This book will help anyone who needs to learn more about Medicare and how Medicare can work for them

Book of Medicare was written to help people understand the terminology around Medicare and how it works to help individuals make a more informed decision

10,000 new Medicare Beneficiaries enroll daily

Step 1: Get informed

Step 2: Speak with an agent to discuss plans available in your area

Book of Medicare is an accepted marketing publication by the US Centers of Medicare and Medicaid Services filed under MULTIPLAN_PACIFIC_BOM_M

Essential Reads Inside Our Book

Understanding How Medicare Works

Book of Medicare is an accepted marketing publication by Medicare and Medicaid Services filed under MULTIPLAN_PACIFIC_BOM_M

Medicare Part A

Original Medicare Part A, provides coverage for medically necessary:

  • Inpatient hospital care
  • Skilled nursing facility care
  • Home healthcare services
  • Acute care
  • Rehabilitation care
  • Skilled long-term care
  • Hospice care

Book of Medicare is an accepted marketing publication by Medicare and Medicaid Services filed under MULTIPLAN_PACIFIC_BOM_M

Medicare Part B

Original Medicare Part B, provides 80 percent coverage for a wide range of medically necessary services and supplies, including:
  • Primary care physician visits
  • Outpatient care
  • Preventive care services
  • Durable medical equipment
  • Mental healthcare
  • Laboratory tests
  • X-rays and other diagnostic tests

Book of Medicare is an accepted marketing publication by Medicare and Medicaid Services filed under MULTIPLAN_PACIFIC_BOM_M

Medicare Part C

Medicare Part C, also known as Medicare Advantage Plans, are Medicare health plans offered by private insurance companies. These plans typically combine the benefits of Medicare Part A (hospital insurance) and Part B (medical insurance) with prescription drug coverage, all in one plan, which is then an MAPD plan.

Book of Medicare is an accepted marketing publication by Medicare and Medicaid Services filed under MULTIPLAN_PACIFIC_BOM_M

Medicare Part D

Medicare Part D, helps cover the cost of prescription drugs; it is offered by private insurance companies and designed to work alongside Original Medicare. It is an optional program, which means the Medicare beneficiary does not have to enroll in a plan if they do not want prescription drug coverage. However, by not signing up for a Medicare Part D PDP when first eligible, a beneficiary will likely face a lifetime penalty if/when they decide to sign up later on.
  • Medicare Part D premiums are paid directly to the private insurance company. It has a deductible, copayments, and coinsurance for some drugs. The out-of-pocket costs to the beneficiary will depend on the Part D plan selected.
  • Medicare Part D does not cover all prescription drugs, and it does not cover drugs that are NOT medically necessary. It also does NOT cover drugs used for cosmetic purposes or for the treatment of weight loss or weight gain.
  • Plans change every year, so it is wise to seek out a local insurance agent to make sure the beneficiary is in a plan that is suitable for their needs.
  • Most Medicare drug plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs.

    Book of Medicare is an accepted marketing publication by Medicare and Medicaid Services filed under MULTIPLAN_PACIFIC_BOM_M

    Medicare Supplement

    Medicare Supplement Plans, also known as Medigap Plans, are a type of insurance which help cover the gaps not covered by Original Medicare. These costs include Part A and B deductibles, copayments, and coinsurance. Supplement plans are offered by private insurance companies and are designed to work alongside Original Medicare.
    • Medicare supplement plans are federally regulated standardized plans, which means they must follow certain rules set by the federal government. All Medicare Supplement plans must offer the same benefits regardless of which insurance company sells it.

    About the Author

    Carter Gray

    Carter Gray is one of the Managing Principals of Pacific Insurance Group in Bellevue, Washington. He has a Bachelor of Arts degree in English literature from the University of Washington and has been licensed in the insurance industry since 2000, helping thousands of clients with their insurance journey.

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    Why Does Medicare Exist?

    Essential Knowledge for Every Senior Citizen!

    Original Medicare was established in 1965 and cover services that are reasonable or necessary to save lives, improve health, and provide comfort before dying. Medicare is a government-funded healthcare program for people over the age of sixty-five and other eligible individuals.

    Why Sign Up for Original Medicare?

    Get Wise About Medicare: The Overlooked Details That Can Cost You!

    Signing up for Original Medicare is an important decision for many individuals as they approach age 65 or if they meet certain eligibility criteria due to disability. Medicare is a federal health insurance program in the United States that provides coverage for medical expenses.
    Here are some reasons why signing up for Medicare is important:

    Age Eligibility: Most people become eligible for Medicare when they turn 65. Enrolling in Medicare during your Initial Enrollment Period (IEP), which begins three months before your 65th birthday month and ends three months after, ensures that you have health coverage as you enter your senior years.

