What you need to know about Medicare and Medicare Advantage plans

Medicare Enrollment Period is Oct. 15-Dec. 7

Keith Silvernail and Cathy McGuire are both knowledgeable about Medicare and Medicare Advantage plans.

Every fall, those 65 and older are inundated with mailings and information detailing the Medicare Annual Enrollment Period, the period when those eligible can join, switch, or drop a Medicare Advantage or Part D prescription drug Plan and also apply for a Medicare supplement insurance plan. Confused? Many people are.
But then there is McGuire Insurance Group’s Keith Silvernail to the rescue. Licensed to provide health insurance products and a master certified America’s Health Insurance Planner, Silvernail has spent over 20 years working with a supplemental insurance product before transitioning to the life insurance and Medicare field. According to Silvernail, America’s Health Insurance Plans’ certification is accepted by all, and required by most carriers for those agents wishing to sell Medicare Advantage (MA) or Prescription Drug Plans (PDPs) for the current certification year.
“Medicare and Medicare Advantage plans can be very confusing. I do like helping people navigate these Medicare questions and help solve their issues,” he said. That help can be found at the McGuire Medicare Resource Center, which is open Tuesday and Thursday from 9 am to noon. While Silvernail represents four carriers offering Medicare Advantage and Prescription Drug plans, he guides those who stop by the resource center to the product or products best suited to meet their individual healthcare needs.

What is Medicare and Medicare Advantage?
Silvernail explained, “Original Medicare, Part A and Part B is provided by the federal government. One is automatically enrolled if at age 65 you are receiving Social Security or Railroad Retirement Board benefits. The cost of the plan is deducted from your monthly social security or RR retirement stipend. Part A covers hospital stays and Part B covers doctor visits.
Medicare Advantage plans are through private providers and combine Part A and Part B and often prescription drug coverage. Other benefits such as routine vision and dental care, hearing exams or hearing aids, and wellness benefits such as gym memberships are included in most Medicare Advantage plans. The benefits vary by plan and could include other extra benefits such as transportation to medical appointments and virtual visits. The plan costs vary, and plans start at $0. Plans can change each year so it is always good to review yours to be sure it still meets your needs.” Copay amounts may vary based on the type of service received.
“There are many factors to consider,” Silvernail noted. “Many plans contract with a specific network of doctors and hospitals. Medicare Advantage plans are also required to set an out-of-pocket maximum. We need to look at your overall health, how often you visit the doctor, your prescription medication needs, and what specialized coverage is important to you to find the best Medicare Advantage product for you. You have many options when it comes to your Medicare coverage. But you can only make changes to your plan between Oct. 15 and Dec. 7. So now is the time to find out if you are in the correct plan for your health needs.”

What is supplemental health insurance and why would I want that?
Silvernail answered, “These plans are known as Medigap plans and can help pay some of the out-of-pocket costs not covered by Medicare Parts A & B. These plans are offered by private insurance companies and are standardized by the federal government. Medigap plans are available to those 65 and older who have enrolled in Medicare Parts A and B. There is a monthly premium based on the level of services required but out-of-pocket costs vary depending on the plan selected. Prescription drug coverage is not included but you can select the physician of your choice rather than being required to choose a network provider and you can see a specialist without referrals. A supplemental plan is ideal for those whose health care co-pay expenses are high. A variety of plans are available that offer different levels of financial protection.”
He added that there are 86 different plans offered by the four providers we represent, which include Anthem, Aetna, United Health Care, and Devoted Health.

The McGuire Group
Silvernail joined Cathy McGuire and her associates in the McGuire Group Insurance Agency last spring. In addition to health insurance, Silvernail also specializes in whole-life products. He said two of the agency’s affiliated companies, Erie and Frankenmuth, provide excellent life insurance options, as well.
In addition to Medicare Advantage and Medigap products other health insurance and life products, the McGuire Group offers insurance products for autos, motorcycles, boats, homes, renters, landlords, and businesses, as well.

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