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If you have questions regarding your Medicare Options. We are here to help.
Here are a few of the option we provide.
How does Medicare work?
Medicare is a health insurance program run by the federal government. Generally, the program is meant for citizens who are aged 65 or above. Citizens who are under 65 can also enroll in the program if they meet certain requirements. Medicare helps the beneficiaries cover certain medical expenses and services. In exchange for the medical services covered under the program, Medicare enrollees must pay certain premiums, deductibles, copayments, and other costs specific to the plan.
There are some eligibility requirements you must meet to qualify for Medicare. First, you must be 65 years or older, except for in certain circumstances, such as having a disability. If you receive Social Security disability benefits, you can enroll for Medicare after the 24th month of receiving benefits. Also, people who have End-Stage Renal Disease and Amyotrophic Lateral Sclerosis automatically qualify for Medicare. Lastly, you must be a citizen of the United States or a permanent resident for at least five years to be qualified for Medicare.
Parts of Medicare
Medicare is divided into different parts. Original Medicare consists of Medicare Part A and Part B, while Part C is also known as Medicare Advantage. There are other parts such as Part D and Medicare Supplement plans (Medigap).
Part A
Medicare Part A alongside Part B constitutes Original Medicare. Medicare Part A covers the cost of inpatient hospital services, skilled nursing facility care, hospital insurance, hospice care, and certain home health services. Medicare Part A and Part B have the same eligibility requirements. If you enroll for Part A, there are some costs you are to cover in exchange for the services offered by the plan.
For most Medicare enrollees, Part A is premium-free. However, if you have not paid up to 40 quarters of Medicare taxes, you will pay a monthly premium, depending on the amount of Medicare taxes you paid while employed.
Part B
Part B is also part of Original Medicare. Medicare Part B covers outpatient hospital services, doctor visits, lab tests, mental healthcare services, preventive screenings, durable medical equipment, and ambulance services. While most people qualify for premium-free Part A, Part B typically requires a monthly premium payment. For 2025, the average Part B premium is $185. The cost of the premium may be higher for enrollees with a high income.
Once you meet the annual deductible of $257 (2025) for Part B, you will only pay for 20% of the approved costs for specified services under Medicare Part B.
Medicare Advantage - Part C
Think of Medicare Advantage as a one-stop-shop for your healthcare needs. Instead of juggling different parts of Original Medicare, Part C rolls everything into one convenient package. Private insurance companies offer these plans with Medicare's seal of approval, making it easier to manage your healthcare. Just like a smartphone that does it all, Medicare Advantage combines your hospital and medical coverage while often throwing in extras like prescription drugs, dental care, and vision coverage – things Original Medicare doesn't typically cover.
Many seniors love Medicare Advantage because it can mean lower monthly costs and simpler healthcare. You'll usually have a primary doctor who helps coordinate your care, making it feel more like the insurance you might have had through your job. Sure, you'll need to stick to doctors in your plan's network, but the trade-off is often worth it for the extra benefits and potentially lower costs. Plus, some plans even include gym memberships and wellness programs to help keep you healthy and active.
Keep in mind that while you'll still pay your Part B premium, many Medicare Advantage plans have low or even zero additional monthly premiums. It's like getting a premium cable package with all the channels, but sometimes at basic cable prices. If you're looking for an all-in-one Medicare solution that might save you money while offering extra perks, Medicare Advantage could be right up your alley.
Part D
Medicare Part D, commonly known as a Prescription Drug Plan (PDP), helps you manage the costs of your medications. While Original Medicare covers hospital stays and various medical services, it doesn’t extend to most prescription drugs, which is where Part D becomes essential. Offered by private insurance companies, these plans are specifically designed to assist with the expenses associated with prescription medications, whether for chronic conditions or sudden health needs. Having a Part D plan gives you peace of mind knowing that you have support for your medication costs.
Learn more about Prescription Drug Plans Below.
Medigap
Medicare Supplements, also known as Medigap plans, are designed to fill the "gaps" in coverage that Original Medicare (Parts A and B) doesn't pay for. Think of it as an extra layer of protection for your healthcare costs. While Medicare covers many medical expenses, you're still responsible for things like deductibles, copayments, and coinsurance. That’s where Medicare Supplements step in, helping to cover these out-of-pocket costs so you can handle your healthcare expenses with more predictability and fewer surprises.
Medigap plans are offered by private insurance companies, but they work differently than Medicare Advantage. Instead of replacing Original Medicare, these plans work alongside it. For example, if Medicare pays 80% of your medical bill, a Medicare Supplement plan may cover the remaining 20%, depending on the plan you choose. There are several standardized Medigap plans available (with letters like Plan G or Plan N), each offering different levels of coverage to fit your needs.
