UnderstandingMedicare_2

Senior-Preferred-4c
Medicare Advantage (HMO) 

Overview
Senior Preferred is a Medicare Advantage plan with four different coverage options. All four plans offer comprehensive medical coverage, worldwide urgent and emergency coverage and fixed premiums regardless of your age. Two plans also include Part D drug coverage. Senior Preferred plan options are sure to fit your needs for cost and coverage.

To learn more or schedule an appointment to meet with a Senior Preferred representative, please call Customer Service at (608) 881-8275 or (800) 394-5566. 

What is a Medicare Advantage plan?

  • It is a type of Medicare health plan offered by a private company that has a contract with Medicare to provide you with all of your Part A and Part B benefits. Most Medicare Advantage plans also offer Part D prescription drug coverage. You still have Medicare, however services are covered by the Medicare Advantage plan, not original Medicare.
  • Medicare Advantage plans must cover all of the services original Medicare covers, except hospice care. Original Medicare covers hospice care even if you are in a Medicare Advantage plan.
  • Medicare Advantage plans can also include additional benefits.

SeniorChoice_2c_copy
Medicare Supplement

Overview
Senior Choice is a Medicare Supplement (Medigap) plan from Gundersen Health Plan that is designed to work in conjunction with original Medicare. Senior Choice members enjoy a variety of benefit plans, the freedom to choose any Medicare participating provider and the same great customer service you know and rely on from Gundersen Health Plan. 

To learn more, contact a health insurance advisor. You can view the list of advisors here. You can also call Gundersen Health Plan Sales & Marketing at (608) 881-8242 or (866) 491-1335.

What is a Medicare Supplement policy?

  • Medicare Supplement (Medigap) insurance is sold by private companies, but is different from Medicare Advantage. Medicare Supplement policies pay some of the healthcare costs that original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
  • Some Medigap policies also offer coverage for services that original Medicare doesn't cover, like medical care when you travel outside the U.S.
  • If you have original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered healthcare costs. Then your Medigap policy pays its share.

 

MEDICARE OVERVIEW

If you have questions about Medicare, Senior Preferred or Senior Choice, please don't hesitate to contact our Customer Service Department.

Resource Guide

What Is Medicare? 

​​Medicare is health insurance for people:

  • Age 65 or older
  • Under age 65 with certain disabilities
  • Of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)

How do I enroll in Medicare? 

If you are drawing Social Security you will automatically get your Medicare card in the mail approximately 3 months before your birthday. If you are not drawing, you will need to contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) no earlier than 3 months prior to your birthday to get enrolled.

Do I need any other coverage other than Medicare?

Medicare does not cover 100% of your medical charges.  Most beneficiaries purchase a Medicare Supplement or a Medicare Advantage plan to help offset the charges Medicare doesn't pay.

You can also learn more at medicare.gov.

By selecting the link above, you will leave the Gundersen Health Plan website.

Medicare A, B, C and D helps cover hospital, skilled nursing facility, hospice and home health care services.  There is generally no cost for Part A.

Medicare Part B helps cover doctors, outpatient and home health care services as well as medical equipment. Generally, a monthly premium ($121.80 for 2016), will be deducted from your social security check for Part B. 

Medicare Part C  is the term used to describe Medicare Advantage plans. Medicare Advantage is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage plan, Medicare services are covered through the plan and aren't paid for under original Medicare. Most Medicare Advantage plans also offer prescription drug coverage.

Medicare Part D covers prescription drugs. Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan when you're first eligible, and you don't have other creditable prescription drug coverage, or you don't get Extra Help, you'll likely pay a late enrollment penalty. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

Do I need Medicare?

If you (or your spouse, whichever one is carrying health insurance) are still actively employed and you are covered by an Employer Group Plan through that employment, you can defer Part B without being penalized.  Once you (or your spouse, whichever one is carrying the insurance) stops actively working, you will need to be enrolled in Part B to avoid being penalized. If you continue group health insurance coverage and defer Part B, you will need to confirm that the prescription drug coverage through the group health insurance is “Creditable Coverage”.  The employer will be able to advise you on whether or not it is.  If it isn't, you will need to enroll in a Medicare Part D plan to avoid a penalty in the future, for not having creditable prescription drug coverage.