Medicare
What You Need to Know

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CMS, the Center for Medicare and Medicaid Services, requires that insurance agents providing Medicare Part D Prescription and Medicare Advantage Plans to people on Medicare, first receive from the Medicare beneficiary the Government form below or have an approved teleconference call with you.   After I receive the Scope Of Appointment form from you either by fax, mail or email, or we complete the call, then I can provide you with detailed Medicare Part D prescription and Medicare Advantage Plan information. 

Medicare is a valuable government health program for people over age 65 and people that qualify due to disability.  It can be very confusing.  This is the place to find help understanding Medicare and Medicare Programs.

There is no charge to the individual for using the services of a licensed health insurance agent—the commission is entirely paid by the carrier. The carrier is prohibited from selling the policy any cheaper if an individual does not use an agent.

Medicare is the United Sates federal government health insurance program to provide health insurance to the elderly and disabled. Medicaid is a different government program providing benefits for people qualifying with low income. Medicare begins for most people at age 65. Medicare is also available for qualifying disabled individuals of any age.

Medicare coverage for hospital services is provided under Part A, and coverage for physician and other professional services is provided under Part B. For beneficiaries entitled to Social Security benefits, Part A coverage is provided with no premium payment required from beneficiaries. Both Part A and Part B have annual deductibles and coinsurance requirements, meaning that beneficiaries are financially responsible for a portion of the care they receive. Under Part B, beneficiaries also pay a monthly premium.

Medicare supplement insurance was designed to fill in the gaps in Part A and Part B coverage. The most common type of supplement is Medigap. Medigap is specifically designed to supplement Medicare benefits and is regulated by federal and state law. The majority of states (including the District of Columbia and US territories) have limited the number of Medigap plans that can be offered. The National Association of Insurance Commissioners has developed 10 different Medigap plans that are now part of state and federal law. These plans are described in detail below.

Massachusetts, Minnesota, and Wisconsin are exceptions to the Medigap rule. Each of these states had alternative Medigap standardization in place when the federal program was enacted in 1992 and they were allowed to keep their existing plans. You can obtain details on the Medigap plans available in these states by contacting the state insurance department.

The 10 Medigap plans are designated by the letters "A" through "J," with Plan A being the basic plan and Plan J being the most comprehensive. Not every plan is available from every insurance company or in every location. If an insurance company sells Medigap plans, it must offer the most basic package (Plan A) in addition to whatever other plans it chooses to sell. In addition, some states have limited the number of plans available to beneficiaries.

To summarize, Medicare has two main parts:

It is very important to remember that Medicare pays based on Medicare approved amounts. This applies to Part B medical services and very importantly to Part A nursing facility services. Medicare covers less than 5% of the nursing/convalescent facility costs.

Insurance that goes with Medicare includes Medicare Supplement/Medigap policies, Long Term Care plans and Medicare HMO plans that administer your Medicare benefits. The Medicare HMO plans are only available in limited areas.

It is important to remember that when you first become eligible for Medicare, all insurance companies with a Medigap product are required by law to sell you a Medigap plan regardless of your health. After 6 months, however, insurance companies are allowed to raise the price if you are not healthy or not sell you a plan at all. Some states have laws guaranteeing that anyone on Medicare can purchase a Medigap plan, but most states do not. This could effect people if they want to leave a Medicare HMO and return to Medicare Supplement policy.

The linked WebPages below will provide you with descriptions of Medicare's benefits, Medicare Supplement/Medigap policies.  If you would like to apply or need further information, please e-mail or call. The contact information is also below. We look forward to hearing from you. 

Please call 1-888-592-0311 extension 702 or email for information

John K. Arnold
Florida Health Insurance
Group, Employee Benefits & Individual Health Insurance Specialist
Website Address  www.floridahealthinsurance.com
E-Mail: John K Arnold    

Phone: 407-592-0311
Fax:     407-386-7053

If outside the US, it is best to e-mail as we can respond more quickly.  Thanks.

Let me know how I can help you.

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