Small Business Insurance Services Inc. is a Brokerage firm that has no allegiance to
any insurance company. Our agents are also multi state licensed.
We shop all major carriers for you so you always get the BEST
plan at the LOWEST price. Each plan can be customized to fit your
specific needs and budget. There are multiple ways for consumers to
purchase Medicare Supplement Insurance. However, the best way is to use an
experienced Broker. Most especially since it costs nothing extra do
so. This being the case, why not tap in to our expertise?
If you prefer you
can call us toll free @
(866) 724 7123
for a free no obligation Medicare Supplement telephone
consultation from one of our multi-state licensed Brokers. Or, you
can click on the quote link below and begin comparing plans by price
and plan design. Be sure the "Senior Plans-Ages 65+"
button is selected.
Click to download 2013 Medicare Guide
to understand Medicare Plans:
Guide to Medicare Parts
A and B:
Learn about Medicare Supplement or "MediGap"
One of the most common questions we receive about
Medicare supplement insurance is how it differs from a Medicare
Advantage plan. Below are 5 basic differences for you to consider.
In our view a
medicare supplement insurance policy is the best
option for seniors looking to fill in the gaps left by basic medicare. But you can review the information below and make your own
Medicare Supplement Insurance
No Network Restrictions: Any doctor,
hospital, or other medical provider that accepts medicare must
accept your medicare supplement insurance plan. You can choose
to see any doctor in any city when you want.
Easy To Compare Plans: All
medicare supplement insurance policy are standardized. This means that
you can be sure that plans from different companies all have the
exact same coverage (plan designated by letter – C, F, N, etc…)
Stable Pricing: While some companies
have rate increases each year, the premiums for your plans
remain fairly steady. Especially if you work with an
independent agent who can shop all the best companies for you.
No Restricted Enrollment or Change
Deadlines: With a
medicare supplement insurance policy you can
change your plan at any time for any reason. You don’t have to
rush around at the end of the year worried about getting stuck
in a bad plan. Of course health conditions play a factor when
buying a new policy, but again a quality independent agency has
multiple companies all with different underwriting guidelines.
You Can Cover 100% Of Out of Pocket
Expenses: With certain medicare supplement insurance plans you
can cover every gap left my original medicare. No co-pays,
deductibles, or other shared costs. This makes budgeting for
your medicare care very easy. All you pay is your medicare part
B premium and your medicare supplement insurance premium and
everything else is taken care of.
Please note: The most comprehensive
Medicare Supplement plan is "Plan F". Their is also a "High
Deductible Plan F". However, we do not recommend this plan due to
the significantly higher out of pocket expense it exposes the
policyholder to. The best priced "Plan F" in Illinois is available
from Mutual of Omaha. To view all of the Medicare plans offered by
Mutual of Omaha and the premiums required
click here. To use our online
quoting software to run multiple comparison quotes for Medicare
supplement plans click our quote link below:
Medicare Part D - Prescription
Medicare Part "D" and Prescription Drugs:
Paying for prescription drugs can be quite
costly, which is why Medicare Part D was created as part of the
Medicare Prescription Drug, Improvement, and Modernization Act of
2003 (also known as the Medicare Modernization Act or MMA). Meant to
help subsidize the cost of prescription drugs, Medicare Part D came
into effect in 2006. Below is some general information on Medicare
Part D and what to expect as a result of some changes in the future.
How Medicare Part D Works
Those who have Medicare Part A and Medicare Part
B are eligible for Medicare Part D. There are two options for
receiving Medicare Part D benefits. One can choose to enroll in a
Medicare Advantage plan with prescription drug coverage, or one can
enroll in a Prescription Drug Plan (PDP). Enrollment for Medicare
Part D lasts from November 15 through May 15 of the following year.
