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Five Things Original Medicare Does Not Cover

Medicare and Medicare Advantage help with suzie
Online, Phone or in person Suzie can help.

When it comes to health insurance for seniors, Original Medicare is a popular choice. Millions of Americans select it every year. It offers coverage for many essential health services. There are some gaps in coverage for Original Medicare that you need to be aware of.

Here are five key things that Original Medicare does not cover and some examples to help illustrate these gaps.

1. Routine Dental Care

Dental Care is one of the top requested needs. This can surprise many who planned on relying only on Medicare alone for their health insurance needs. Original Medicare does not cover routine dental care, including cleanings, gum scrapings, crowns, fillings, and dentures. Suzie has several different Dental Plans to fill in the gap.

Example:
Imagine you’re 70-year-old retiree, Mrs. Johnson. You notice some discomfort in your mouth after eating some Quincy Corn and decide to visit your dentist. After the exam, the dentist tells you a filling fell out and the pain is from a root canal you need. This painful surprise is out of pocket because Original Medicare doesn’t cover dental.

2. Vision Care

Original Medicare covers eye exams for people with diabetes and annual glaucoma tests for high-risk patients.  It does not cover routine eye exams or hardware like glasses or contact lenses. Are you sensing a trend for medical coverage from the shoulders up?

Example:
Mr. Thompson, an 68-year-old retired teacher, starts having trouble reading the Wenatchee World. He schedules an eye exam at the Vision Center at Confluence and discovers he needs an updated prescription. Mr Thompson is paying out of pocket for the exam and glasses because these are not covered by original Medicare.

3. Hearing Aids and Exams

Hearing loss is common among seniors, but Original Medicare does not cover hearing aids or the exams needed to fit them.

4. Long-Term Care

Original Medicare does cover skilled nursing facility care, but only for a limited time and under specific conditions. It doesn’t cover custodial care, which includes help with daily activities like bathing, dressing, and eating if that’s the only care you need.

Example:
Imagine you are Mrs. Rivera, 82, and living alone while your kids are living in Montana. After a fall, you find it difficult to manage daily tasks like bathing and dressing. You need long-term care to help with these activities. Unfortunately, Original Medicare does not cover this type of care. This expense is going to add up quickly.

5. Overseas Health Care

Original Medicare generally does not cover health care when you travel outside the United States. This can be a significant concern for those who love to travel or have family abroad. We had to start using a travel insurance exchange to provide options.

Example:
Mr. and Mrs. Davis, a retired couple, decide to take a dream safari to Africa. While abroad, Mrs. Davis falls ill and needs medical treatment. Since Original Medicare doesn’t cover international medical care, they face hefty medical bills, adding stress to what should have been a relaxing trip.

Insurance review are important

Getting Help with Coverage Gaps

Navigating the complexities of Medicare and understanding what it does and does not cover can be overwhelming. This is where Suzie with Wenatchee Insurance comes in. Suzie helps clients understand their Medicare options and then finds solutions to cover the gaps left by Original Medicare.

Suzie can help you explore Medicare Advantage plans, which often include additional benefits. These plans might also provide some coverage for long-term care and overseas health care. Additionally, Suzie can guide you through supplemental insurance options, known as Medigap policies, which can help cover some of the out-of-pocket costs not covered by Original Medicare.

Conclusion

Don’t let coverage gaps surprise you reach out and have a chat with Suzie today and ensure you have comprehensive health coverage for all stages of life. While Original Medicare provides valuable coverage, it’s crucial to be aware that it has limitations.

Routine dental care, vision care, hearing aids, long-term care, and overseas travel health care are significant areas where coverage gaps can occur.

By understanding these gaps and seeking assistance from professionals like Suzie at Wenatchee Insurance, you can find the right coverages to meet your needs.

health or medicare enrollment suzie makes it easier

Topics: Medicare, Original Medicare, Medicare Advantage, travel insurance, Cashmere, Wenatchee Insurance, Suzie, Enrollment, Glasses, Contacts, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth

What additional benefits do Medicare Advantage plans offer?

medicare advantage plans have extras

The Secret Perks of Medicare Advantage Plans: It’s Like Finding Extra Fries in Your Bag!

Who doesn’t love discovering extra fries at the bottom of their EZ’s bag? Medicare Advantage plans can be just like that—with extra perks you didn’t even know you could get. Who better to help you find these hidden gems than Suzie and Wenatchee Insurance?

Vision, Dental, and Hearing: The Big Three Imagine going to your La Fuente for some Carne Asada, and they throw in free flan with your meal. Medicare Advantage plans can include vision, dental, and hearing benefits. That’s right! They help cover your eye exams, dental cleanings, and hearing aids. These added touches can make the difference from good to great.