One of the biggest benefits of Medicare Supplements is flexibility. Unlike Medicare Advantage plans, which typically require you to stay within a network of doctors, Medigap lets you see any provider in the country who accepts Medicare – no referrals or network restrictions. This makes it a great option for those who travel often or want the freedom to choose their healthcare providers.
Keep in mind, you’ll pay a separate premium for a Medigap plan on top of your Medicare Part B premium. However, many people find the peace of mind in knowing their out-of-pocket costs are significantly reduced makes it worth the investment. If predictability, freedom of choice, and comprehensive coverage are important to you, a Medicare Supplement plan might be the right choice to ensure your healthcare is as stress-free as possible.
Reach out to us today at 800-971-2989 for more information and help with Medicare plans in Nebraska.
Prescription Drug Plans
Medicare Part D, also known as a Prescription Drug Plan (PDP), is Medicare’s way of helping you manage the cost of your medications. While Original Medicare covers hospital stays and medical services, it doesn’t include most prescription drugs – that’s where Part D comes in. These plans are offered by private insurance companies and are designed specifically to help you pay for prescription medications, whether they’re daily maintenance drugs or medications for unexpected health issues.
Prescription Drug Plans are available as stand-alone plans that work alongside Original Medicare or Medicare Supplement plans, or they can be included with Medicare Advantage plans (Part C). Each plan has its own list of covered drugs, called a formulary, which is organized into tiers. Medications in lower tiers generally cost less, while higher-tier drugs may require higher copayments or coinsurance.
One of the features of Part D plans is the cost-sharing structure. You’ll typically pay a monthly premium, an annual deductible (for some plans), and copayments or coinsurance for each prescription. It’s important to take note of the "donut hole" coverage gap – a phase where your drug costs might temporarily increase after you and your plan have spent a certain amount on medications. However, catastrophic coverage kicks in after the gap, significantly reducing costs for the rest of the year.
Choosing the right Part D plan is essential, as the medications you need and the plan’s costs can vary widely. It’s a good idea to review each plan’s formulary, network pharmacies, and out-of-pocket costs to ensure it fits your specific needs. If prescription drug costs are a concern, getting a Medicare Part D plan is a smart way to protect your budget and ensure consistent access to the medications that keep you healthy.
Dental/Vision/Hearing Plans
Dental, vision, and hearing plans provide specialized coverage for areas of health that Original Medicare typically doesn’t cover. These plans are offered by private insurance companies and can be purchased separately or bundled with certain Medicare Advantage plans for added convenience. As we age, maintaining oral health, clear vision, and good hearing becomes increasingly vital to overall well-being, yet these services often come with significant out-of-pocket costs without additional coverage.
For seniors, regular dental checkups can help prevent issues like gum disease or tooth loss, both of which are linked to broader health concerns such as heart disease and diabetes. A dental plan can cover routine cleanings, exams, x-rays, and even more extensive procedures like dentures or crowns, making oral health care both accessible and affordable. Similarly, vision plans ensure that seniors have access to critical services such as annual eye exams, glasses, contact lenses, and treatments for conditions like cataracts or glaucoma, which can significantly impact quality of life if untreated. Hearing plans offer coverage for hearing exams and hearing aids, both essential for managing age-related hearing loss, which can lead to communication challenges and even social isolation without proper intervention.
By investing in dental, vision, and hearing plans, seniors can enjoy better overall health, improved quality of life, and greater financial security. These plans help reduce out-of-pocket expenses for essential care, enabling individuals to focus on staying active, connected, and engaged in their golden years. For seniors who want a comprehensive approach to managing their healthcare, adding this specialized coverage can offer valuable peace of mind.
Hospital Indemnity Plans
Hospital Indemnity Plans are supplemental insurance policies designed to provide financial protection by helping to cover the out-of-pocket costs associated with hospital stays and related expenses. While Medicare Advantage plans offer broad healthcare coverage, they often come with cost-sharing requirements like copayments, coinsurance, or deductibles when you’re admitted to a hospital or need extended care. A Hospital Indemnity Plan can help fill these gaps, providing additional peace of mind and financial security.
Here’s how they work: With a Hospital Indemnity Plan, you receive a cash benefit for each day you’re hospitalized, typically based on the terms of your policy. This benefit is paid directly to you, not to the hospital or healthcare provider, so you can use the money however you see fit. Whether it’s to cover hospital admission costs, pay for ongoing treatment, or help with everyday expenses like rent, groceries, or transportation, the flexibility of these plans makes them a popular choice for Medicare Advantage enrollees looking to reduce unexpected medical expenses.
Hospital Indemnity Plans are especially beneficial for those on Medicare Advantage plans with higher cost-sharing for hospital stays, ambulance services, or skilled nursing facilities. By offsetting these costs, these plans make it easier to manage the unpredictable expenses that can arise during a health emergency. For seniors looking to protect their savings and avoid financial stress during challenging times, adding a Hospital Indemnity Plan to their Medicare Advantage coverage can help ensure they’re fully prepared for whatever life brings.
