How to determine which Medicare plan is right for you!
When it comes to choosing a Medicare plan, you have several choices. This is a good thing
Medicare is a national health insurance program for folks who are 65 or older, certain younger people with disabilities, and those with end-stage renal disease.
If you’re turning 65 soon, you’ll have some critical healthcare decisions to make.
Known as Medigap Plans, Medicare Supplement Plans fill in the “gaps” of medical costs that aren’t covered by Original Medicare, such as coinsurance, copayments, and deductibles.
Medicare Advantage Plans, or Medicare Part C, can be used to substitute Medicare Part A and B, as well as offer prescription drug coverage.
Medicare Part D is coverage for prescription drugs that you get from a retail pharmacy. With this program, you can access medications at more affordable rates. Plus, it provides insurance against unfavorable drug costs.
It can be challenging to figure out which Medicare plan will fit your budget and healthcare needs. However, our agents specialize in Medicare, and we want to help you compare your options. Regardless of your budget, there’s a plan available for you!
Annuities are essentially financial cushions that help alleviate financial concerns. An individual will pay an insurer a certain amount of money, and in return, the insurer will pay the individual back with a lump sum or through payments at a later date.
Medicare can be confusing and overwhelming. At Cornerstone Senior Advisors, we walk people through the process of Medicare every day to find the right plan at the right price.
At Cornerstone Senior Advisors, we specialize in helping you find the best Medicare supplement for YOUR needs. If you have a question, comment, or concern, we want to hear from you!
There are a few ways to get in touch. You can fill out the contact form, send us an email, or call our office.
As independent insurance agents, we have acquired an abundance of knowledge, and we’re eager to share this expertise with you in the form of articles and blog posts.
The Cornerstone blog covers a wide range of topics — from Medicare Advantage news to retirement planning tips, and much more.
When it comes to choosing a Medicare plan, you have several choices. This is a good thing
Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage plan that provides organized care to beneficiaries with specific needs. Like all Medicare Advantage plans, SNPs will have a network, typically either an HMO or a PPO.
SNPs restrict their membership to beneficiaries who have certain illnesses, chronic conditions, or circumstances. The plans must contain all of the same services as Original Medicare.
However, Special Needs Plans adjust their network, plan benefits, and drug formulary to accommodate the individuals’ needs. All Special Needs Plans have a built-in Part D drug plan as well.
There are different types of Special Needs Plans, and they all work in different ways.
A SNP based on health conditions is designed to provide outstanding support for those who have a chronic illness. For instance, the SNP might grant access to a network of providers who are experts at treating these specific illnesses.
These providers collaborate to organize your care. The plan often nominates a care coordinator that will help you access community resources, manage your health condition, and follow your provider’s orders. Also, the plan’s built in drug formulary will likely offer a list of drugs that treat this specific health condition.
To qualify for a Chronic Illness Special Needs Plan, you must have one or more of the following health conditions:
To join this plan, ask your agent for a chronic condition form that will verify your eligibility. Have your doctor complete this form and return it.
Chronic Illness SNPs differ by county. Insurance carriers get to decide where they’ll offer certain plans. It may or may not be hard to find a SNP in your area that specializes in the condition you have. Check with your Medicare insurance agent to see what’s available.
Medicare beneficiaries who reside in an institution, like an assisted living center or nursing home, could qualify for an Institutional SNP.
Institutional SNPs are like the chronic illness SNP but they instead concentrate on the provision of organized care to a person who is no longer living alone. The beneficiary has to be expected to live in the institution for a minimum of 90 days.
Some beneficiaries also qualify for Medicaid, which is a health insurance program for those with low incomes. When you qualify for Medicare and Medicaid, you can maintain your Original Medicare and have Medicaid operate as your secondary coverage, or you can sign up for a Dual Eligible Special Needs Plan.
The costs to join will be mostly covered for you. Expect to spend little (or nothing) on copays, deductibles, and coinsurance for Part A and Part B services that the plan provides. Since Medicaid pays any premium for you, many DSNPs have a $0 premium.
DSNPs frequently offer these benefits, too:
Your Medicare agent or your plan will have to validate your eligibility for Medicaid before enrolling you in the Dual Eligible Special Needs Plan.
To qualify for enrollment, you must be enrolled in both Medicare Parts A and B and live in the plan’s service area. You’ll keep paying Social Security for your Part B premium the whole time that you’re enrolled in the plan (unless Medicaid covers this is for you). You’ll also pay a monthly premium that the plan charges for the SNP, plus the deductibles, copays, and coinsurance.
Sometimes these plans are offered without a monthly premium.
You can enroll in a SNP during your Initial Enrollment Period for Medicare or during any Fall Annual Election Period.
In certain situations, some folks may also qualify for Special Enrollment Periods during the year. These situations include:
If you lose your eligibility for a Special Needs Plan, you’ll have a grace period that allows you to leave the plan and join another — or return to Original Medicare.
Cornerstone Senior Advisors works with a multitude of Medicare Advantage Special Needs Plans. We want to help you find the right SNP for your situation. For questions, or to set up an appointment, call (316) 260-3331 today.