Checking Prescriptions & Provider Networks

• Ensuring Eligibility: We verify if doctors and Specialists are enrolled in Medicare or have opted out. This ensures they can be paid by Medicare and that your services are covered. 
• Carrier Networks: Understanding which providers are in your plan's network helps ensure smooth coordination of your care and avoids potential billing issues. 
• Checking Prescription Formularies: Medicare Part D prescription drug plans have a formulary, which is a list of covered drugs. We ensure that your medications are on the formulary and that your plan's cost-sharing (copays, coinsurance, deductibles and premiums) aligns with your budget. 
• Understanding Tiered Prescription Coverage: Many plans have tiered coverage, meaning that the cost of your prescriptions could based on which tier and the plan's network.  

- Medicare Supplement Insurance (Medigap) helps cover out-of-pocket costs not covered by Original Medicare (Parts A and B).

- Typically covers deductibles, co-payments, and coinsurance related to hospital stays and other costs.

- Sold by private insurance companies and comes in standardized plans with the same basic benefits across different providers.

- Once enrolled, policies are guaranteed renewable, ensuring ongoing coverage as long as premiums are paid.

- Medigap does not cover prescription drugs, dental, vision care, hearing aids, or long-term care.

- Available only to those with Original Medicare (Parts A and B); not applicable for Medicare Advantage enrollees.

- Offers a one-time open enrollment period at age 65 upon enrolling in Medicare Part B, allowing for policy purchase without health proof.

- Plans are identified by letters (F, G, N, K) with varying monthly premiums based on the specific plan, location, and insurance company.

- Medigap provides essential financial protection for medical expenses, reducing out-of-pocket costs for those with Original Medicare.