some choose to get their benefits from a Medicare Advantage Plan, also known as a Medicare private health plan or Part C.
If you are enrolled in an Medicare Advantage Plan, you generally receive the same benefits offered by Original Medicare.
Your Medicare health plan decisions affect how much you pay for coverage, what services you get, what doctors you can use, and your quality of care.
When you first sign up for Medicare and during certain times of the year, you can choose how you get your Medicare coverage.
The Advantages of Using EHLI-S
You will experience many advantages when working with EHLI-S. Once you select an experienced agent for your personal Medicare coverage guidance, you will be provided with the following services:
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Analyze specific health insurance needs during in-person consultations with an experienced agent.
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An agent will provide a detailed definition of benefits associated with each Medicare plan.
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Determine eligibility.
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Perform a comprehensive review of your current needs to find plan coverage that will minimize individual out-of-pocket costs.
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Identify specific Medicare plans that will facilitate desired physicians and hospitals.
What are the parts of Medicare?
Different parts of Medicare help cover specific services:
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Medicare Part A (Hospital)
(Covers Inpatient Hospital Stays, care in a skilled nursing facility, hospice care, and some home health care).
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Medicare Part B (Medical)
(Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
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Medicare Part D (prescription drug coverage)
Helps cover the cost of prescription drugs.
Medicare Original Plans
Original Medicare is coverage managed by the federal government. Generally, there's a cost for each service.
Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Generally, after you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (coinsurance).
Generally, you pay a monthly premium for Part B. This premium may change each year.
If you want Medicare drug coverage (Part D), you can join a separate Medicare drug plan.
In most cases, you don't need a referral to see a specialist.
In most cases, you can use any doctor or hospital that takes Medicare, anywhere in the U.S. To help pay your out-of-pocket costs in Original Medicare (like coinsurance), you may buy supplemental coverage. This includes Medicare Supplemental Insurance (Medigap).
Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. Original Medicare doesn’t cover some benefits like vision, dental services, and hearing.
A Medicare Supplement Insurance (Medigap) Policy can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Some Medigap policies also cover services that Original Medicare doesn't cover. One example could be emergency medical care when you travel outside the U.S.
Medicare Advantage
Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans generally include Part A, Part B, and possibly Part D.
In many cases, for non-emergency care you’ll need to use doctors and other providers in the plan’s network.
To see a specialist, you may need to get a referral.
Plans may have lower out-of-pocket costs than Original Medicare.
Plans may offer some extra benefits that Original Medicare doesn’t cover.
