Medicare

Medicare Guidance and Health Care Options for SeniorsA pen and clipboard with a stethoscope on itAI-generated content may be incorrect.

At Preservation 1st Financial Group, LLC, one of our specialties is working with seniors. We understand that Medicare and healthcare costs are major concerns for many seniors. Our team takes pride in guiding Medicare recipients through their options to help fill the gaps that Medicare alone may leave.

Below is an overview of health care options for individuals with Medicare Parts A & B:

1. Medicare Only
With Medicare only, you are responsible for all deductibles and co-pays out of pocket. Prescription coverage is not included—you would need a separate Part D plan for medications. If you opted out of Part B, you are responsible for 100% of Part B costs.

2. Employer Benefits
Some individuals receive supplemental Medicare help through current or former employer programs. These programs may cover Medicare premiums, deductibles, and co-pays. Additional benefits may include prescription coverage, preventative care, dental, vision, and hearing assistance. Many employer programs operate as managed care plans, which may require using specific networks of doctors, hospitals, and providers.

3. VA Benefits
Veterans may use VA benefits to supplement Medicare coverage. Typically, care must be received at VA facilities, and co-pays vary based on financial circumstances. Many veterans receive healthcare coverage at little or no cost. Contact the Veterans Administration for eligibility, benefits, and cost details.

4. Tricare for Life
Available since October 2001, this program supplements Medicare for retired military personnel. Tricare for Life is often the most advantageous option for those who qualify.

5. Medicaid
Medicaid is a needs-based program administered by individual states. It can assist with certain Medicare “gaps,” such as Part B premiums, deductibles, and co-pays, based on income and asset levels. Note that since January 1, 2006, prescription benefits are no longer covered by Medicaid and have shifted to Medicare Part D.

6. Individual Medicare Supplement (Medigap)
These federally standardized supplemental plans are offered through private insurance companies. They help cover deductibles and co-pays not included in Medicare. Premiums typically range from $100–$250 per month, depending on the benefits chosen.

  • Enrollment: If you do not select a supplement during the 6-month open enrollment period, health underwriting is usually required.
  • Coverage: Standard plans cover any doctor or hospital in the U.S. Select plans often require using a network, resulting in lower premiums.
  • Limitations: Medigap policies only mirror Medicare Parts A & B and do not include additional benefits such as dental, wellness programs, or prescription coverage.

7. Medicare Advantage Plans (Part C)
Medicare Advantage plans are an alternative to traditional Medicare. Many plans have no additional premium but require using a network of providers. These plans often include extra benefits such as dental, vision, gym memberships, and wellness programs. Some plans also include Part D prescription coverage.

  • Considerations: Networks, referrals, and plan features vary between companies, so it’s essential to choose a plan that fits your healthcare needs and lifestyle.

Prescription Drug Coverage (Part D)
Since May 15, 2006, Medicare beneficiaries are required to enroll in a Part D prescription plan. Late enrollment may result in a penalty of 1% per month for each month not enrolled.

At Preservation 1st Financial Group, LLC, we represent numerous insurance companies and plans. We can help you navigate the options to select a plan that best meets your health needs and financial situation.