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 our Medicare Specialist Mary Krueger at 715.760.1350 or 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.

By Mary Krueger, Medicare Specialist

Many Medicare eligible participants are familiar with Medicare, but the process is confusing to them so we’re here to assist you with those issues. Here are the answers to some common questions.

Do I need to sign up for both Part A and B or just Part A? 

Whether you choose Part A, B or both depends on the plan you’re on, the benefits you’re looking for and if you have any spend down accounts that can be used. Checking all your options will save you money and find the coverage that suits your needs.

Is it really necessary to get a prescription drug program or can I skip it because I don’t use any prescriptions?

Great question! Even if you do not use any prescriptions, you are required to obtain credible coverage for prescription coverage. Without it, you will acquire a lifetime penalty.

I am already on a Medicare program. Is there any help you can give me?

Yes! We compare your coverages and costs. Perhaps you’ve moved and your new address has a favorable discount or you have increased needs for prescriptions; these issues and others are addressed either during your open enrollment period each fall or at your renewal. We do the shopping for you!

Click here to learn about income related monthly adjustment amount (IRMAA).

For help with your Medicare questions, contact Mary Krueger at 715.760.1350 or mary.krueger@wismedassure.org.

By Mary Krueger, Medicare Specialist

Before enrolling in Medicare, there are several decisions Medicare recipients need to make regarding their existing coverages or changes in their health insurance needs.

Typically, six months prior to becoming eligible (eligibility for Medicare may be because of disability or turning 65), it is a good idea to speak with a Medicare Specialist to establish an open dialog about what you want in your benefits and how much of your budget to designate for it.

Here are a few questions:

• Will I be in a network or have the freedom to choose where I go?
• What are the benefits of choosing a Medicare Advantage or a Medicare Supplement?
• Who will help me if I have a claim and don’t understand the billing?
• Will I need to get preauthorization for my surgery?

These are a few of the concerns that are voiced regularly. Medicare has been providing coverage since 1965. Plans have changed over the years and so have the benefits, which is why it makes sense to have someone who can walk you through these and many other issues with Medicare.

I have enjoyed helping in those decisions for more than 40 years, and it is my pleasure to assist in the decisions Medicare recipients make. Contact me at 715.760.1350 or mary.krueger@wismedassure.org.