Medicare Experts
Medicare Experts
The Medicare Experts Company has been helping people with Medicare for the last 16 years. It is an honor to work with people that have so much life experience.
About Us
The Medicare Experts Company has been helping people with Medicare for the last 16 years. It is an honor to work with people that have so much life experience. As a brokerage we are focused on finding the right plan that fits your needs. We are not product salesmen. We all want a plan that has our Doctors, Medication and Dentists for the lowest cost possible. It takes many hours of certifications, training and studying to be of value to our clients. We are prepared for the challenge and invite you to call, text email or drop by our Henderson office located conveniently in the same business center as the local social security office in Henderson.
Contact Us
Contact Us
Medicare is a federally administered health insurance program providing health coverage to nearly 55 million Americans above the age of 65. Medicare also provides coverage to other individuals who are eligible due to certain disabilities, or permanent kidney failure, or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health related expenses, but it doesn’t cover all medical expenses. Long-term care is not covered by Medicare.
Medicare Basics
Part A
Inpatient Hospital Care
Skilled Nursing Services
Hospice Care
Part B
Doctors' Visits
Outpatient Hospital Services
Durable Medical Equipment
Physician - Administered Drugs
Part C
Medicare Advantage Plans, Which Combine Parts A & B
May Cover Vision, Dental And Hearing
Part D
Prescription Drug Coverage
You have choices for how you get Medicare coverage. If you choose to have Original Medicare (Part A and Part B) coverage, you can buy a Medicare Supplement Insurance (Medigap) policy from a private insurance company. Supplements cover some of the costs that Medicare does not, like deductibles and coinsurance.
The Centers for Medicare and Medicaid Services (CMS) is the federal agency responsible for the Medicare program. But the Social Security Administration processes your application for enrolling in Original Medicare.
Who Is Eligible For Medicare?
A Person who has been a U.S. citizen / legal resident for at least five consecutive years and is at least one of the following :
- Age 65 or older
- Younger than 65 with a qualifying disabilitiy
- Any age with a diagnosis of end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)
Part A Coverage
If you are over the age of 65, and you are a U.S. citizen or permanent resident, you are eligible for Part A. And it won’t cost you anything per month if one of the following applies:
- You receive (or are eligible to receive) Social Security benefits or Railroad Retirement (RRB) benefits.
- Your spouse (even if deceased or you are divorced) receives (or is eligible to receive) Social Security or RRB benefits.
- You or your spouse worked long enough in a government job through which you paid Medicare taxes.
- You are a dependent parent of a fully insured deceased child.
If you don’t meet these requirements, you may be able to get Medicare Part A by paying a monthly premium.
Part B Coverage
If you are eligible for Medicare Part A at no cost, you can enroll in Medicare Part B by paying a monthly premium. If you have higher income, you may be required to pay a higher Part B premium.
If you are not eligible for Part A at no cost, you can buy Part B without having to buy Part A if you are age 65 or older and you’re one of the following:
- A U.S. citizen.
- A lawfully admitted noncitizen, who has lived in the United States for at least five years.
You Have Choices
When you understand the basics of Medicare, you will quickly learn that there isn’t a “one size fits all” plan. We are here to educate you about all your choices.
Choices include:
- Original Medicare: Coverage managed by the federal government. Generally, there is a cost for each service.
Original Medicare includes:
Part A
- Inpatient hospital stays,
- Care in a skilled nursing facility
- Hospice care
- Some home health care
Part B
- Certain doctors services
- Outpatient care
- Medical supplies
- Preventive services
- Original Medicare with a stand-alone prescription drug plan (Part D) and/or a Medicare supplement insurance plan
- Medicare Advantage (Part C) plan : a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Most Medicare Advantage plans offer prescription drug coverage, vision, hearing and dental benefits.
Step 2
Decide if you need additional coverage. You can choose 2 options:
Option 1 : Add one or both of the following to Original Medicare
- A Medicare Supplement Insurance plan (Offered by private companies.)
- A Medicare Prescription Drug plan (Offered by private companies.)
Option 2 : Choose a Medicare Advantage plan
- A Medicare Advantage plan (Offered by private companies.) Also known as Part C, this plan combines Parts A & B, provides additional benefits, and most plans cover prescription drugs.
Contact us to learn more. Our professional and experienced agents want to help you be successful in choosing you're Medicare options.
Medicare In The News
VBE Process Change to be in Effect on May 3, 2022
Beginning May 3, 2022, Wellcare will discontinue VBE for all enrollment types, with the exception of Dual-Eligible Special Needs Plan (DSNP) and Chronic Condition Special Needs Plan (CSNP) enrollments. However, effective May 3, 2022, VBE admin payments will increase to $125 for each DSNP & CSNP enrollment!
CMS Issues New Policies to Provide Greater Transparency for Medicare Advantage and Part D Plans
The Centers for Medicare & Medicaid Services (CMS) issued a final rule for the Medicare Advantage and Part D prescription drug programs that will improve experiences for dually eligible beneficiaries and provide greater transparency for the MA and Part D programs.
View a fact sheet on the final rule at: https://www.cms.gov/newsroom/fact-sheets/cy-2023-medicare-advantage-and-part-d-final-rule-cms-4192-f
IRMAA 2022 Update Reminder!
You might be surprised by how many of your potential clients are impacted by IRMAA. So, here is your reminder to brush up on IRMAA and the 2022 IRMAA thresholds!
Income-Related Monthly Adjustment Amount, or IRMAA, is the additional cost Medicare Beneficiaries pay on Medicare Part B and D Premiums when their modified adjusted gross income is above a certain threshold. It is guaranteed that no matter who your client is, they are trying to save money on healthcare costs. The downside for most beneficiaries is that IRMAA is calculated based on their earnings reported on their IRS tax return from two years ago. So, you must be prepared when a client calls you to discuss their concerns regarding their Medicare payments.
CMS Pressured to Scale Back Medicare Part B Premium Increase
Last month, Health and Human Services Secretary Xavier Becerra instructed CMS to reassess this year’s standard premium, which jumped to $170.10 from $148.50 in 2021. Since then, pressure from officials continues to increase after Medicare's preliminary decision to cover the costly Alzheimer’s drug, Aduhelm, only for a limited group of beneficiaries – which would greatly reduce Medicare's spending.
While reducing the premium would be unprecedented, there's a chance that Medicare Part B premiums for 2022 could be reduced.
No Surprises Act Implementation: What Brokers Need to Know for Clients
The No Surprises Act creates important new federal protections against surprise medical bills – a leading cause of affordability concerns for consumers. The federal government estimates the NSA will apply to about 10 million out-of-network surprise medical bills a year.
Insurance Companies Required to Cover Cost of At-Home COVID-19 Tests – Excluding Medicare & Medicaid
In January, HHS announced that insurance companies and group health plans would be required to cover the cost of 8 FDA-approved over-the-counter at-home Covid tests per covered individual per month.
The goal is to expand Americans’ access to free testing. But the administration is facing criticism because the coverage requirement doesn't apply to Medicare or Medicaid plans.