The best priced Medicare Part D plan is available from Humana. To
enroll for their Part D plan available through an exclusive
relationship with Wal Mart
Changes to Medicare Part D – The Health Care
The Patient Protection and Affordable Care Act (PPACA)
was signed into law on March 23, 2010. As expected, the health care
form bill will affect Medicare coverage in a few ways. Original
Medicare coverage (Part A and Part B) will remain untouched, but
there will be some changes to both Medicare Part D and Medicare
In the case of Medicare Part D, the changes from
PPACA are meant to close the so-called doughnut hole by the year
2020. The doughnut hole refers to the gap in coverage when a person
spends more than $2,700 but less than $6,154. Between these two
amounts, the person in the doughnut hole must handle all costs out
of his or her own pocket.
This year, those who fall into the hole will
receive a $250 rebate to assist with payments for prescription
drugs. In 2011, those with Medicare Part D will also receive a 50%
discount on name brand prescription drugs. Additional discounts will
be covered over the next several years.
Understanding Medicare Advantage Plans:
Individuals who are eligible for Medicare will
notice that there are certain gaps in medical treatment that are not
covered by Medicare Plan A or Medicare Plan B. To cover these gaps,
there are multiple options available, but it fundamentally comes
down to a choice of a Medicare Advantage or a Medicare supplement
insurance plan. When choosing between the two, you need to consider
a number of different factors. Below are some general considerations
for those deciding between Medicare Advantage plans and a
medicare supplement plans.
What are Medicare Advantage Plans?
Once referred to as Medicare + Choice and
Medicare Part C, Medicare Advantage refers to health care plans
provided by Medicare-approved private companies. Medicare Advantage
plans will cover urgent care needs as well as emergency care needs.
Medicare Advantage will also cover medical treatments in Original
Medicare (Part A and Part B), with the exception of hospice care
(which is covered by Original Medicare). Extra coverage may be
offered through some Medicare Advantage plans, such as prescription
drug coverage (Medicare Part D), dental care, eye care, and programs
promoting health and wellness.
Medicare Advantage Plans may take the form of a
Health Maintenance Organization (HMO) plan, Preferred Provider
Organization (PPO) plan, or a Private Fee-for-Service (PFFS) plan.
There are also Special Needs Plans (SNP) available for those who
have certain severe medical conditions or disabilities.
Should I Choose Medicare Advantage or Medicare
The answer to this question will be determined by
your health care needs. Medicare supplement plans allow more
flexibility in that you can visit any doctor without the need for a
referral. Medicare Advantage plans do not afford as much freedom
since visits with doctors outside of your network are not covered.
Cost comes into play when it comes to deciding between Medicare
Medicare supplement insurance policy as well. In general,
Medicare Advantage is more affordable, though it does come at the
loss of flexibility, which may be problematic for addressing certain
health care needs. Consider the following:
Medicare Advantage plans are NOT Medicare Supplements.
Medicare Supplements and Medigap are interchangeable terms - the
two terms refer to the same type of standardized plans that work
with Medicare. Medicare Advantage plans do NOT "supplement"
Medicare; they take the place of it.
Medicare Advantage plans have widely varying benefits that
can be found on plan "Summary of Benefit" documents. These range
from plan to plan, change each year, and are very long (i.e.
different co-pays for different procedures, in-network vs. out
of network, etc.). Medicare Supplement plans are all required to
go by the Federally-standardized plans chart.
The plans work very differently. The easiest way to explain
it is that Medicare Supplement/Medigap plans pay AFTER Medicare
pays. They "supplement" Medicare. Medicare Advantage plans pay
INSTEAD of Medicare. They take the place of Medicare in paying
Medicare Advantage plans have an annual enrollment period at
the end of each year. This is because the plans change, benefits
and premium, each year. Medicare Supplement plans do NOT have an
annual enrollment period. You can change plans at any time of
the year, but the benefits never change on these types of plans.
Medicare Supplement Plans (Medigap) Advantages Over Medicare
While both types of plans can be viable options, and Medicare
Advantage may even make more sense in very urban areas that have
high Medigap premiums and large Advantage plan networks, there are a
handful of very significant reasons why we believe Medigap plans to
be more viable long-term and more advantageous. Below, you will find
a list of facts about the plans that, we think you'll agree, make
Medigap plans the more prudent choice:
Medigap plans never change - they are guaranteed
renewable and your benefits will never change. Medicare
Advantage plans change on an annual basis. Their changes
include formulary changes, benefit changes, network changes,
premium changes, deductible changes, etc.
