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What is Medicare and How Do I Qualify?Medicare is a U.S. federal health insurance program mainly for people 65 or older, or for younger people with certain disabilities or specific medical conditions. You may become eligible for Medicare based on one of the following: You are 65 or older You are under 65 with a qualifying disability. Medicare eligibility starts after 24 months of receiving Social Security Disability Insurance (SSDI). You have a diagnosis at any age of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS,also called Lou Gehrig’s disease). All Medicare applicants need to be a U.S. citizen or a permanent legal resident who have resided in the United States continuously for at least five years.
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What is Medicare Advantage (Part C)?Medicare Advantage plans are offered by private insurance companies contracted through Medicare as an alternative to Original Medicare. These plans combine all of the benefits of Medicare Part A (hospital) and Part B (medical), and may also include prescription drug coverage, if they are Medicare Advantage Prescription Drug Plans. These plans combine all of the benefits of Medicare Part A (hospital) and Part B (medical), and may also include prescription drug coverage, dental or vision coverage all for an affordable and sometimes $0 monthly plan premium.
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PPO vs. HMO vs. HDHP
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Special Needs Plans (SNP)Dual Special Needs Plans (DSNP) Dual SNPs focus on consumers who receive state assistance with cost sharing. These plans are tailored to low-income, aged and disabled people who need help to get the most from what is available to them through Medicare and Medicaid. Dual SNPs provide consumers with benefits in addition to the benefits covered by Original Medicare, such as routine eyewear and transportation to doctor appointments. Members must have Medicaid to enroll. Chronic Condition Special Needs Plans (CSNP) Chronic Condition Special Needs Plans (SNP) are designed for Medicare eligible consumers diagnosed with chronic conditions such as diabetes, cardiovascular disorders and/or chronic heart failure. These plans offer benefits in addition to those covered by Original Medicare such as dental, vision, transportation, and routine podiatry. UnitedHealthcare offers a variety of Chronic Condition SNP options for Medicare eligible consumers. Institiutional Special Needs Plans (ISNP) Institutional SNPs focus on consumers who reside in a contracted skilled nursing facility or assisted living communities and require an institutional level of care. Institutional SNPs may provide consumers with benefits in addition to the benefits covered by Original Medicare, such as routine eyewear and dental coverage (preventive and/or comprehensive).
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What are Medicare Prescription Drug Plans (Part D)?Medicare Part D plans add prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans. A prescription drug plan may help you save money on existing prescriptions or on medication needs in the future.
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Medicare Supplement (Medigap) PlanMedicare Supplement Insurance Plans insured by private health insurance plans which are designed to supplement Original Medicare. They help pay some of the health care costs that Original Medicare may not cover (such as copayments, coinsurance, and deductibles). For hospital and medical, Medicare is primary which covers (80%) / Medigap is secondary which covers only (20%) out of pocket expenses. Various Medicare Supplement plans by state may include: Plan A, B, C, G, F, K, L, and N (except in Massachusetts, Minnesota and Wisconsin, which have different plans designations). Each plan has its own specific benefits so consumers can which one best fits their needs or budget goals. For detailed state-specific information on underwriting eligibility, guaranteed issue or Medicare Open Enrollment, please consult with an experience, licensed agent by Leosapro Insurance Agency. ----------------------------------------------------------------------------------------------------------------------------------------------- The following eligibility rules apply for Medicare Supplement applicants: Enrolled in Medicare Parts A and Part B Both must be active at time of the plan effective date Age 65 or older Under age 65 with certain disabilities approved by SSA (may vary by state) Applicant is required to be US citizen or legal permanent resident
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