Fitness Programs: Get Moving! Some plans can offer fitness programs. Think of it as your gym membership without the hefty price tag. You could be doing Zumba at the community center or swimming laps at the local pool—all included complementary to your plan. Who knew staying healthy could be this much fun?

Transportation Services: Ride On! Ever need a ride to the doctor’s office and wish you didn’t have to bother your neighbor? Medicare Advantage plans can offer transportation services. It’s like having your own taxi service, so you can sit back and relax on your way to appointments.

Over-the-Counter Allowances: Stock Up! Some plans give you allowances for over-the-counter items. Imagine walking into the local pharmacy and grabbing vitamins, pain relievers, or even Band-Aids without pulling out your wallet.

Why Wenatchee Insurance? Navigating these perks can be like hunting for Easter eggs. But with Wenatchee Insurance, you’ve got the ultimate guide. They know all the ins and outs of the local Medicare Advantage plans and can help you find one that offers the best extras for your lifestyle.

When you are ready. Suzie would love to help you navigate through available plans.

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

How do I compare Medicare Part D plans in Eastern Washington?

Medicare Part D plans and Suzie from Wenatchee Insurance can help

Comparing Medicare Part D Plans: A Humorous Guide with Wenatchee Insurance

Picture this: you’re on a reality TV show called “Medicare Matchmaker,” hosted by none other than Wenatchee Insurance’s very own Suzie. She’s the perfect host, with a knack for making complex insurance terms as delightful as a game of charades. Your mission? To find the ideal Medicare Part D plan. Ready to play? Let’s dive into this hilarious yet informative adventure.

Round 1: The Introduction

Suzie: “Welcome to Medicare Matchmaker! Today, we’re comparing Part D plans, where finding the right fit is like choosing the perfect dance partner. Each plan has its own rhythm, and it’s our job to make sure you don’t end up with two left feet!”

Sample: “It’s like speed dating for your prescriptions. In one corner, we have the ‘No Deductible Dan’ plan, and in the other, ‘Low Premium Lucy.’ Who will sweep you off your feet?”

Round 2: The Quickstep – Monthly Premiums

First up, monthly premiums. Think of them as the cover charge to get into the dance hall. Some plans charge more, some less, and it all depends on how fancy you like your dance floor.

Suzie: “If you’re a frugal Fred or Frida, you might prefer a lower premium. But remember, cheaper isn’t always better. It’s about finding that sweet spot where cost meets coverage.”

Sample: “Imagine paying to get into a club only to find it’s karaoke night and not the salsa dance you hoped for. That’s what a low premium with poor coverage feels like.”

Round 3: The Tango – Deductibles

Next, we tackle deductibles. It’s the amount you pay before your plan starts to pitch in. High deductibles can feel like a long, slow tango, but for some, it’s worth the wait.

Suzie: “A high deductible plan might seem daunting, but if you’re not a frequent flyer at the pharmacy, it could save you money in the long run.”

Sample: “Think of it as a slow dance with a mysterious partner. The anticipation might just make the end result all the more rewarding.”

Round 4: The Waltz – Coverage and Formularies

Now, let’s waltz through coverage and formularies. Each plan has a list of covered drugs, known as a formulary. It’s crucial to ensure your medications are included.

Suzie: “Imagine showing up to the waltz in sneakers—just wrong. Similarly, the wrong plan might not cover your essential meds. Always check the formulary!”

Sample: “You wouldn’t wear a tutu to a tango, right? Matching your meds to the formulary is the same principle.”

Round 5: The Jive – Co-pays and Co-insurance

Next, co-pays and co-insurance. These are the out-of-pocket costs you’ll jive to when picking up your prescriptions.

Suzie: “Do you prefer a steady, predictable co-pay or are you a bit of a gambler, willing to jive with co-insurance? It’s all about your comfort with cost variability.”

Sample: “Co-pays are like knowing the DJ’s playlist in advance. Co-insurance? That’s like a surprise dance-off—exciting but unpredictable.”

Final Round: The Freestyle – Donut Hole

Ah, the infamous donut hole—a temporary limit on what the drug plan will cover. It’s a bit like the freestyle round—unexpected and sometimes tricky.

Suzie: “Navigating the donut hole can feel like doing the cha-cha on a minefield. But fear not, we’ll help you avoid the worst pitfalls.”

Sample: “The donut hole is that moment when the music stops, and you’re left wondering if you’ve been dancing to the wrong tune. But with the right plan, you’ll glide through it with ease.”

The Final Decision

After all the dances, it’s time to make your choice. Suzie wraps up the show with her signature flair.

Suzie: “Congratulations! You’ve compared premiums, deductibles, formularies, and more. With Wenatchee Insurance, you’re not just choosing a plan—you’re choosing peace of mind. Let’s make your Medicare Part D plan the best dance partner you’ve ever had!”