Medigap plans are not currently being threatened by
recent health care reform changes which greatly reduced funding
to the Advantage plans (which are Federally-subsidized).
These recent changes led to many top Advantage plan providers
pulling completely or partially out of this market (CIGNA,
Wellcare, etc.). It is a universal assumption that Medigap plans
have greater long-term viability and stability.
Medicare Advantage plans have deductibles, co-pays
and coinsurance that can range from service to service. This is
a complex system of co-pays and deductibles that, in a good
year, may not be a problem, but if you have any health problems,
can quickly add up to a large expense. Medigap plans, at
the top few levels, have no (or very small) out of pocket costs.
They are designed to fill in the gaps in Medicare. The top
Medigap plan, which 43+% of people have, Medigap Plan F, fills in all the gaps in Medicare so you
don't have any out of pocket co-pays or deductibles at the
doctor or hospital.
Medicare Advantage plans have networks of
doctors/hospitals that you must stay within to receive full
coverage. These networks are, generally speaking, regional in
nature. So if, for example, you are traveling, you may be hard
pressed to find a doctor that works with your plan. Medicare
Supplements can be used anywhere that takes Medicare,
nationwide. If they take Medicare, they have to take one of the
standardized Medigap plans, regardless of what insurance company
When you are first eligible for Medicare, you can choose
either type of plan - Advantage or Supplement - in your initial
open enrollment period. After that point, you can always move
from a Medicare supplement to a Medicare Advantage
plan, because Advantage plans do not use medical underwriting.
Regardless of your health (with the exception of ESRD), there
are no pre-existing conditions. However, you can NOT always go
the opposite way. In almost all states (NY, CA, MO are
exceptions), Medicare Supplement companies use medical
underwriting. This means you can be denied coverage or made to
pay more for pre-existing conditions.
Changes to Medicare Advantage – The Health Care
On March 23, 2010, the Patient Protection and
Affordable Care Act (PPACA) was signed into law. The provisions of
this law not only apply to individuals, business owners, and health
insurance companies, they will also have some effect on Medicare.
While the PPACA will not require seniors to change their Medigap
coverage, there are some changes that current and future Medicare
recipients should be aware of. Below is a general look at some of
the ways that the health care reform bill will alter Medicare.
Health Care Reform and Original Medicare
While there will be no cuts for Original Medicare
plans, there will be some enhancements in coverage as a result of
health care reform. Medicare will start paying for wellness visits
each year. As it stands at the moment, only a general check up is
paid for when a person initially enrolls in Medicare.
Health Care Reform and Medicare Advantage Spending Cuts
Medicare Advantage will see a number of spending
cuts as a result of the health care reform bill, amounting to $132
billion. These spending cuts will be phased in over a period of 10
years. There will also be a $40 billion reduction on Medicare
payments for home health care and a $22 billion reduction on certain
Medicare payments to hospitals.
Health Care Reform and the Medicare Part D
The health care reform bill aims to close the gap
in Medicare Part D prescription drug benefit. In the current
program, coverage ends when $2,700 is spent on prescription drugs
and resumes again once $6,154 is spent. All prescription drugs
purchased between those two amounts must be handled out of pocket.
This has been referred to as the doughnut hole.
This year, those who fall into the doughnut hole
will receive a $250 rebate to help with payments for prescription
drugs. In 2011, they will be eligible for a 50% discount on brand
name drugs. These discounts would expand over the course of the next
few years. It is projected that by 2020, an estimated 75% of
prescription drug costs will be covered.
Health Care Reform and the Medicare Payroll Tax
Individuals earning more than $200,000 a year and
couples earning more than $250,000 a year will experience a 0.9%
increase in their Medicare payroll tax. Beginning in 2013,
individuals earning more than $200,000 a year and couples earning
more than $250,000 a year will also experience a 3.8% surtax on
Still have questions? Call us toll free @
(866) 724 7123
for a free no obligation Medicare Supplement telephone
consultation from one of our multi-state licensed Brokers. Remember,
it costs you nothing more to use a Broker.