Medicare Advantage Plans: Original Medicare Coverage and More

Looking for more answers about Medicare Advantage Plans? This is blog post will give you some of the answers you are looking for.

When researching Medicare options, it’s important to know what’s available. This way, you can make sure you’ll have the coverage and benefits you need for the coming year. One important decision you have to make might be between Original Medicare and a Medicare Advantage plan.

Original Medicare – Basic Coverage for Your Health Care Needs

Medicare is a federal program that provides access to health insurance for people 65 or older and people younger than 65 with certain disabilities. Original Medicare is health insurance run by the federal government under the Medicare program.

Original Medicare is a government benefit and includes Part A and Part B. Part A helps pay for care you receive in a hospital or a skilled nursing facility. Part B helps pay for doctor visits and other outpatient medical services. Original Medicare provides the same coverage for the same cost to everyone who has it. Original Medicare doesn’t generally include prescription drug coverage. If you need this coverage, you’ll need to buy a standalone Medicare Part D prescription drug plan.

Medicare Advantage – Additional Coverage and Extra Benefits

Medicare Advantage plans (Medicare Part C) are offered by private insurance companies and offer another way to get Medicare benefits. Every Medicare Advantage plan provides the same coverage offered by Original Medicare. Beyond that, plan benefits and pricing can vary a great deal.

Here are some of the extra benefits you can get with a Medicare Advantage plan. Again, plan benefits can vary greatly from plan to plan, so keep this in mind when doing your research.

  • Prescription drug coverage
  • Dental care, eye care and hearing care coverage
  • Wellness and fitness programs
  • Worldwide urgent care and emergency coverage
  • Mail order pharmacy benefit
  • Cap on out-of-pocket costs

Compare Costs

One important way Original Medicare differs from Medicare Advantage plans is cost. These are some of the differences you might see:

  • Deductibles – In Medicare Part A, you’ll pay a deductible for each “benefit period.” A benefit period begins when you enter the hospital and ends when you have been out of the hospital for 60 days in a row. In 2012, this amount is $1,156. For Part B, you’ll pay a yearly deductible, which in 2012 is $140. Most Medicare Advantage plans use deductibles in combination with other cost sharing arrangements, like copays and coinsurance. You should look at an individual plan to see what this amount will be.
  • Copays and Coinsurance – In Original Medicare Part A, you’ll only pay a copay after the 60th day of a long hospital stay, when it will be a daily copay. Some cost sharing in Medicare Part B uses copays, while some uses coinsurance. For copays, Medicare sets a dollar amount that you will pay for each service or product you use. For coinsurance, Part B generally pays 80% of the cost and you pay the remaining 20%. However, there are some exceptions to this rule. Copays and coinsurance amounts vary widely between Medicare Advantage plans, so be sure to take this into consideration when finding a plan that fits your finances.
  • Premiums – Most people don’t pay a premium for Original Medicare Part A. For 2012, Part B premiums range from $99.90 to $319.70 per month. Just like all coverage costs, the premiums charged by Medicare Advantage plans are up to companies offering them and can vary widely from plan to plan. While premiums are not the only consideration when you’re looking at plan costs, it can be an important one.
  • Annual out-of-pocket expense cap – Original Medicare has no out-of pocket cap on expenses. All Medicare Advantage plans must cap your annual out-of-pocket expenses at a level set by Medicare. These expenses can include deductibles, copays and coinsurance. Premiums are not included. For 2012, this cap is $6700.

–This information was provided by Medicare Made Clear – Turning 65 ? Looking for reliable Medicare Insurance? or Looking to get better rates. The Litchfield Insurance Agency assists the Beaver Medical Group in Redlands. Whether it be Medicare, Health, Life. We will find the right plan for you. Serving Redlands, Banning, Yucaipa and the Inland Empire. – Turning 65 ? Looking for reliable Medicare Insurance? or Looking to get better rates. The Litchfield Insurance Agency assists the Beaver Medical Group in Redlands. Whether it be Medicare, Health, Life. We will find the right plan for you. Serving Redlands, Banning, Yucaipa and the Inland Empire.

Becoming eligible for Medicare in 2012?

If you are going to be turning 65 and are new to Medicare. This article has 10 things you should know to help you prepare.


Becoming eligible for Medicare in 2012? Learn 10 things you can do to help prepare.

