Tag Archives: medicare supplement

10 Things You Might Not Know About Medicare in the US

Doctor taking blood pressure of her smiling patient

We’ve said it before, and we’ll say it again, Medicare is confusing. Which is why we dedicate our lives to helping seniors PREPARE for Medicare before they enroll. Knowledge is power! So with that being said, here is a list of 10 things that you probably don’t know about Medicare, and some of them may surprise you!


  1. Medicare covers more than just senior citizens. Medicare is designed for the aging population, but under certain circumstances, people under the age of 65 can be enrolled. If you have a qualifying disability or End Stage Renal Disease (ESRD), you can get covered under Medicare.
  2. Baby boomers are aging into Medicare at a rate of 10,000 per day. Back when Medicare was first designed, people weren’t living nearly as long as they are today. Add that to the baby boomer generation who are rapidly aging into Medicare at a rate of 10,000 people PER DAY, and you can see how Medicare is quickly going to get into trouble.
  3. Enrollment can happen outside of AEP. There is a common misconception surrounding Medicare that you can’t change your plans unless it’s during the Annual Election Period (AEP) from October 15-December 7. While this is true for Medicare Advantage (Part C) and Prescription Drug Plans (Part D), you can change from Medicare supplement plan to plan anytime you want. There are always “special election periods” and change of status that can warrant a change outside of AEP as well.
  4. Each part of Medicare covers something different. While the parts of Medicare can be the most confusing part, it’s all for good reason. Each part of Medicare means something different and works differently. Part A is for your hospital care, Part B is for healthcare outside of the hospital such as routine doctors’ visits and preventive care, Part C is Medicare Advantage, and entirely different program from original Medicare altogether, and Part D is the prescription drug plan. Every part works differently to make one whole picture.
  5. How much Medicare actually pays out. Medicare supplemental insurance was created to fill in the coverage gaps left behind by original Medicare. Did you know that traditional Medicare only covers 80% of the Medicare-APPROVED costs? That means, YOU as the enrollee are responsible for that other 20%. This is where Medicare supplement insurance comes in. It covers your 20% if you keep up with your monthly premiums, and can save you a ton.
  6. A “non-participating” doctor still takes Medicare. Despite what the status title of “non-participating” doctors suggests, doctors under this status DO accept Medicare. They just don’t accept it at the amount that Medicare pays, meaning these doctors reserve the right to charge the patient additional money on top of what Medicare approves. While it seems confusing, don’t be too alarmed if your doctor becomes a “non-participator”- it just means that they reserve the right to charge you 15% more than Medicare approves. This is typically only found with specialty doctors/treatments.
  7. Waiting to enroll in Part D can cost you FOR LIFE. Once you’ve reached Medicare enrollment time, you also have to enroll in your Part D drug plan. If you don’t, you have to wait until the following AEP, AND Medicare charges a fee every month for the rest of the time you’re on Medicare (aka, the rest of your LIFE!) While the fee is minor, it can add up depending on your lifespan. 1% of the national average in premiums in what you pay PER month, so 12% per year, lasting forever.
  8. Medicare doesn’t cover everything. If you’ve been to your doctor for a physical and you WEREN’T charged for it, your doctor didn’t file it properly. Physicals and some other procedures aren’t covered under Medicare. While Medicare paired with a supplement covers almost everything, and mostly the big stuff, it doesn’t cover everything.
  9. Medicare doesn’t work outside the USA. Getting ready for a big vacation to Europe? Make sure you understand before you go that your traditional Medicare coverage doesn’t apply out of the country. If you have a Medicare supplement, you’re covered. However, traditional Medicare without a supplement or Medicare Advantage does NOT work outside the United States.
  10. On average, with Medicare you get WAY more than you pay for. While your Medicare premiums and co-pays do add up, compared to the average amount of usage, you are saving a TON. Medicare may not be perfect, but it is still possibly the greatest government healthcare coverage known to us. Take advantage of it by preparing yourself properly with a supplement so you don’t get stuck with huge bills, but rather a predictable monthly premium.


It’s true; Medicare is complex. But it’s one of the best working healthcare systems out there, and if used properly it can save enrollees a ton of money in their health care and keep them healthier, longer.


What is the Difference Between Medicare Part A and B?

Non captive agents help you get the best coverage at the best price

Ever wondered what all the different parts of Medicare actually mean? There are many terms and ideas associated with Medicare that are constantly thrown around, but do you truly know what they mean? Our blog is aiming to answer some of the common and consistent Medicare questions so that you can better understand the industry, and furthermore, your coverage.


So let’s dive in today with the basics: defining the two primary parts of original Medicare, Part A and Part B. We’ll get into Part C & D on another day.


Okay, so let’s start with the more basic Medicare Part A.