Sample: “Remember, the perfect plan is like the perfect dance partner—balanced, supportive, and in sync with your needs. With Wenatchee Insurance by your side, you’ll always be in step.”

And there you have it, folks! Comparing Medicare Part D plans doesn’t have to be a chore. With a little humor and a lot of expertise from Wenatchee Insurance, you’ll find the perfect plan that keeps you twirling through life with a smile.

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

Which Medicare Advantage plan network is for me?

Medicare plan 65 Wenatchee Advantage

Finding Your Medicare Advantage Network: It’s Like Picking your favorite Ice Cream Flavor!

Choosing a Medicare Advantage plan network can feel like deciding on the best ice cream flavor at the Owl Soda Fountain. But don’t worry! Suzie and Wenatchee Insurance is here to help you find the perfect match—no brain freeze included.

HMO vs. PPO: The Big Scoop First up, we’ve got the Health Maintenance Organization (HMO) plans. These are like sticking to your all-time favorite ice cream flavor. You’ve got to choose from a specific set of doctors and hospitals (your favorite ice cream parlor). But the upside? You know exactly what you’re getting, and it’s usually cheaper.

Preferred Provider Organization (PPO) plans are a bit more adventurous. They let you try different flavors from various parlors. It’s like getting a huckleberry shake from Not Dougs or headed to Coldstone in Leavenworth. Sure, you might pay a little more, but the freedom to explore is worth it if you’re the kind who likes to mix things up.

Wenatchee Insurance: Your Ice Cream Guide Wenatchee Insurance is like the friendly staff at the local ice cream shop who knows the top secret flavors. They’ll help you figure out if you’re more of an HMO or PPO person. Maybe you need to see a specialist in town, or you want the flexibility to travel and still get coverage. They’ve got the scoop on it all.

Local Flavor: The Farmer’s Market Example Think of HMO plans like sticking with your favorite vendor at the Wenatchee Farmer’s Market. You always buy your honey crisp apples from Royal Produce because they’re the best. PPO plans are like wandering around the Farmers’ market, trying different stands, and discovering new favorites. Both have their perks!

Why Networks Matter Choosing the right network is crucial because you don’t want to end up going to a doctor who’s out of your plan’s network. It’s like getting a surprise bill after indulging in the most expensive sundae. No one wants that!

Wenatchee Insurance to the Rescue! Suzie at Wenatchee Insurance knows all the local doctors and hospitals. They can tell you which plans your favorite specialists are in, so you don’t have to switch doctors and start from scratch. They’ll make sure your Medicare Advantage plan fits like a glove (or like a perfectly scooped cone).

So, whether you’re a loyal vanilla fan or you like to mix chocolate chip with rocky road, Wenatchee Insurance will help you find the Medicare Advantage network that’s just right for you. Because picking insurance shouldn’t be as stressful as picking a dessert!

Insurance Bundle

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

What medicare prescription Drug Plans (Part D) are available in Eastern Washington?

medicare prescription plan d talk to Suzie at Wenatchee

Discovering Your Medicare prescription Match: A Light-hearted Journey Through Part D Plans with Wenatchee Insurance

When it comes to finding the right Medicare Prescription Drug Plan (Part D) in Eastern Washington, the options can feel like a never-ending buffet. But fear not! Suzie with Wenatchee Insurance is here to help you navigate the smorgasbord of choices with humor and experence. Let’s dive into the delightful world of Medicare Part D plans, where each plan is like a quirky character at a neighborhood cook out.

The “Budget Benny” Plan

First up is the “Budget Benny” plan. Benny is that guy who always brings the cheapest dish to the cook out but somehow manages to make it taste great. This plan has a low monthly premium and keeps costs minimal. Perfect for those who are pinching pennies but still want solid coverage. With Budget Benny, you won’t break the bank, and you’ll still get your essential medications covered.

Sample: “Imagine Benny showing up with a big bowl of chili—simple, affordable, and everyone loves it. That’s what you get with the Budget Benny plan: basic but beloved.”

The “Luxury Lucy” Plan

On the other end of the spectrum, we have “Luxury Lucy.” Lucy arrives at the cook out with gourmet hors d’oeuvres, a cheese platter, and artisanal bread. This plan has a higher premium but offers extensive coverage, low deductibles, and includes a wide range of medications. Ideal for those who prefer their healthcare coverage to be as luxurious as their lifestyle.

Sample: “Luxury Lucy is like the friend who treats every meal like a Michelin-star event. With this plan, you’re not just covered—you’re covered in style.”