Are you or a loved one becoming eligible for Medicare in this year? You’re not alone. This year, an estimated 10,000*baby boomers will turn 65 each day. Learn ten key things you can do—or for yourself or a loved one—to help be prepared when the Medicare enrollment window opens.

  1. Learn how eligibility and enrollment work. There’s an Initial Enrollment Period (IEP) around the time you become eligible (for most, their 65th birthday). Learn about IEP—and possible penalties that may apply if you miss it. Also learn how to switch plans if you change your mind.
  2. Understand the basics of Medicare. Learn how the different Medicare “parts” work and what they cover. Then start thinking about which plan(s) fit your coverage needs and your budget. This short video gives an overview of Medicare.
  3. Research plans available in your area. While Original Medicare benefits are the same nation-wide, the availability and pricing for Medicare Advantage plans (Part C), prescription drug coverage (Medicare Part D) and Medicare Supplement Insurance plans can vary by location.’s plan finder tool can help.
  4. Consider your current coverage. If you have employee or retiree health coverage, talk with your plan administrator about your choices, then compare it with Original Medicare and Medicare Advantage plans.
  5. Review the coverage you need and your budget for health care costs. Original Medicare doesn’t cover everything, so look into additional coverage if you need it. You can add a Part D plan for prescription drug coverage or apply for a Medicare Supplement plan (Medigap) to help cover some costs like copays and coinsurance. Or you may want a Medicare Advantage plan that offers medical and hospital coverage, plus benefits like drug coverage, eye care and more.
  6. If you need help paying for Medicare costs, find out if you qualify for financial assistance. To find out what programs are in your state, contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778), 7 a.m. to 7 p.m. Monday through Friday, to find the Social Security office nearest you.
  7. Consider filling out an authorization form granting a trusted loved one the right to access your personal information. This step can make it easier for your caregiver to help should you need it.
  8. Get answers to your questions. Contact the Medicare helpline 24 hours a day, 7 days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. You can also contact UnitedHealthcare® Medicare Made Clear to learn more 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, 7 days a week.
  9. Gather the documentation you need to enroll.You’ll need:
    1. Your birth date, contact info and emergency contact information for a loved one.
    2. The policy number, group ID numbers, and any other identifying information for your current health care plan.
    3. Contact information for your current doctors and other health care providers.
    4. A list of current medications, health conditions and treatments.
    5. Bank account information, if you’d like to set up automatic payments.
  10. Make an appointment for a preventative visit.Medicare beneficiaries qualify for a one-time visit during the first 12 months they’re enrolled in Medicare.–This information was provided by Medicare Made Clear
    – Are you a senior age 65+ looking for Medicare Supplemental Insurance? Call 909-790-7748. We will explain your options and find the right plan for you.

How much does Medicare cost and how does cost sharing work?

Turning 65 and New to Medicare

Four words you need to know

Understanding how Medicare shares costs is a big part of choosing the right Medicare benefits. You’ll see four words over and over again on this site that have special meaning in Medicare. Mastering them will pay off.

  • Premium
  • Deductible
  • Copay
  • Coinsurance

These are names for different ways that Medicare shares the cost of your care with you. Medicare’s reasoning is simple: If you pay some of the cost of the health care you use, you will use it more carefully. And you’ll be encouraged to do things that help keep you healthy and that may reduce your need for medical care.

Medicare costs: You pay a share of your coverage.

1. Medicare Premium

Your premium is the fixed amount you pay to participate in Original Medicare (Medicare Parts A and B) or a Medicare plan offered by a private insurance company. Most Medicare premiums are charged monthly.

Cost sharing: You pay part of the amount and Medicare pays the rest

2. Medicare Deductible

Your deductible is the set amount you have to pay before your plan will pay the rest.

3. Medicare Copayment

Your copayment is the fixed amount you pay, like $10, for a service or product. Some people call this a “copay.”

4. Medicare Coinsurance

Coinsurance is splitting your health care costs with the plan on a percentage basis. For example, you pay 20%, and the plan pays the remaining 80%.

Important: It’s easy to focus only on your monthly premium when you compare plans. But you should also look at your other plan expenses like annual deductibles, copays and coinsurance.

For example, a plan with a lower monthly premium might cost you more over the course of the year because you have to pay a large deductible or you have a higher copay for your prescriptions.

