Senior Choice Plans is not endorsed by or affiliated with Medicare or any government program.
Frequently Asked Questions
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Common Questions About Medicare
Original Medicare is what is provided by the Federal Government. It is broken down into 2 parts:
Part A – Hospital coverage (has coverage with deductibles for hospital stays, commonly known as inpatient). Most seniors do not pay a premium for Part A coverage.
Part B – Medical coverage (coverage with deductibles for doctors visits, outpatient surgeries, durable medical equipment, most of your medical procedures). Most seniors pay a Part B premium of $148.50 per month, but it can be higher based on income.
Your monthly premium is the amount that you are expected to pay to be covered by the insurance plan. While many Medicare Advantage (Part C) Plans have $0 premiums, it can vary upon where you live, your income, and the plans that are offered in your area. Medicare Supplement Plans will also have a monthly premium to get the coverage that you chose.
A Co-Payment or Co-Pay is the amount in dollars that you are required to pay when you use a service on your Medicare Plan. This is different that a percentage that you are required to pay as those would be considered “Co-Insurance which you can find more information on below. Some plans do include a $0 co-pay for certain services, while others require you to pay for items when you use the services. Co-Payments also apply to prescription drugs as well.
A deductible is the amount of money that you are required to pay before the insurance plan pays its portion of the bill. Some Medicare Plans do have a deductible.
Co-Insurance is the amount that you are required to pay when you are using a service on your plan. These amounts are defined in percentages. For instance, you are required to pay 20% of the bill and the insurance company will pay for 80% of the bill. 20% of the bill is what we consider to be your co-insurance
A service area is the zip code or county that you reside in for the majority of the year. This is where the plan is available to be offered in.
For Medicare Advantage Plans we see that there are defined by the county that you are in. This means that if you have a plan and you live in Atlanta Georgia and you have a friend that lives in Charlotte North Carolina that you would be in different service areas, and the majority of the time your coverage will be different from the one offered for your friend. This also means that if you do move from your home that you are required to inform that plan so you can get a new plan in your service area.
Medicaid is Insurance that is provided to individuals that are financially hard shipped. This type of insurance is run by the states and every state has different regulations for Medicaid and names for states programs.
A low-income subsidy or extra help is assistance form the federal government to help subsidize the cost of medications based on your level of assets and income. Items that can be subsidized are certain drug premiums, as well as formulary covered medications.
These are plans that are for individuals that qualify for both Medicare and Medicaid. These plans allow for the individual to get extra benefits for normally no additional charge, and use a network that is determined by an insurance company, rather than by the state. These plans do vary depending on where you live