Pete Alberti, Medicare Insurance Broker
Pete Alberti
Kentucky Health Solutions
Medicare Broker Licensed in KY, FL, IN, MI, MO, NC, OH, TN and WV
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Lexington, KY
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Pete Can Help With:
About Me
We are an Independent Health Insurance Agency for Medicare Supplement/Medigap, Medicare Advantage, Prescription Drug and Dental Plans.
We can also help with insurance for those under 65 needed an individual or family health insurance plans. Feel free to contact us for help.
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Q&A with Pete Alberti
I'm turning 65 next month; what are the first steps I should take regarding Medicare enrollment?
Answer: It's great you're planning ahead for your Medicare enrollment! Turning 65 is a significant milestone, and understanding the Medicare process is crucial. Here's a breakdown of the first steps you should take:
1. Understand Your Initial Enrollment Period:
* Enrollment begins three months before the month you turn 65, includes the month you turn 65, and ends three months after that month. This 7-month window is your primary opportunity to enroll in Medicare.
* Missing this window can lead to late enrollment penalties.
2. Determine if You'll Be Automatically Enrolled:
* If you're already receiving Social Security benefits, you'll likely be automatically enrolled in Medicare Part A and Part B.
* If you're not receiving Social Security, you'll need to enroll manually.
3. Learn About Medicare Parts:
* Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
* Part B (Medical Insurance): Covers doctors' services, outpatient care, and preventive services.
* Part C (Medicare Advantage): Private health plans that offer Medicare benefits.
* Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs.
4. Decide Which Coverage You Need:
* Consider your current health status and anticipated healthcare needs.
* Evaluate whether Original Medicare (Parts A and B) or a Medicare Advantage plan (Part C) is right for you.
* If you choose original medicare, you will likely need to enroll in a part D plan for prescription drug coverage.
5. * Employer Coverage: If you're still working and have employer-sponsored health insurance, you may be able to delay enrolling in Part B. However, it's essential to understand how this might.
Contact us at 859-309-5033 for help with your Medicare planning
Are Medicare Advantage plans really "free," or is that just clever marketing?
Answer: The concept of "free" Medicare Advantage plans can be misleading. While some Medicare Advantage plans advertise $0 monthly premiums, it's crucial to understand that this doesn't mean you won't have any healthcare costs. Here's a breakdown:
* $0 Premium Doesn't Mean $0 Cost:
A $0 premium means you don't pay a monthly fee to the private insurance company offering the Medicare Advantage plan. However, you'll still likely have other out-of-pocket costs, such as:
* Co-payments: Fixed amounts you pay for specific services (e.g., doctor's visits, prescriptions).
* Coinsurance: A percentage of the cost you pay for services.
* Deductibles: The amount you pay before your plan starts covering costs.
Contact at 859-309-5033 if you would help with your Medicare Planning
Do Medicare Advantage plans save money?
Answer: The question of whether Medicare Advantage plans save money is complex, with varying perspectives. Here's a breakdown of key considerations:
Potential Cost Savings for Individuals:
* Lower or Zero Premiums:
* Many Medicare Advantage plans offer low or even $0 monthly premiums.
* Out-of-Pocket Maximums:
* These plans typically have a limit on your annual out-of-pocket expenses, providing a degree of financial protection. Traditional Medicare lacks this cap.
* Additional Benefits:
* Many Medicare Advantage plans include benefits not covered by Original Medicare, such as dental, vision, and hearing care, which can lead to cost savings if you utilize these services.
* Consolidated Coverage:
* Medicare Advantage plans often combine Medicare Part A, Part B, and Part D (prescription drug coverage) into a single plan, streamlining costs.
Concerns About Overall Costs:
* Higher Costs to the Medicare System:
* Reports, such as those from the Medicare Payment Advisory Commission (MedPAC), indicate that Medicare Advantage plans can cost the Medicare system more than Original Medicare. This is due to factors like how the plans are paid, and coding intensity.
* Potential for Hidden Costs:
* While premiums may be low, Medicare Advantage plans can involve copayments, coinsurance, and other out-of-pocket costs that can accumulate.
* Prior Authorizations and Network Restrictions:
* Medicare Advantage plans often require prior authorizations for services and have network restrictions, which can limit access to certain providers and potentially lead to unexpected costs.
In summary:
* For some individuals, Medicare Advantage plans can offer potential cost savings through lower premiums and added benefits.
* However, from the perspective of the overall Medicare program, there are concerns that these plans may increase costs.
* It is very important for an individual to carefully review the details of any medicare advantage plan they are considering.