Medicare, Oversimplified On Purpose |

Some people show up carrying a grocery bag full of unopened mail. Not because they don’t care, but because there is so much of it, and none of it makes sense, and opening it only makes the pile worse.

And be honest. Did you ever read the benefits book from your job? The whole thing, front to back? Neither did anyone else. People don’t want to become experts in their coverage. They want it to work when they need it, and someone competent to call if it doesn’t.

So let’s skip the pile and tell you what all the fuss is actually about.

Medicare is like a big eighty-twenty plan that doesn’t cover drugs.

That’s it. Oversimplified? Yes, as I said, but it is close enough for this example.

Essentially, that’s the gist of the program, and it’s the reason for every phone call, every commercial, and every envelope in that bag.

For medically necessary procedures, Medicare pays about 80% of the approved amount. You pay the remaining 20%. And unlike the plan you had at work, nothing caps your 20%. In other words, there’s no annual out-of-pocket maximum waiting to catch you if something big happens.

It also doesn’t cover your prescriptions.

So…Two holes: an uncapped 20%, and no drug coverage. Everything you’ve been hearing about is trying to sell you a way to fill them.

So why do people come see us?

We put a ceiling on the 20%, and we make sure your prescriptions are covered, with a plan that works the way you want it to work.

That’s the whole job. Do those two things and you’re finished. Genuinely finished.

And there are two ways to do it.

A Medicare Supplement plus a drug plan.

The supplement picks up your share of the 20%, and a separate prescription plan covers your medications.

Or a Medicare Advantage plan with drug coverage included.

One plan, with a cap built in and prescriptions folded in.

Both types are popular, but neither is perfect. People tend to gravitate toward one or the other based on their personal preferences and unique life circumstances.

Helping you figure out which one that is, and finding the plan that fits you specifically, is literally what we do.

The alphabet, since you’ll hear it anyway

Part A

The hospital side. Inpatient stays, skilled nursing, hospice, some home health. Most people pay nothing for it, because you already paid through payroll taxes over your working life.

Part B

The doctor side. Office visits, outpatient care, lab work, imaging, preventive care, medical equipment. And the doctors who treat you during a hospital stay bill here too, not under Part A. This one has a monthly premium, and it’s where most of the 20% lives.

A and B together are Original Medicare.

Part C

Medicare Advantage. A private plan that bundles A and B together, usually with drug coverage included.

Part D

Prescription drugs. Original Medicare doesn’t cover them, so this is its own plan.

Four letters. That’s the primary vocabulary.

So what’s going on with you?

The two holes are the same for everyone. How you close them depends on where you are right now.

Or just call us at 281-894-7540. Ten minutes on the phone usually beats an hour of reading.

Not connected with or endorsed by the United States government or the federal Medicare program.

Real Clients. Real Help.

Linda L.- Magnolia, Texas

“Just wanted to let everyone know how great you were I needed to change my Medicare health insurance and he went the extra mile for me I would highly recommend him.”

Mark H.- Magnolia, Texas

“Justin is genuinely committed to doing the right thing. He’s honest and has proposed what makes sense for me and my business partner. ”

B.F.- Houston, Texas

“Justin cares for his clients. He took the time to find out my needs & concerns. As a result found exactly what I wanted. I would recommend him to anyone.”

Call Us 281-894-7540

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Our Services Are Always Free:

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Medicare, Oversimplified On Purpose