Getting Started

Medicare Advantage plans are designed to cover All the health benefits of Medicare A & B: Inpatient and Outpatient services. They can provide Medicare Rx coverage (Part D) - in the same way as a stand alone plan. And they can offer Extra benefits - not covered by Medicare: dental, vision, hearing, gym memberships and the like. The private insurance companies build the plan which meets the rigorous requirements and are measured and evaluated by Medicare.

Let’s think on the plan as a metal Lunch Box: like we all had as kids in elementary school. If you wanted a whole apple, plus a sandwich, plus chips and a thick brownie; Mom or Dad may have to had cut the apple into slices to fit. Or maybe you got a flat cookie. The point is everything had to fit into the Lunch Box. AND everybody had a different Lunch Box. All of these benefits have to fit into YOUR Lunch Box

Fun Side Note: we were at the Museum of American History in Washington DC this summer. They had an exhibit “Taking America to Lunch” - a collection of lunch pails, buckets and boxes from the 1840’s to present.

Let’s Look at What is Most Important
​1. Doctors

Your doctor, primary, specialist, and your local hospital who are Most Important for your health care. You have a trusted relationship with these medical professionals. We want to preserve and enhance this.

Other doctors, dermatology, routine eye, physical therapist and the like: we want to try to have these in the network. In some cases, folks will change one of these providers to get the best overall plan. Out of network: All Advantage plans have network of providers with whom they are contracted. We need to review the plans carefully as to how the plan would work beyond the local service area. And, remember – a life threatening emergency is covered where you are.

2. Rx Medications

The key point is that the insurance company negotiates directly with Rx manufacturer. “We are going to buy 10 million dosages of ABC drug - What’s your best price?" By evaluating your unique combination of medications we’ll find the most effective plan for you. Pharmacy. Where you get your medications can have some effect on the overall cost, especially if your pharmacy is not a preferred with that company. All plans offer 90 day mail order.

3. Medical Benefits