Medicare

What is Medicare?

Medicare is the government sponsored health insurance coverage for people over 65. It also includes people who have social security disability for over two years as well as children and adults under 65 with disabilities.

What does it cover?

Medicare covers medically necessary health related procedures.

What are the two parts of Medicare?

  • Part A: Hospitalization: This is coverage for inpatient stays in a hospital. Part A has a deductible that applies to each stay in hospital, not an annual deductible. There are no monthly premiums for this coverage as long as you or your spouse is “vested” through the social security payments made while working.
  • Part B: Doctors and outpatient procedures. This is the part of Medicare that covers outpatient procedures, doctors’ visits, labs, ambulance and all procedures that are done in a day surgery. This coverage has a monthly premium that varies based on individual income. An individual is responsible for an annual deductible and approximately 20% coinsurance for Medicare approved charges.

What is Medicare Supplement or Medi-gap coverage?

This is an insurance policy purchased from a private insurance company to pay for the co-insurance and deductibles of traditional Medicare Parts A and B. We offer Medicare supplement policies from the most competitive and respected companies available in Washington state. (click here for a free quote)

What is Medicare Part D?

Medicare Part D is coverage for prescription drug costs. This coverage is offered by private insurance companies that are contracted through Medicare. There are many companies that offer programs in the state of Washington. These programs are specific to each individuals needs as they are based on the medications an individual takes on a regular maintenance basis. These programs have deductibles and copays and preferred pharmacies. It is imperative that clients understand how their Medicare Part D program works to get the best possible coverage. These programs are fluid and should be reviewed on an annual basis.

Part C or Medicare Advantage, What is it and how much does it cost?

Medicare Advantage or Part C is where a private insurance company provides benefits equal to or greater than traditional Medicare. A patient transfers their benefits from the federal government program (traditional Medicare) to a private insurance company. They do not lose their Medicare benefits, they are transferred and administered by a private insurance company. These programs usually include the Part D prescription drug coverage as well. The cost for these programs can be as little as a $0 per month, (meaning that the client pays only the part B premium, and the plans receives no extra premium) to as much as $200 per month on top of the Medicare Part B premium. The cost and benefits are specific to each company. These programs are zip code specific and need to be reviewed carefully to make sure they fit your needs as a client. We represent numerous companies that offer Medicare advantage, including Humana, United Healthcare (AARP), Regence Blue Shield and Group Health Cooperative. (click here for information and quote.)

This is a short over view of the Medicare Health programs available. If you have more questions please feel free to contact John at Castell Insurance and we can answer all of your questions.

These are your benefits that you are entitled to, let us help you understand them and get maximum benefit from them.