medicare

By Mary Krueger, Medicare Specialist

It’s early 2024 and its already time to explore Medicare options for 2025. Many Medicare enrollees want to look at what is suitable for their needs in the Medicare market. If you have started looking for yourself or someone else, there are many different ways to procure coverage. Let’s explore some ideas for the 2025 Medicare Advantage programs that are being considered by medicare.gov.

Medicare Advantage

One of your options is the Medicare Advantage program. Insurance companies have slightly different copays and out-of-pocket maximums, so it’s very important to look at those. Additionally, some of your coverages are limited to in-network clinics and hospitals. Out-of-network procedures may require you to pay more or all of the bill. This is why it is critical to understand what your plan covers. Medicare pays the insurance companies for your care, so you do not need to show your Medicare card to the provider, you only need your insurance card.

Medicare Supplement (Medigap)

Your other options are the Medicare Supplement (also known as Medigap) policies which do not have networks. This seems to be the most popular option with our members with plans written through WisMed Assure. The freedom to choose where you get care (as long as the facility accepts Medicare) has been a very important benefit for those who are semi or fully retired.

Losing coverage

If you are age 65 or older, you have a right to guaranteed issue within 63 days of when you lose or end certain kinds of health coverage. When you have a guaranteed issue right, companies must sell you a Medigap policy at the best available rate, regardless of your health status, and cannot deny you coverage.

Choosing to enroll

Under federal law, you get a 6 month “Medigap Open Enrollment” period. It starts the first month you have Medicare Part B and you’re 65 or older.

Disability eligibility

Options are also available for those under age 65 who are eligible for Medicare because of a disability.

We are here to help you. Contact the WisMed Assure team at insurance@wismedassure.org, complete this quick online form, or call 608.442.3810 for help with your insurance needs.

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.

By Mary Krueger, Medicare Specialist

As many of you on Medicare know, October 15 to December 7 is the Annual Election Period for Medicare Part D and Medicare Part C (Medicare Advantage). This often coincides with a flurry of research needed and concerns expressed by client recipients and this year was no exception.

For many, a prescription drug deductible is an easy choice, but the issue of very expensive prescriptions is a familiar plea. Therefore, searching for solutions is top priority.

One of those requests came from a physician and his wife who had vastly different prescription needs. One was taking a simple generic drug that would not meet the deductible but the other needed to find a way to reduce the cost of their estrogen cream and heart medication.

In this case, the best option was prescription discount cards (GoodRx and SingleCare) along with their Medicare Part D plans. These discount cards are a great way to research costs online to find more economical ways to get prescription medications. In this case, the savings amounted to more than $72 per month on one and $31 per month on the other medication.

Additionally, I assisted a family that saved more than $8,210 in a year for experimental MS drugs using a discount card.

Free discount cards have been a great help for many of my customers and are worth exploring in addition to the Part D plans. Not only can these cards help you personally, but they can be a great resource for your patients.

If you need assistance with your Medicare choices, let me know. We are here to help you! Contact Mary Krueger at 715.760.1350 or mary.krueger@wismedassure.org.

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.