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Medicare Plans

Working With Original Medicare For Better Coverage:

Working With Original Medicare for Better Coverage:
A Medicare Advantage Plan is a health plan offered by a private insurance company that works directly with Medicare to provide you with all their traditional Part A and Part B benefits.

Medicare Advantage Plans Include:

  • Preferred Provider Organizations (PPO)
  • Health Maintenance Organizations (HMO)
  • Medicare Medical Saving Account Plans (MSA)
  • Private Fee-For-Service (PFFS)
  • Special Needs Plans (SNP)

Below is a "Top 10 List" to review when you're considering a Medicare Advantage Plan.

  1. You're still in the Original Medicare Program and have all Medicare right and protections.
  2. You still get complete Part A and Part B coverage through the plan.
  3. You are only enrolled in a plan for 1 year and you can only join a plan at certain times during the year.
  4. You can join a Medicare Advantage Plan even if you have a pre-existing condition. The only exception is End-stage Renal Disease (ESRD).
  5. You must follow plan rules. If you go to a doctor, other health care provider, facility, or supplier that doesn't belong to the plan's network, your services may not be covered, or your cost may be higher. You should always verify coverage with your plan before you receive any service or schedule an appointment with a referred specialist to make sure they are covered by the plan's network.
  6. A number of Medicare Advantage plans are all inclusive plans meaning, they also include prescription drug coverage. To ensure it is the right plan for you always review the drug formulary.
  7. If you join a clinical research study, some costs may be covered by your plan. Contact the plan administrators for more information.
  8. Medicare Advantage Plans can't charge more than Original Medicare for certain services like chemotherapy, dialysis, or skilled nursing facility care.
  9. Medicare Advantage Plans also offer an annual cap on how much you pay for Part A and Part B services during the year. This annual maximum out-of-pocket amount can be different between advantage plans. You should consider this when choosing a plan.
  10. If the plan decides to stop participating in Medicare, you will have to join another Medicare Health Plan or return to Original Medicare.

*Source: Medicare.GOV, A Federal Government Website Managed By the Centers For Medicare & Medicaid Services

Medicare is a complex program and as a result many of senior citizens need answers. While there are no "one size fits all" answers, the team at David A. Crotts has a large network of carriers, and we will partner with you to find the best fit for your needs and budget.

Less than 60% of Medical Costs Are Actually Covered by Medicare

One of the great benefits that Americans receive as they mature is Original Medicare. However, Americans who qualify are surprised to discover that all medical costs are not covered under the government-sponsored plan. In fact, Original Medicare covers less than 60% of medical expenses. With all the deductibles, co-pays and exclusions, many seniors are left with burdensome medical expenses and are wondering what their options are to help cover these additional costs.

A Medigap or Medicare Supplement private insurance policy provides coverage for those medical expenses either partially covered or not covered at all by Medicare. All plans are standardized by the government. However, while the benefits are the same from one company to the next, there are still many options to choose from, and premiums and extra costs may vary significantly. It is important to be well-versed in those options before sitting down to make a decision.

At David A. Crotts & Associates, we represent many of the strongest Medicare Supplement carriers in the industry. Our team of experts will help you explore the options available and choose the plan that best fits your needs. Contact us today for more information.

Medicare Supplement Insurance (Medigap) Plans

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used) 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part A hospice care coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled nursing facility care coinsurance 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part A deductible 100% 100% 100% 100% 100% 50% 75% 50% 100%
Medicare Part B deductible 100% 100%
Medicare Part B excess charges 100% 100%
Foreign travel emergency (up to plan limits) 100% 100% 100% 100% 100%
Out-of-pocket limit in 2013
$4,800 $2,400

* Plan F also offers a high-deductible plan in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2,110 in 2013 before your policy pays anything.

** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission.

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    Greenwood, SC 29649
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Should you elect to call the numbers prodvided above, you will speak with a licensed sales agent who can answer questions and provide information concerning Health Insurance Plans both On / Off the Federal Marketplace Exchange, Medicare Supplement Insurance plans. In addition, an agent may also be able to connect you with a licensed sales agent to discuss Medicare Advantage and or Medicare Part D Prescription Drug Plans.

Neither David A. Crotts & Associates nor its agents are connected with or endorsed by the U.S. government or the Federal Medicare Program.