    Legal Requirement: If you’re not covered by another creditable health insurance plan and you delay enrolling in Medicare after you become eligible, you may face penalties and higher premiums when you do eventually sign up. These penalties can be permanent and can result in increased healthcare costs over time.

    Comprehensive Coverage: Medicare provides comprehensive health coverage that includes Part A (hospital insurance), Part B (medical insurance). This coverage pays for most hospital stays and roughly 80% of doctor visits.

    Protection Against High Medical Costs: Medicare can protect you from high out-of-pocket medical expenses. While it may not cover all costs, it significantly reduces the financial burden of medical care, which can be particularly important as you age and may require more healthcare services.

    Network of Providers: Medicare typically has a broad network of healthcare providers, making it easier for you to access medical services. You can see doctors and specialists who accept Medicare assignment, giving you a wide range of choices for your healthcare needs.

    Access to Preventive Services: Medicare provides coverage for many preventive services, such as screenings, vaccinations, and wellness visits, which can help you maintain your health and catch potential health issues early.

    Guaranteed Issue Rights: Enrolling in Medicare during your Initial Enrollment Period guarantees your right to enroll in a Medicare Supplement Insurance (Medigap) plan without the need for medical underwriting. Medigap plans can help fill the gaps in Medicare coverage.

    Eligibility for Other Programs: Being enrolled in Medicare may make you eligible for other programs, such as Medicaid or low-income assistance programs, depending on your income and assets.

    Peace of Mind: Knowing that you have health insurance coverage as you age can provide peace of mind for you and your loved ones, knowing that you’re prepared for healthcare expenses.

    It’s important to note that the specific rules and eligibility criteria for Medicare can vary depending on your circumstances and where you live.
    Therefore, it’s recommended that you research and understand your options, or consult with a Medicare advisor to make informed decisions about enrolling in Medicare as well as discuss Medicare Supplement plans or Medicare Advantage Prescription Drug Plans in your area.

    Read More

    Why Sign Up for Original Medicare?

    Get Wise About Medicare: The Overlooked Details That Can Cost You!

    Signing up for Original Medicare is an important decision for many individuals as they approach age 65 or if they meet certain eligibility criteria due to disability. Medicare is a federal health insurance program in the United States that provides coverage for medical expenses.
    Here are some reasons why signing up for Medicare is important:

    Age Eligibility: Most people become eligible for Medicare when they turn 65. Enrolling in Medicare during your Initial Enrollment Period (IEP), which begins three months before your 65th birthday month and ends three months after, ensures that you have health coverage as you enter your senior years.

    Legal Requirement: If you’re not covered by another creditable health insurance plan and you delay enrolling in Medicare after you become eligible, you may face penalties and higher premiums when you do eventually sign up. These penalties can be permanent and can result in increased healthcare costs over time.

    Comprehensive Coverage: Medicare provides comprehensive health coverage that includes Part A (hospital insurance), Part B (medical insurance). This coverage pays for most hospital stays and roughly 80% of doctor visits.

    Protection Against High Medical Costs: Medicare can protect you from high out-of-pocket medical expenses. While it may not cover all costs, it significantly reduces the financial burden of medical care, which can be particularly important as you age and may require more healthcare services.

    Network of Providers: Medicare typically has a broad network of healthcare providers, making it easier for you to access medical services. You can see doctors and specialists who accept Medicare assignment, giving you a wide range of choices for your healthcare needs.

    Access to Preventive Services: Medicare provides coverage for many preventive services, such as screenings, vaccinations, and wellness visits, which can help you maintain your health and catch potential health issues early.

    Guaranteed Issue Rights: Enrolling in Medicare during your Initial Enrollment Period guarantees your right to enroll in a Medicare Supplement Insurance (Medigap) plan without the need for medical underwriting. Medigap plans can help fill the gaps in Medicare coverage.

    Eligibility for Other Programs: Being enrolled in Medicare may make you eligible for other programs, such as Medicaid or low-income assistance programs, depending on your income and assets.

    Peace of Mind: Knowing that you have health insurance coverage as you age can provide peace of mind for you and your loved ones, knowing that you’re prepared for healthcare expenses.

    It’s important to note that the specific rules and eligibility criteria for Medicare can vary depending on your circumstances and where you live.
    Therefore, it’s recommended that you research and understand your options, or consult with a Medicare advisor to make informed decisions about enrolling in Medicare as well as discuss Medicare Supplement plans or Medicare Advantage Prescription Drug Plans in your area.

    Read More

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