Health Insurance, A Serious Matter with Today's Rising Healthcare Costs

Author

Felice Johnson, Retirement Specialist

For more information about the author, click to view their website: Felice Johnson, Retirement Specialist

Posted on

Dec 20, 2023

Book/Edition

Pennsylvania - Greater Pittsburgh Area

Health insurance is a serious matter, especially with today's rising healthcare costs. 

What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Medicare Part A (Hospital Insurance)
Helps to pay for inpatient hospital care, psychiatric hospital care, medically necessary short-term skilled nursing facility care following a hospital stay, home health care and hospice care. Most people do not pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.

Medicare Part B (Medical Insurance)
Helps to pay for doctor's services, outpatient hospital services and various medical services and supplies. This is a voluntary program and a monthly premium must be paid. Assistance to pay for this premium may be available for individuals with low income. Visit www.Medicare.gov or contact your nearest Social Security Administration office for specific information about benefits.

Medicare Part C (Medicare Advantage Plans)
A type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your Part A and Part B benefits (and possibly some additional benefits). A Medicare Advantage Plan essentially manages the healthcare of the plan's members. The government pays these companies money each month for each member. The company then helps to pay for medical care by doctors and hospitals that the member needs.
Medicare Advantage Plans include:
• Health Maintenance Organizations (HMO)
• Preferred Provider Organization Plans (PPO)
• Private Fee-for-Service Plans (PFFS)
• Medicare Medical Savings Account Plans [MSA)
• Medicare Specialty Plans

If you're enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Must Medicare Advantage Plans offer prescription drug coverage. In addition to a monthly premium, you may be responsible for out-of-pocket costs including an annual deductible, co-pays and co-insurance for office visits, hospital stays and outpatient services like physical therapy. Depending on the type of Medicare Advantage plan you choose, you may need a referral from your primary care physician to see a specialist or get lab work.  Doctors and specialists outside your plan's provider network may be partially covered but you will pay more to use them instead of an in-network provider.  

Medicare Advantage Plans in Allegheny County:
• Aetna (855) 335-1407
• Allwell PA Health and Wellness (866) 224-1076
• Highmark (800) 576-6343
• Humana Insurance Company (800) 833-2312
• UnitedHealthcare Insurance (800) 281-7522
• UPMC for Life (877) 381-3765

Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-far- Service Plans, and Medicare Medical Savings Account Plans.  These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Are you new to Medicare?  Do you have questions regarding your existing Medicare coverage?  Get one-on-one help.  I have answers!    Felice Johnson, Retirement Specialist at 412-726-6450.

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Local Services By This Author

Felice Johnson, Retirement Specialist

Medicare/Medicaid/Insurance 5 Curry Ct, Turtle Creek, Pennsylvania, 15145

Individual Retirement Planning SolutionsI am an independent licensed insurance agent that truly puts the client first.  Driven to provide the best solutions for my clients, I offer nothing but the best products from industry leaders from more than 180 companies.  I am passionate about changing people's lives and protecting them from financial catastrophe due to unforeseen illness and death.  I have a responsibility to always educate and make recommendations based on the needs of each individual client. Contact me today!- Medicare Planning / Health - education for your rights and options with the Medicare Program and associated supplemental services (Medicare Supplement, Medicare Advantage, Hospital Indemnity, Part D Prescription Drug, Cancer Protection, Denta/Vision/Hearing, Final Expense, Recovery Care/Post Hospital)- Insurance Planning - provide protection for loved ones for life events and/or catastrophes by transferring the risks. Ensuring lifestyle and asset protection (Life Insurance, Individual Health Insurance, Wealth Transfer, Retirement Supplements, Non-Qualified Deferred Compensation)- Retirement Planning - setting aide funds to provide deferred incomes benefits at retirement (Rollover/ROTH/Traditional IRA, SEP, CD Alternatives)- Income & Legacy Planning - helping individuals prepare for retirement's transition from asset accumulation to income generation and asset distribution and having a plan to provide continuation of your legacy.  (Guaranteed Life Income, Survivor Replacement Income, Pension Maximization, Disability Insurance, Gifting, Charitable Donations, Protection of Future Generations)- Personal & Business Insurance - providing coverage and security to individuals and businesses (Home & Renters Insurance, Auto Insurance, Business Insurance)