ABC&D's of Medicare



General Information

920-287-5302

General

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The ABC&D’s of Medicare
Medicare Advantage – Part 2
by Timothy Lorenz, an Independent Insurance Agent,
serving the Senior Community of Sheboygan County
Medicare & You for 2018(19) lists all the Advantage plans
offered in the State of Wisconsin, unfortunately it does not list
plans by county. If you can navigate the internet, Medicare offers
a website, www.medicare.gov that does offer a list of plans by zip
code and county.
Another source of information is an independent insurance
agent that offers both Medicare Supplement plans and Medicare
Advantage plans. A good agent will review both traditional
Medicare Supplement and Medicare Advantage plans pointing out
the advantages and dis-advantages. The State of Wisconsin places
a special burden on insurance agents, especially with regard to
suitability. The agent has the responsibility to make sure that the
insurance product is suitable for you and that you understand how
the program works.
There are a number of insurance providers offering Advantage
plans in Sheboygan County. What distinguish providers are their
underlying mission statements. Some of these providers operate to
generate the greatest level of profit for their shareholders, while
some operate to provide the greatest medical benefit and value
to their clients. Medicare & You for 2018(19) offers a “members
rated” statement for each insurance provider in the listing of
Medicare Health Plans in Wisconsin.
Medicare requires all Advantage plan providers to have a
“Summary of Benefits” that are similar in style and content;
this allows easy side by side comparisons of the Medical Benefit
Categories that define the benefits. The six most important
categories are: Premium and Out-of-Pocket Loss Limit; Inpatient
Hospitalization cost and copays; Skilled Nursing Care cost and
copays; Out-patient Services and Prescription drug benefits.
The progression of Medicare Advantage plans for the past 10
years is higher copays and higher annual out-of-pocket-loss-
limits. The annual out-of-pocket-loss-limit is the defining element
of Medicare Advantage plans and range from $3400 to as high as
$10,000 per year (2018)! Loss limits represent an annual ceiling
of potential financial liability that you may sustain when a serious
medical event occurs. An enrollee with major medical issues could
readily hit the annual out-of-pocket-loss-limit, so you need to be
careful when choosing a plan!
To learn more about Medicare and your Medicare options you
can call me at 920-457-2911 (home) or 920-287-5302 (cell) or stop
by at 2708 N 7th St., Sheboygan W 53083.
– Advertisement –
Keywords Sheboygan County, Independent Insurance, Senior Community, Agent serving, Timothy Lorenz, Insurance Agent, prescription drug, Medicare Advantage, health insurance, Election Period, Initial Election, Medicare Supplement, health care, Medicare Prescription, insurance providers
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