Medicare Solutions

Overwhelmed by your Medicare plan options? Dehncke Insurance Services specializes in Medicare Insurance with over 25 years’ experience. With all the different options available, we can help you decide what plan best suits your individual needs.

You may call, e-mail or click on the link “Request a Quote or Consultation” and we will get back to you as soon as possible. Below is some general information on the different Parts of Medicare.

The Centers for Medicare and Medicaid Services (CMS) requires agents to document the scope of an appointment prior to any face-to-face meeting. If you would like to print a scope to bring to your meeting, click on the link. Or you can get one when you come to a meeting. Filling out the scope form is easy; just initial the different plans you are interested in in the upper portion of the form and then sign your name where is says Beneficiary Signature. Then simply bring it with you and hand it to the agent.

Scope of Appointment

Original Medicare Part A

What's covered?

In general, Part A covers:

Original Medicare Part B

What's covered?

Part B covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition.

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment. Part B covers things like:

What Original Medicare A & B Doesn't Cover

Medicare doesn't cover everything. If you need certain services Medicare doesn't cover, you'll have to pay for them yourself unless you have other insurance or you're in a Medicare health plan that covers them. Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments. Some of the items and services that Medicare doesn't cover include:

  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care

Many of these options may not be covered with Original Medicare, but could be covered under Medicare Advantage Plans or Medicare Supplement Plans.

I can walk you through your options in detail.

Medicare Advantage Plans - bringing better coverage (Part C)

Medicare Advantage Plans cover all Medicare services

Medicare Advantage Plans must cover all of the services that Original Medicare and will also cover additional items.

In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care. The plan can choose not to cover the costs of services that aren't medically necessary under Medicare.

Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).

Original Medicare covers hospice care even if you're in a Medicare Advantage Plan.

If you're not sure whether a service is covered, check with your provider or health plan provider before you get the service.

I can walk you through all of the plan options currently available.

Medicare Part D - Prescription Drugs

What drug plans cover

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary).

Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less than a drug in a higher tier.

Medicare Supplement Insurance Plans

Medicare Supplement Insurance Plans are also called Medigap. They are designed to work with Original Medicare Parts A and B. They help pay for some health care costs not covered by Original Medicare, such as deductibles and coinsurance. You must have Medicare Parts A and B to qualify for a Medicare Supplement plan. These plans are offered by private insurance companies in your state. People with Original Medicare and a Medicare supplement can choose from any of the stand-alone Part D prescription drug plans to pay for their drugs.

Medicare Cost Plans

Medicare Cost Plans are a type of Medicare health plan available in certain areas of the country.

Here are important facts about Medicare Cost Plans:

  • You can join even if you only have Part B.
  • If you have Part A and Part B and go to a non-network provider, the services are covered under Original Medicare. You would pay the Part A and Part B coinsurance and deductible.
  • You can join anytime the plan is accepting new members.
  • You can leave anytime and return to Original Medicare.
  • You can either get your Medicare prescription drug coverage from the plan (if offered), or you can join a Medicare Prescription Drug Plan (Part D).

Another type of Medicare Cost Plan only provides coverage for Part B services. These plans never include Part D. Part A services are covered through Original Medicare. These plans are either sponsored by employer or union group health plans or offered by companies that don't provide Part A services.

Note: you can’t enroll in both a Medicare Supplement plan and a Medicare Advantage plan.

 

All reference material found on this page is sourced from www.medicare.gov.

Contact us today, you may call, email or click on the link “Request a Quote or Consultation” and we will get back to you as soon as possible.