Medicare Part A


This is your hospital insurance. Any inpatient hospital stays, care received in a skilled nursing facility, hospice care, and some health care are covered under Medicare Part A. This is pretty straight forward; however, it can be more complex depending on your healthcare status and provider. Often times “under observation” can be a troublesome status for a patient covered under Medicare to have, because it can cause trouble with coverage. That’s a story for another day though, so for now, just remember that “Medicare Part A covers your stay” (in most cases).


Medicare Part B


Okay, so this is your actual health insurance coverage. This covers two types of medical services:


  • Preventive medical services such as flu shots, illness screenings, and the like, are considered preventive services. The lines here can become a bit blurred, but essentially, any sort of screenings or lab work that is done in an attempt to prevent major illness is considered preventive. Additionally, coverage can extend to necessary durable equipment like walkers or wheelchairs, when a diagnosis requires that.
  • Necessary treatment is covered when patients require treatment and care to treat conditions or illnesses. Included in this category are x-rays, lab work, outpatient services, and doctors visits that are necessary per your condition.


For part B, just remember it either helps prevent illness with preventive care coverage or treats an illness or condition.


If you don’t have a Medicare supplement plan in addition to your original Medicare coverage, then you are responsible for paying a deductible annually, as well as 20% of the Medicare-approved amount with participating providers. This 20% can really add up quickly, especially if you are being treated for a serious illness. This is why in most cases it makes sense to have a Medicare supplement plan to back up your original Medicare.

Well that in a nutshell is Medicare Part A and B. Stay tuned for more Medicare news, tips, and facts by following our blog or social channels.

Save Money and Time On Health Insurance with a Non-Captive Provider

Non captive agents help you get the best coverage at the best price

Non-captive agents help you get the best coverage at the best price, always. 

Okay, so we know insurance is a source of stress and angst for people everywhere. Am I in the right plan? Am I overpaying? Will our coverage be enough if something terrible happens?


If you’ve asked yourself these questions about your health insurance plan, then you are definitely not alone. It’s extremely difficult to navigate the sea of insurance options, plans, prices, and companies- it can be almost impossible to go it alone.


But even if you have someone to help you, how can you be sure that they have your best interest at heart? If you are working with a captive agent, we’d be willing to bet that they usually don’t.
So, what is a captive agent? A captive agent is an insurance salesperson who works for one insurance carrier and, therefore, can only offer products from said carrier, nowhere else. These are your typical big-name insurance companies like Blue Cross Blue Shield, HAP, or Humana. If you’re working with one of these companies, don’t worry, they all offer good products that meet health insurance needs. However, the agents representing these brands can only give you the price and coverage quotes of the products they have access to- which means only one carrier option. Aside from that, sometimes there are incentives given to agents for selling a certain product. This product might not be the best option for you, but if it gets your captive agent on a trip to the Bahamas they won’t tell you that.


This is why we ALWAYS recommend that you select your health insurance plan with the guidance and help of a non-captive advisor. Non-captive providers can select the best coverage for you at the best price from an infinite list of carriers. Not only that, but they can explain thoroughly the details of your plan and stay with you for years to come.


Try calling into find your captive insurance agent at their home office and we can almost guarantee you’ll be pushed through an automated phone system. Select a non-captive provider and you can access them directly anytime you want for questions or help regarding your plan.


Having a non-captive provider not only saves you money, but it saves you time and worry. A non-captive agent is not tied down to one carrier or persuaded by incentives to sell products like captive agents are. They only select the best plan at the best price to suit each client’s individual needs.


Okay, so let’s recap the primary differences between captive and non-captive insurance advisors:


  • Flexibility– Non-captive agents have the flexibility to select from a wide variety of carriers and plans, not just one. This means they have a much higher chance of finding the perfect coverage/price for you.


  • Accessibility- Instead of calling into a major corporation and going through the run-around, you can more quickly and easily access your non-captive advisor year round. Get a bill that doesn’t make sense? Give your non-captive advisor a call and they’ll be sure to help.


  • Dedicated Resource- Even if you aren’t sure you’re ready to buy yet, a non-captive provider will give you information about the plans, health care laws, and policies whenever you need help. Think of your non-captive advisor as a dedicated resource for all insurance questions.


  • Fluidity- Whereas many captive providers want you to think you’re stuck in your plan, there can sometimes be a way out if rates get to high (especially with Medicare supplement insurance). The ability you have to move if your plan doesn’t work out as well as you thought, is a benefit only offered by non-captive providers.


  • Freedom- The freedom to live your life without stressing about your health insurance plan and how it affects your bank account, is something that can only be reached with non-captive agents.


For these reasons, we highly recommend you seek a non-captive provider to be your health insurance guide. Your wallet will thank you.