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Medicare

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Understanding Your Medicare Options

Navigating Medicare doesn’t have to be complicated. At Benefit Plans Inc., our experienced Medicare specialists help residents understand their options and find the right coverage for their unique needs.

Hospital Insurance (Part A)
Medical Insurance (Part B)
Medicare Advantage Plans (Part C)
Medicare Prescription Drug Plans (Part D)
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(757) 461-0519

When to Seek Medicare Guidance

Consult with Medicare specialists when approaching eligibility, changing coverage needs, or navigating complex enrollment decisions and benefit options.

Approaching age 65

Retiring from employer coverage

During Annual Enrollment Period

Business Growth

Special Enrollment Periods

Understanding the Difference in Medicare Choices
Which One is for You

Before choosing a plan we want to be sure you know the difference between your many options; In particular how Medicare Supplements and Medicare Advantage Plans differ. Many people sign up for Advantage Plans thinking they are Supplements, they are not.
A Medicare Supplement Insurance Plans is used with original Medicare. Any caregiver that accepts Medicare will take a Supplement because they only need to bill Medicare. Medicare pays their part (generally 80% of Medicare covered benefits) and sends the remainder of the bill to the Supplement which pays their part (generally 20%). It is important to note that Supplements do NOT include Prescription Drug Coverage (Part D, PDP) and for those that do not get a PDP when first eligible there will be a penalty when they do get a PDP. (there are exceptions to this) A Medicare Supplement does not change year to year (although the cost does generally go up the coverage does not change).
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These “bundled” plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare drug coverage (Part D).

Medicare Part D provides essential prescription drug coverage to complement your Original Medicare benefits. These standalone prescription drug plans (PDPs) work with your existing Medicare coverage to help manage medication costs. Each Part D plan features a formulary (list of covered drugs) organized in tiers, with lower-tier medications typically costing less than higher-tier options. Understanding these tiers is crucial – while generic drugs usually occupy lower tiers with better pricing, brand-name medications often fall into higher tiers with increased costs. If you need a higher-tier medication, your healthcare provider can request a formulary exception for lower copayments when medically necessary. At Benefit Plans Inc., our Medicare specialists help you compare Part D plans to find coverage that best matches your prescription needs and budget.

Benefit Plans, Inc

Your Complete Insurance Solution

347 S Witchduck Rd
Virginia Beach, VA 23462
Call: 757-461-0519

Frequently Asked Questions

Some frequently asked questions about the service that you may have questions about

What's the difference between Medicare Advantage Plans and Medicare Supplement Insurance?
Medicare Advantage Plans are all-in-one alternatives to Original Medicare that combine Part A, Part B, and usually Part D into one plan with network-based coverage and predictable copayments. Medicare Supplement Insurance works with Original Medicare to fill coverage gaps, paying the 20% that Medicare doesn't cover, but requires separate Part D prescription coverage and allows you to see any Medicare-accepting provider.
When should I start planning for Medicare coverage?
You should begin exploring Medicare options at least 3-6 months before turning 65 or losing employer coverage. This timing allows you to understand your Initial Enrollment Period, compare plan options, and avoid potential late enrollment penalties. Our Medicare specialists at Benefit Plans Inc. can help you create a timeline that ensures seamless coverage transition.
Do I need prescription drug coverage (Part D) if I don't take many medications?
Yes, it's highly recommended to enroll in Part D when first eligible, even if you don't currently take medications. Delaying Part D enrollment results in permanent late enrollment penalties that increase your premiums for life. Having coverage in place protects you from unexpected prescription needs and ensures you're prepared for future health changes.
Can I change my Medicare plan if I'm not satisfied with my current coverage?
Yes, you can make changes during Medicare's Annual Open Enrollment Period (October 15 - December 7) when you can switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or modify your Part D prescription coverage. Certain life events may also qualify you for Special Enrollment Periods that allow mid-year changes.
How do Medicare Supplement plans handle pre-existing conditions?
During your Medigap Open Enrollment Period (the 6 months after enrolling in Medicare Part B at age 65 or older), insurance companies cannot deny coverage or charge higher premiums due to pre-existing conditions. Outside this period, medical underwriting may apply, making it potentially more difficult or expensive to obtain coverage.
How does Benefit Plans Inc. help me choose the right Medicare coverage?
Our experienced Medicare specialists provide personalized consultations to understand your healthcare needs, budget, and preferred providers. We compare plans from multiple carriers, explain the differences between Medicare options, assist with enrollment, and provide ongoing support for plan changes, claims issues, and annual reviews to ensure your coverage continues to meet your evolving needs.