Annual Enrollment Period Oct 15- Dec 7

 During the Annual Enrollment Period (AEP), you are allowed to change your Medicare plan. The knowledgeable advisors at Medicare Pathways are here to help you navigate through the choices offered.

Medicare can be exceedingly complicated and complex. The truth is, Medicare and the insurance companies do very little to simplify the information. At Medicare Pathways we have conducted hundreds of Medicare workshops for numerous years all over Indiana. We pride ourselves in being able to break through the maze of information and condense it into easily understandable information.

 Medicare Part A is sometimes referred to as HOSPITAL insurance and covers medically necessary hospital services and care. Medically necessary is deemed as: services, tests, or materials needed, according to accepted standards of medicine, to prevent, diagnose or treat a malady.  Medicare Part A (Hospital Insurance) covers blood you get as a hospital inpatient.  About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. 

 Medicare Part B is sometimes referred to as MEDICAL insurance and covers certain physician services, outpatient care, medical supplies, and preventive care.  Other services covered include mental health services, X-rays and lab tests, chiropractic care when manipulation of the spine is medically necessary to fix a subluxation of the spine (when one or more of the bones of the spine move out of position), and select prescription drugs, including immunosuppressant drugs, some anti-cancer drugs, some anti-emetic drugs, some dialysis drugs, and drugs that are typically administered by a physician.  Medicare Part B (Medical Insurance) covers blood you get as a hospital outpatient.

While not part of Original Medicare, the Medicare Prescription Drug Plan (Part D) is very important. It provides coverage for prescription drugs which is offered under Medicare. You can either sign up for a Medicare Prescription Drug Plan (Part D) on its own or receive drug coverage through your Medicare Advantage Plan (Part C).  Each plan that offers prescription drug coverage through Medicare Part D must give at least a standard level of coverage set by Medicare. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different “tiers” on their formularies.

 Medicare Supplemental Insurance, or Medi-Gap, is insurance on top of your Original Medicare insurance and pays for a portion of deductibles, co-payments, and co-insurance for Part A and Part B services.

Medicare Supplemental Insurance has standardized plans A through N and the percent of out-of-pocket expenses covered depends on the standardized plan you select. You cannot have both Medicare Advantage and Medicare Supplemental Insurance; it’s one or the other. Compare coverages from each to help determine your best solution. Prescription drug coverage is not included with this plan.