Remember that the Medicare premiums, deductibles and copays shown in this guide are accurate for 2011, but may change from year to year.

– This information is provided by Medicare Made Clear

If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website and we will give you a quote and help you keep money in your pocket.

George C. Litchfield
CA Insurance License # 0B56846
Litchfield Insurance Agency

Medicare Made Clear – Guide to Medicare Part A & Part B – Turning 65 & New to Medicare


Please feel free to call us about any of your Medicare questions (888) 891-5557 or Text MEDICARE to 99000

If you like this video please visit our website for more great information and videos

New Survey: Beneficiaries, Boomers Remained Confused By Medicare

The National Council on Aging (NCOA) and UnitedHealthcare recently released the results of a study that revealed that a large percentage of baby boomers and seniors ages 65 and over do not understand Medicare and are unaware of important recent or impending changes to the program.

The study results confirmed the need for more education regarding the nation’s largest health insurance program, even more so because over the next two decades tens of millions of people will be added to the program. Over the next 20 years, an average of 10,000 boomers a day will turn 65 and become eligible.


UnitedHealthcare and NCOA surveyed 1,000 seniors ages 65 and over and 500 “leading-edge” baby boomers ages 60 to 64 to gauge their understanding of the Medicare program. The survey was conducted as part of an ongoing partnership between the two organizations to help Medicare beneficiaries, their caregivers and baby boomers learn more about their health-care options now and in the years ahead.

The Results

More than half of survey respondents find Medicare confusing or do not understand it at all, and most do not understand the program’s structure. Only a third correctly identified Part A as helping to cover the costs of hospital care. Less than 25 percent knew that Part B helps cover the costs of a doctor visit, and more than two-thirds did not know what Part C covers. Only 12 percent were aware that Part C helps cover the costs of hospital care, doctor visits and prescription drugs, and even fewer, 7 percent, knew that Part C is synonymous with Medicare Advantage.

The confusion about Medicare is not limited to the program’s structure. Nineteen percent of respondents who reported being enrolled in Medicare said they do not know what type of coverage they have.


There was also confusion found dealing with the dates of Annual Election Period (AEP). In previous years, the AEP began November 15 and ended December 31. This year, it starts a month earlier, on October 15, and ends December 7. Only 9 percent of survey respondents were able to identify the new start date, with even fewer respondents (3 percent) correctly identifying the new enrollment deadline. The majority (63 percent) believe beneficiaries continue to have until Dec. 31 to make an enrollment decision.

One of the most important findings was the respondents were unaware of the new cost-saving opportunities. More than a third of respondents ages 65 and over who are enrolled in Medicare are spending $1,000 or more out of pocket each year on their health-care costs. The survey found that a significant portion of respondents (29 percent) are worried about their ability to pay out-of-pocket health-care costs, yet most who are enrolled in Medicare are not taking steps to save money on their coverage.


Although the majority of respondents (58 percent) described their ability to evaluate and choose the best Medicare coverage to meet their health and financial needs as excellent or good, nearly half reported that they have never shopped around to find the best coverage for them. About another 25 percent of respondents have not shopped in two or more years.

The survey also found that the majority of potentially eligible Medicare beneficiaries are not taking advantage of important programs that could help them better afford their health care. Of the 36 percent of  respondents ages 65 and over who would qualify for assistance with their Medicare costs based on their income, more than two thirds (68 percent) had never heard of the Medicare Savings Programs, which help people with limited income pay some or all of their premiums, deductibles and coinsurance.

UnitedHealthcare and NCOA are leveraging their partnership to help simplify the often complex nature of becoming a Medicare beneficiary. UnitedHealthcare and NCOA are hosting a series of educational meetings at senior and community centers across the country and distributing public service announcements for TV and radio stations nationwide to raise awareness of resources to help boomers and beneficiaries learn more about Medicare.

Complete survey results and more information about the partnership between UnitedHealthcare and NCOA can be found at .

This information was provided by The National Council on Aging (NCOA) and UnitedHealthcare

If you would like more information on the different choices you have with Medicare call us today at 909-790-7748 or visit our website at



10 key things you should know about Medicare – Residents of Redlands, Yucaipa, Banning, Beaumont

10 key things you should know about Medicare

  1. There are two ways to get Original Medicare (Part A and Part B).

    ChooseOriginal Medicare on its own, with the option to add Medicare Part D prescription drug coverage and/or Medicare Supplement Insurance (Medigap) for more complete coverage. Or choose a MedicareAdvantage (Medicare Part C) plan that bundles Original Medicare with extra benefits and may include prescription drug coverage in one plan. Once you’ve made this decision, it’s time to compare plans and pricing, and make a selection that meets your needs.