Short Term & Long Term Care Plans
Short-Term Care and Long-Term Care plans provide critical financial support for services that aren’t typically covered by Medicare, helping individuals manage the high costs associated with ongoing care needs. These plans are designed to cover different time periods and care requirements: Short-Term Care plans usually provide coverage for temporary care needs lasting a few months up to a year, while Long-Term Care plans are geared toward extended care for chronic conditions or disabilities that may require years of support. For seniors, having one or both of these plans can offer essential protection against the potentially overwhelming expenses of care later in life.
Short-Term Care plans are ideal for situations such as recovery after surgery, injury, or illness and can cover care provided in your home, an assisted living facility, or a nursing home. They typically bridge the gap when Medicare or other health insurance plans fall short. These plans are valuable for covering temporary care that helps seniors regain independence or adjust to changing health needs without draining their savings.
Long-Term Care plans, on the other hand, are designed to address more permanent care needs, particularly for chronic illnesses like Alzheimer’s disease, or disabilities that make daily living tasks difficult. They cover services such as bathing, dressing, meal preparation, and other essential activities that aren’t covered by Medicare. This care can be provided at home, in assisted living facilities, or in nursing homes, depending on the individual’s needs.
Both types of care are incredibly important for seniors because the costs of these services can quickly add up, putting a strain on personal finances. By securing a Short-Term or Long-Term Care plan, seniors and their families can better prepare for the future and protect their savings while ensuring access to the care they need. These plans are especially valuable for providing peace of mind, as they not only help manage costs but also ensure that individuals receive compassionate, comprehensive care during what can often be stressful or challenging times.
Final Expense
Final Expense Insurance, often referred to as burial or funeral insurance, is a specialized type of life insurance designed to help cover the costs associated with end-of-life expenses. These plans provide a smaller death benefit compared to traditional life insurance, typically ranging from $5,000 to $25,000, and are specifically intended to cover funeral services, burial or cremation, outstanding medical bills, or even unpaid debts. For seniors, Final Expense Insurance offers an affordable and straightforward way to ensure that their loved ones won’t face financial burdens during an already emotional time.
One of the biggest advantages of Final Expense Insurance is its simplicity. The application process is typically easier than other life insurance options, with many plans offering guaranteed acceptance for seniors within certain age ranges (often between 50 and 85) without requiring a medical exam. The premiums are predictable and remain fixed for the life of the policy, making it easy for seniors to budget. When the insured passes away, the beneficiaries receive the payout directly and can use it for any purpose, though it is primarily intended to cover end-of-life costs.
For seniors, this type of coverage is not just about financial planning – it’s about leaving a legacy of care and preparedness. Funerals and related expenses can quickly add up, often costing upwards of $10,000 or more. Without a plan in place, these costs can fall on family members, creating unnecessary stress during a difficult time. Final Expense Insurance ensures that everything is taken care of, allowing seniors to have peace of mind knowing their loved ones won’t face a financial burden. It’s an affordable way to secure dignity and stability for both the policyholder and their family during life’s most challenging moments.
Under 65 Health Plans
Under 65 health plans provide vital coverage for individuals and families who are not yet eligible for Medicare. These plans include a wide range of options, with Affordable Care Act (ACA) Marketplace plans being among the most popular. Created through the ACA, the Health Care Marketplace allows individuals under the age of 65 to shop for and enroll in quality health insurance that meets federal coverage standards. These plans are designed to ensure that everyone has access to essential care, regardless of pre-existing conditions or income level.
ACA Marketplace plans cover essential health benefits such as doctor visits, hospital stays, preventive care, prescription medications, maternity care, and mental health services. To make health coverage more affordable, many Marketplace enrollees qualify for subsidies or premium tax credits based on their income and household size. These savings can significantly reduce the cost of monthly premiums and, in some cases, out-of-pocket expenses like deductibles and copayments.
One of the key advantages of ACA plans is the flexibility and choice. The Marketplace offers different "metal tiers" – Bronze, Silver, Gold, and Platinum – to suit varying budgets and healthcare needs. Bronze plans generally have the lowest premiums but higher out-of-pocket costs, while Platinum plans offer the most comprehensive coverage with higher premiums. This allows individuals to choose a plan that aligns with their healthcare priorities and financial situation.
For those under 65, having health insurance is essential for protecting against unexpected medical expenses and ensuring access to necessary care. ACA Marketplace plans provide a reliable option for affordable, comprehensive coverage, whether you’re self-employed, unemployed, or working for an employer that doesn’t offer health benefits. These plans are particularly beneficial for individuals with pre-existing conditions, as insurers cannot deny coverage or charge higher premiums for health issues under the ACA. For those seeking peace of mind and protection from financial risk, Under 65 health plans – especially those available through the Health Care Marketplace – are an excellent resource for accessible and affordable healthcare.