Medicare Service Overview

Medicare is health insurance for people 65 and older, and some people under 65 if they have been declared disabled (SSDI), have Lou Gehrig’s Disease (ALS), or have End-Stage Renal Disease (ESRD). It can be confusing with all of the parts, plans, and rules of Medicare! We’re here to help simplify the process and walk you from start to finish. Whether you’re about to turn 65, over 65 and looking to retire, or 65 or over and still working, we can help you understand the different options you have available to you.

We’ll start from the beginning to explain what each part means and the rates, and we will compare all of your options as far as Medicare Supplements, Prescription Drug Plans, and Medicare Advantage plans. We will help you enroll to ensure you get the correct effective date. We’ll be here throughout the year to help answer questions and service your Medicare needs. Each year, we’ll go over your renewal and shop any of the products you’d like to ensure you have the best plan to meet your needs.

 

What Can Medicare Cover?

• Hospital Stays. Medicare Part A covers inpatient hospital stays, which include semi-private rooms, nursing services, and meals during your stay. It also covers skilled nursing facility care for a limited period following a hospital discharge, hospice care, and home health care.
• Outpatient Services. Medicare Part B envelops outpatient care, including doctor visits, preventive services (like screenings and vaccines), lab tests, and outpatient surgeries. It also covers other medically necessary services and supplies, including certain durable medical equipment (DME).
• Prescriptions. Medicare Part D provides prescription drug coverage, which is provided by private insurers and approved by Medicare. This plan can cover prescription medication costs, with various formularies available that determine which drugs are covered and at what cost.
• Preventive Services. Medicare also focuses on preventive health care. Many preventive services, such as annual wellness visits, flu shots, and cancer screenings (such as mammograms and colonoscopies), are covered without any cost-sharing, encouraging beneficiaries to stay proactive about their health.
• Mental Health Services. Medicare can cover mental health services, including inpatient psychiatric care, outpatient mental health services, and substance use disorder treatment. These services assist beneficiaries in managing mental health conditions and support their overall well-being.
• Home Health Care. Medicare can include certain types of home health care services, such as part-time or intermittent skilled nursing care, home health aide services, and rehabilitative services, such as physical therapy—generally for homebound patients who require skilled care.
• Skilled Nursing Facility Care. After a qualifying hospital stay, Medicare will cover skilled nursing facility care, including rehabilitation services like physical and occupational therapy. This coverage is limited to a specific period, and certain conditions must be met.
• Durable Medical Equipment (DME). Medicare covers durable medical equipment for home use, such as wheelchairs, walkers, and oxygen equipment. However, equipment must be prescribed by a doctor and meet specific criteria to be eligible.

 

Service Areas

✓ Louisiana

 

Medicare: Find An Agent

Meet our licensed insurance agents dedicated to providing personalized insurance solutions tailored to your unique needs.

 

Frequently Asked Questions:

1. What is the cost of having an insurance broker?

Our services are at no cost to you, the client. We get paid from the insurance carrier at no additional fee to you. The rates you get from an independent broker are the same ones from the insurance company.

2. What is the difference between Medicare & Medicaid?

Medicare is a federal health insurance program for people 65 and older and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources. It offers benefits like nursing home care, personal care services, and assistance paying for Medicare premiums and other costs. Some people qualify for both Medicare and Medicaid.

3. What is Part A?

Part A (Hospital Insurance): Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

4. What is Part B?

Part B (Medical Insurance): Helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment), and many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits).

5. What is Part C?

Part C (Advantage plan): Private insurance companies approved by Medicare run these Louisiana medicare advantage plans. They offer all of the benefits under Part A and Part B; most include drug coverage and sometimes extra benefits like vision or dental care.

6. What is Part D?

Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs (including many recommended shots or vaccines).

7. What is a Medicare Supplement (Medigap)?

These plans are offered by private insurance companies. They can help cover out-of-pocket costs that Original Medicare (Parts A and B) does not pay, such as copayments, coinsurance, and deductibles. There are multiple plans (A, B, F, G, N) offered by multiple carriers. It is important to note that as of January 1, 2020, new enrollees can no longer purchase Plan F.

9. If I’m ready to enroll in Parts A and B, where do I go to fill out the application?

You can complete the application through the Social Security website: https://www.ssa.gov/benefits/medicare/. Then click “Apply for MedicareOnly.”

10. Do I have to choose the same plan as my spouse?

No, Medicare differs from private insurance — it doesn’t offer plans for couples or families. You don’t have to make the same choice as your spouse.

 

Find Your Medicare Plan With Allied Benefits Solutions

Not everyone in Louisiana knows how to choose the right Medicare plan. But with Allied Benefits Solutions by your side, you have a trusted partner to guide you through the selection process. Our agents can offer personalized guidance to consider your unique healthcare needs.

Contact us immediately if you or your loved ones require assistance finding the most suitable Medicare plan.