Euless Texas Medicare Insurance
Waht is Medicare?
Medicare is like a health insurance policy offered to senior-citizens, along with people under 65 who have disabilities in certain ways. It is considered to be an entitlement: If you paid Medicare taxes on your earnings while working (they’re usually taken out of your paycheck automatically, just like your Social Security contributions), you are automatically eligible for Medicare at age 65. It is not income-based.
Medicare has four parts. Some parts require payment of a monthly premium just like private health insurance, but the program is not based on your financial need:
- Part A – covers hospital care: Covers the cost of being in a medical facility.
- Part B – covers doctors, medical tests, and procedures: Basically, anything that is done to you. There is a monthly premium for Part B coverage.
- Part C – Medicare Advantage: This is an alternative to traditional Medicare coverage. Coverage often includes Parts A, B, and D. Private insurance companies administer Medicare Advantage plans.
- Part D – Prescription drug coverage: Part D is administered by private insurance companies, and you are required to have it unless you have coverage from another source. Part D requires you to pay a monthly premium in most cases.
Medicare isn’t like a comprehensive health insurance plan. If you only have traditional Medicare, there are gaps in coverage. For example, Medicare doesn’t cover any long-term care, unless you purchase a Medicare Advantage Plan or a Medigap (Medicare Supplement) policy.
Even if you aren’t eligible for Medicaid, you may qualify for one of three Medicare Savings Programs (MSPs), administered by your state’s Medicaid program.
Federal income and resource limits listed below are for 2015. Limits for 2016, when released, will be slightly higher. Some states have more liberal allowances, so it might be worth applying even if you are over the limit.
- Qualified Medicare Beneficiary (QMB) Program: QMB helps pay for Medicare Part A premiums, Part B premiums, deductibles, co-insurance, and co-payments. Income limits are $1,001 for an individual and $1,348 for a couple. The value of assets (or “resources”) you can own are limited to $7,280 for a single person and $10,930 for a couple.
- Specified Low-Income Medicare Beneficiary (SLMB): SLMB helps pay for the cost of Medicare Part B premiums. SLMB income is limited to $1,197 for an individual and $1,613 for a couple. Resources limits are the same as for the QMB program.
- Qualifying Individual (QI) Program: QI helps pay the cost of Medicare Part B premiums only. Each year, you have to apply for QI benefits (or re-apply). These benefits are granted on a first-come, first-served basis; priority is given to those who received QI benefits the previous year. Income limits are $1,345 (individual) and $1,813 (couple). Resources allowed are the same as for QMB and SLMB. You may not receive QI benefits if you qualify for Medicaid.
If you qualify for a QMB, SLMB, or QI program, you will automatically qualify to get “Extra Help” paying for Medicare prescription drug (Part D) coverage. In determining the value of your resources, your checking and savings account balances, as well as the value of all stocks and bonds, are counted. Your home, one car, a burial plot plus $1,500 worth of burial expenses, furniture, and other household and personal items are not counted.
If someone qualifies for both Medicare and Medicaid, they are “dual eligible.” Under this status, most if not all, of your healthcare costs will be covered. Medicaid will pay for most of your Medicare Parts A and B premiums (if there are premiums), along with deductibles and co-payments you may have. It doesn’t matter if you get your Medicare coverage through a Medicare Advantage (MA) Part C plan or traditional (Original) Medicare.
If you are “dual eligible” and receive full Medicaid, your prescription drug coverage (Part D) will go through Medicare, but you will automatically qualify for Extra Help paying for your medicines. In addition, Medicaid may cover some drugs that Medicare does not.
As a taxpayer, you contribute to Medicare during your working years and will receive Part A coverage probably at no cost to you. Additional coverage, such as Part B and Part D, might be required and could come with a monthly premium. Because Medicare has gaps in coverage, you’ll likely need additional coverage that might come with an extra monthly premium on top of what you already pay.
Medicaid is a needs-based program. Although states have the option of charging out-of-pocket fees, certain groups, such as children and people living in institutions, are generally exempt from these costs.
Since life expectancies are getting longer, and retirement savings are falling short, more and more seniors might find themselves qualifying for Medicaid benefits, either in full or in part. In addition to helping with medical costs, Medicaid offers coverage not normally available through Medicare, such as extended nursing home care and custodial or personal care services. But since the income requirements are stringent and the program penalizes people who try to shed assets right before they apply, long-term planning is required to qualify.
What We offer
Ashford Insurance offers UnitedHealthcare® Medicare Solutions Medicare Advantage Plans. You can get your Euless Texas Medicare benefits through Original Medicare, or you can choose a Medicare Advantage Plan. With Original Medicare, the government pays for your Medicare benefits when you get them.
Ashford Insurance offers Euless Texas Medicare Supplement Insurance Plans also called Medigap or Medsup. Medicare Supplements are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M and N. Each standardized Medigap policy must offer the same basic benefits no matter which insurance company sells it.
Some people have both Medicare and Medicaid. If so, they could be “dual eligible.” That’s where dual special needs plans — or “dual” plans — come in. Dual plans combine the benefits of both Medicare and Medicaid into one simple health plan. If you have Medicare and Medicaid, chances are you could qualify for a dual plan.
Ashford Insurance offers Euless Texas Part D Prescription Drug Plans. Part D Plans are coverage for retail prescription drugs, or the medications that you pick up at a pharmacy. This is a voluntary program which allows you to access medications at an affordable rate, and insures yourself against any prescriptions you may need future.
Ashford Insurance is an Independent Marketing Organization working with UnitedHealthcare® Medicare Solutions. Attend one of our local Medicare Seminars: Meeting List
We promote Medicare insurance plans through UnitedHealthcare® Medicare Solutions branded products. We specialize in Euless Texas Medicare Insurance.
Sonia, “The Medicare Insurance Lady”, has been helping Medicare eligibles in Texas with their Medicare Insurance now since 2005. She has been married to John Ashford since 1982 and they reside in Bedford, Texas. They have six adult children and nine adorable grandchildren that they love to spoil. In Sonia’s limited spare time she enjoys quilting and crafting. They have several pets at home including freshwater fish and a Havanese Shih Tzu named Precious.