Medicare & Medicare Supplements

Helping you have a better understanding of Medicare

What’s Medicare?

Medicare is the nation’s largest health insurance program serving more than 59 million people. 

It’s run through the Centers for Medicare & Medicaid Services, also known as CMS. CMS is a government program part of the U.S. Department of Health and Human Services.

Medicare is Broken Down Into Parts

Part A Helps Cover

  • Hospitalization
  • Skilled nursing facilities
  • Hospice care
  • Home health

Part B Helps Cover

  • Doctor appointments
  • Outpatient care
  • Preventive services
  • Occupational/physical therapies
  • Home health

Part C Helps Cover

  • Extra benefits, including prescription coverage

Part D Helps Cover

  • Dental
  • Vision
  • Wellness programs

Know Your Iowa Medicare Options

OPTION 1

Original Iowa Medicare
Medicare Part A helps cover hospital and other inpatient costs. Medicare
Part B helps cover doctor and other healthcare provider costs. Together
they form Original Medicare, available through the federal government.

OPTION 2

Medicare Advantage (MA)

Includes not only Medicare Parts A but also Medicare part B (often requires paying Part B premium in addition to the MA premium). Hence often includes extra benefits and services such as prescription drug coverage

Enrolling in Medicare

Initial Enrollment Period (IEP)

  • To enroll must sign up for Medicare within your initial enrollment period:
  • Three months prior to your 65th birthday
  • The month you turn 65
  • Three months after you turn 65

Eligibility For Iowa Medicare 

  • Once you turn 65 years of age you may be eligible for Medicare Parts A and B, even if you still work.
  • Iome cases you may be eligible for premium-free Medicare Part A through your spouse. However, you still must qualify by age or disability.
  • Some may also be eligible for Medicare Parts A and B if you’re under 65 and have a disability either, or end-stage renal disease (ESRD).

Make Sure Your Needs Are Met

Healthcare History

  • Do you have a chronic condition?
  • Will your healthcare needs grow in the near future?

Prescription Drugs

  • Prescription drug spending may increases in the future.
    Medicare Part D may help cover the cost.

Need more coverage than Medicare Part A
and Part B?

  • A Medicare Supplement Insurance Plan or Medicare Advantage Plan may help cover unexpected healthcare costs.

Choosing Iowa Medicare
Advantage instead of staying with Original Medicare?

  • To acquire an advantage plan you must have not only Medicare Part A but also Part B coverage.
  • However, you usually have to pay an additional monthly plan premium.
  • In order to remain a Medicare member as long as you keep paying
    your Part B premium, if applicable.
  • Along with a having a Medicare Advantage Plan, during the plan you may have an opportunity to purchase optional supplemental benefits, likewise
    dental and vision coverage, for an additional premium.

Types of Medicare Advantage Plans

Health Maintenance Organization (HMO)

  • A majority of cases, a primary care provider arranges your healthcare within the plan’s network.

Preferred Provider Organization (PPO)

  • Choose any provider that accepts Medicare, however, you may pay less for
    in-network services.

Private-Fee-For-Service (PFFS)

  • Generally, there is more freedom to choose providers but a network arrangement
    may still apply.

 

*Private fee-for-service plans are not Medicare Supplement Insurance Plans. Providers that do not contract with a PFFS plan are not required to see plan members. While this may be true, there are exceptions such as emergencies.

Special Needs Plans (SNPs)

  • SNPs are tailored for those who have a not only chronic illness, but also due to things for example, diabetes or a heart condition, or for those who are eligible for Medicare and also receive Medicaid assistance from the state. Institutional SNPs are available for those in situations such as long-term care or skilled nursing facilities.
                                                                                                                            

Important Dates

Oct. 15 – Dec. 7

  • Annual Election Period (AEP) for Medicare.
  • Advantage plans and prescription drug plans for the next calendar year.

Special Enrollment Period

  • Generally, you can only make changes to your plan outside of these time periods due to special conditions. For instance moving out
    of your plan area, leaving an employer group plan, or having
    Medicaid coverage.

Location

465 Northland Ave NE Suite 102

Cedar Rapids, IA 52402

(319) 640-8607

brian@peritiaadvisors.com

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