  2. Medicare Prescription Drug coverage is available.

    Original Medicare doesn’t include prescription drug coverage. That’s where Medicare Part D comes in. You can add Medicare Part D prescription drug coverage as a standalone plan or, depending on where you live, choose a Medicare Advantage plan that includes prescription drug coverage.

    Important: If you don’t sign up for a plan with Part D prescription drug coverage as soon as you become eligible for Medicare, you may pay a penalty on your premium unless you qualify for an exception or have other creditable coverage.

  3. You’ll pay a share of the cost of Medicare.

    Medicare helps you get the health care you need, but you’ll still be expected to pay a share of the cost. You’ve already contributed to Medicare by paying taxes while you worked. Now that you’re starting to use your Medicare benefits, you’ll pay for a share of the care you receive through monthly premiums, co-pays or coinsurance.

  4. Your share of the Medicare costs may be larger than you expect.

    There are some expenses Original Medicare doesn’t cover. Many people who choose Original Medicare add extra coverage, a Medicare Supplement Insurance plan, to help fill in those gaps. Another alternative is to choose a Medicare Advantage plan, which can also help with some of these expenses.

  5. Where you live makes a difference.

    Original Medicare is the same across the United States. But other parts of Medicare (Medicare Advantage and Medicare Part D) are offered by private insurance companies and may be available only in specific counties, states or regions, and not in others—although you may also find Medicare Advantage and Medicare Part D plans that offer nationwide coverage. Medicare Supplement Insurance plans are offered by private insurance companies. These plans may offer nationwide coverage and are available by state.

  6. Original Medicare doesn’t cover all your expenses.

    You’ll find that each part of Medicare has things it doesn’t cover. Find more coverage information on the Understanding Medicare page.

  7. Start by looking at the health insurance coverage you have now.

    Considering your or your loved one’s current health coverage can help you decide what you want in a Medicare plan. For example, if you have group coverage from your current job, or retiree insurance from a former employer, you’ll want to see how this coverage works with Medicare. Ask your benefits administrator for advice on next steps based on your individual situation.


  8. Timing matters when you’re choosing Medicare coverage

    Your Medicare Initial Enrollment Period (IEP) begins three months before your 65th birth month or when you become eligible for Original Medicare due to disability. If you wait until after your IEP to join, you may find you’ll pay more and have fewer choices.

  9. It’s a good idea to review your health care needs once a year.

    Once you choose your Medicare coverage, you’re not locked into that choice. You’ll have the chance to change your choices during the Annual Enrollment Period (AEP) (October 15 through December 7) each year. That’s why it makes sense to check your coverage every year to see if it still fits your needs.

  10. Don’t be afraid to ask for help with Medicare.

    There’s help available for everyone making Medicare choices. And there are financial assistance programs to help with the cost of Medicare for people with limited income and assets. Choosing your Medicare plan is an important decision. Asking an expert will help you know that you’ve made the right one.

Medicare Made Clear

For more information call 909-790-7748 or visit our website at

Medicare Part A, B, C & D – What does it all mean?

What is Medicare?

Medicare is a federally-funded health insurance system for United
States citizens 65 years of age and older or other citizens with
qualifying medical disabilities or medical conditions. In 2009, it
provided coverage for over 45 million people.

Medicare is comprised of 4 parts:
Medicare Part A
Medicare Part B
Medicare Part C
Medicare Part D

Medicare Part A and Part B, also known as Original Medicare, provide coverage for inpatient and
outpatient expenses, respectively.

Medicare Part C, also known as Medicare Advantage, is provided by private insurers and guarantees at
least the same coverage as Parts A and B, by law, but also often offers additional benefits and lower premiums and co-pays.

Medicare Part D is prescription drug coverage, also provided by private insurers.

— George Litchfield

If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call 909-790-7748 or go to our website and we will
give you a quote and help you keep money in your pocket.

What is Medicare? Redlands CA, Yucaipa CA, Banning CA

65 & New To Medicare – How Medicare Works