MEDICARE OPTIONS

Options for every Medicare client.

Medicare Supplement

"Medigap" Plans

Private policies which pay after Medicare.

Get coverage you need to fill the gaps!
Medicare Part A & B provides coverage for basic medical care but many people want to qualify for more inclusive coverage options. A Medicare Supplement (Medigap) insurance plan is a privately owned policy sold by private insurance companies to help pay for Medicare expenses like coinsurance and deductibles.

This policy helps by paying many of the health care costs that Original Medicare doesn’t cover (copayments, coinsurance, and deductibles). Some Medigap policies also cover for services that Original Medicare doesn’t include, like foreign travel emergency care, and with no network restrictions you have the freedom to visit any licensed doctor or hospital that accepts Medicare.

If you have Original Medicare and you buy a Medigap policy, your policy will pay after Medicare pays its share of the Medicare-approved amount for covered costs.

A Medicare Supplement (Medigap) plan can often have many valuable benefits. There are many Medicare insurance options available. Individual review of your Medicare insurance needs with a certified professional agent will give you confidence to choose the right Medicare plan.

ElderCare Associates of Harrisonburg, VA has served seniors and families in the Shenandoah Valley, Virginia, and the mid-Atlantic for over 35 years. We now work for Americans across the nation. Our experience and expertise are unmatched.

Medicare Advantage

"Part C" Plans

Private companies who pay for your healthcare.

Medicare Advantage, also known as Medicare Part C, is a plan offered by a private company that contracts with Medicare to provide Medicare Part A and Part B benefits, including emergency and urgently needed care.

These private plans will usually charge a premium in addition to your Medicare Part B premium. Many also have cost-sharing for services and charge a fixed amount called a copayment or coinsurance whenever you receive these specific services.

If you have health coverage from your current or former employer or union when you become eligible for Medicare, your coverage may be automatically converted into a Medicare Advantage plan and will likely include drug coverage.

Find the right Medicare options for you with our certified professional agents!

Be informed that if you switch to Original Medicare or another Medicare Advantage plan instead, your group coverage could be terminated or health benefits may be reduced, including the health benefits of your dependents, and any other benefits you get from your company.

The choice to stay with this plan, choose Original Medicare, or switch to a Medicare Part C Advantage plan must be carefully reviewed with your dedicated agent.

You may choose to join a plan if you have Medicare Parts A & B; you live in the plan’s service area; and you do not have End-Stage Renal Disease. Medicare Advantage Plans provide all Medicare benefits and covered services.

Your plan may offer extra coverage such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D) as part of the entire policy.

The most common types of Medicare Part C Advantage plans are Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-for-Service Organizations (PFFS). There are also other types of plans you may see including Special Needs Plans (SNPs), Provider Sponsored Organizations, and Medical Savings Accounts (MSAs).

Medicare Advantage plans can often have many benefits. There are many Medicare insurance options available. Individual review of your Medicare insurance needs with your agent will give you confidence to choose the right Medicare options for your needs.

Medicare Prescription Drug

"Part D" Plans

Private companies who pay for your prescription drugs

Medicare Part D (PDP) Prescription Drug Plans help with prescriptions. Each Medicare Prescription Drug Plan has its own Formulary – a list of covered drugs.

The formulary can change each year, which is one of the many reasons Medicare allows you to explore and choose the plan that covers your particular medications during your Medicare Annual Enrollment Period. Medicare Prescription Drug Plans place drugs into tiers on their formularies, each with a different cost.

A drug in a lower tier will usually cost less than a drug in a higher tier. The plan you choose; the drugs you use (i.e., generic or name brand); whether you use a network pharmacy; if your drugs are on your plan’s formulary; as well as if you get Extra Help from Medicare will all affect your total out-of-pocket drug costs.

Drug Plans may have coverage rules to reduce costs.

If a medication you are taking is restricted by these coverage rules, you can ask your Part D Plan for an exception. These rules include Prior Authorization, where you and the prescribing physician need to contact the plan before you can receive certain medications at the pharmacy. Often the prescriber will need to show that the drug is medically necessary.

Quantity Limits are another type of coverage rule that puts limitations on how much medication you can obtain at the pharmacy at one time. Step Therapy may also be a coverage rule for your medications under your plan. Step Therapy requires you to first try one or more similar medications before the plan will cover your prescribed medication.

We are here to support your decisions.

Medicare Advantage plans may include Prescription Drug Coverage benefits.

There are many Medicare insurance options available. Personalized review with your agent will give you confidence to choose the right Medicare Part D Prescription Drug Plan.