Medicare Supplement/Part D (Rx) & Advantage Plans

Rauser_long-term_careBenefit from our experience with seniors.

If you’re at retirement age, chances are you’re being inundated by advertisements for Medicare supplemental insurance. You know you need to choose a plan, but which one? Comparing plans can be time-coming and confusing, and you don’t want to risk making the wrong choice. Let The Rauser Agency help you sort it out. We’ve been working with seniors for years and know which plans provide the best combination of benefits and value. Best of all, our services are available to you at no additional cost. Come visit us. We offer Medicare Supplement, Advantage and Part D Plans from multiple insurers and can help you select the plan that’s right for you.

Points to keep in mind.

If you are going to continue working:

  • If you work for a small employer (under 20 employees), and wish to remain on the group health plan, you are still required to sign up for Medicare Part B. (see below).
  • If you work for a large employer (20 or more employees), and wish to remain on the group health plan, you do NOT need to sign up for Part B yet.
  • If you want to leave the group health plan, or your premiums aren’t subsidized by your employer (e.g., you’re the owner), you will want to sign up for Medicare Part B and buy a Medicare Supplement or a Medicare Advantage Plan (Part C).

If you are retired, or are about to retire:

  • You will want to elect Medicare Part B and buy either a Medicare Supplement Plan with Part D (Rx) coverage or, Medicare Part C, which is supplemental and prescription drug combined.

To sign up for Medicare:

  • You will be eligible for Medicare on the 1st of the month in which you turn 65 (turn 65 on March 17th, you are eligible March 1). Call Medicare (1-800-772-1213) 45 to 60 days in advance of your Medicare
  • Part A of Medicare is automatic at age 65, and free of charge. You are calling to sign up for Part B.

What will this cost per month?*

  • Medicare Part A: $0.00
  • Medicare Part B: $121.80**
  • Medicare Part D: $17.00***
  • Medicare supplement: $196.68****
  • Medicare Advantage: $24.00***

What will this cover?

  • With very few exceptions, all of your doctor, clinic and hospital charges at 100%. For most people, your outpatient prescriptions after a copayment, but this plan requires further explanation. For an official reference piece, please see: http://oci.wi.gov/pub_list/pi-002.pdf

What doctors and hospitals can I use?

  • For most Supplemental Plans any doctor, hospital, anywhere in the country. Emergency coverage outside the U.S.
  • Advantage Plans often have network limitations.

What about some plans that advertise little or no monthly premium?

  • Called “Medicare Advantage” plans, they trade monthly premium for co-pays and cost sharing at time of claim. Instead of a fixed monthly premium for a plan that pays (virtually) all claims, under a plan with little or no premium you will face co-payments for doctor visits and in/outpatient services. The maximum exposure on these plans will be greater than the annual premium under a traditional supplement plan.

What about long-term care?

  • The cost of Long Term Care, at home or in a skilled nursing facility averages $237/ day, something Medicare covers only on a very limited basis. For this reason, we recommend your retirement planning include a review of Long Term Care insurance options. For a proposal, click HERE.

What do I do now?

  • Call Jon Rauser or Chris McArdle at The Rauser Agency. 414-276-2700.

*As of 1-1-17

**Individuals with incomes over $85,000 or households over $170,000 will pay more.

***Representative Plans.

****Representative plans, at age 65. Prices are higher for those past age 65.