Medicare plan 65 Wenatchee Advantage

The “Steady Eddie” Plan

Next, meet “Steady Eddie.” Eddie is dependable, always brings a reliable dish, and you can count on him year after year. This plan offers a balanced approach with moderate premiums and coverage. It’s designed for those who want stability and don’t like surprises—just good, consistent coverage.

Sample: “Steady Eddie is like that comforting casserole at every cook out—hearty, satisfying, and you know exactly what you’re getting.”

The “Flexible Fran” Plan

There’s “Flexible Fran,” who always brings a dish that can be vegan, gluten-free, or carnivore-friendly depending on what’s needed. This plan is all about options and adaptability. Perfect for those who have specific or changing medical needs, Fran’s plan can adjust to whatever life throws your way.

Sample: “Flexible Fran is the chameleon of cook out dishes, just like her plan can adapt to your shifting medical needs.”

The “Value Vicky” Plan

Lastly, let’s not forget “Value Vicky.” Vicky is thrifty and resourceful, bringing a dish that’s cost-effective. This plan strikes a balance between cost and coverage, giving you the most bang for your buck without sacrificing quality.

Sample: “Value Vicky’s plan is like that surprisingly tasty dish made from leftovers—creative, cost-efficient, and surprisingly satisfying.”

Navigating the Buffet with Wenatchee Insurance

Choosing the right Medicare Prescription Part D plan doesn’t have to be overwhelming. At Wenatchee Insurance, we’re your friendly guides at the buffet table of Medicare options. We’ll help you sample each plan, compare the flavors, and find the one that leaves you feeling satisfied and secure.

So, whether you’re a Budget Benny or a Luxury Lucy, a Steady Eddie or a Flexible Fran, Wenatchee Insurance is here to make sure your Medicare Prescription Part D plan fits you like a glove—or like your favorite cook out dish. Call us today, and let’s get started on finding your perfect plan match!

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Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

How do I enroll in a Medicare Part D plan in Eastern Washington?

prescriptions cost money a medicare part d can save

Enrolling in Medicare Part D: A Humorous Walkthrough with Wenatchee Insurance

When you enroll in a Medicare Part D plan kind of feels like applying for a secret society membership—complete with cryptic forms, mysterious deadlines, and possibly a funky handshake or two. Don’t worry! Suzie & Wenatchee Insurance is here to make the process as entertaining as a sitcom episode, where even the most tedious tasks can come with laughter. We are going to walk through the Medicare Part D process together, with a dash of humor.

Step 1: The Invitation

First, you need to get invited to the party, a.k.a. determine your eligibility. Generally, if you’re eligible for Medicare then you’re eligible for Part D. Think of it as receiving your VIP ticket to a chef’s table in the newest restaurant in town.

Example: “You’ve got your golden ticket, just like Charlie in the chocolate factory, except instead of chocolate, you’re getting life-saving medication. Still, pretty sweet deal, right?”

Step 2: The Grand Entrance – Initial Enrollment Period

The Initial Enrollment Period (IEP) is your first chance to join the party. Starting three months before you turn 65, your birth month and ending three months after, you have your initial enrollment period. Seven months seem like a lot however they can go fast. Miss this, and you’ll have to wait for the next party invite. Yes, sometimes you will have to bring a note to get in!

Sample: “Think of the IEP as the VIP entrance to a concert. You get in early, avoid the rush, and grab the best spot near the stage. Miss it, and you’ll be stuck at the back, straining to hear the music.”

Step 3: The Red Tape – Required Information

Now, let’s tackle the paperwork. You’ll need your Medicare number, date of birth, and other personal info.

Sample: “Filling out your info is like completing a membership form for the ‘Cool Kids Club.’ Just a few details and you’re ready to flash that membership card (your Part D plan) proudly.”

Step 4: The Selection Process – Choosing Your Plan

Here’s where it gets fun: Choosing a Part D plan is like picking your Hogwarts house. Do you go with the bravery of Gryffindor (extensive coverage), the loyalty of Hufflepuff (steady and reliable), or maybe the cunning of Slytherin (low premiums but high deductibles)?”

health or medicare enrollment suzie makes it easier

Step 5: The Initiation – Enrollment

Once you’ve chosen your plan, it’s time to officially enroll. You can do this online, over the phone, or by mail. Enrolling in your Part D plan is like taking the final step in joining a secret society. You recite the oath (or just click ‘submit’), and voila! You’re in. Cue the applause and confetti.”

Step 6: The Welcome Package

After enrolling, you’ll receive your membership card and welcome package. Receiving your Part D welcome package is like getting your secret decoder ring. Suddenly, all the mysterious codes (insurance jargon) make sense, and you’re ready to take on the world—or at least the pharmacy.”

Step 7: The Ongoing Adventure

Now that you’re enrolled, the adventure begins. Keep an eye on your medications, costs, and any plan updates. It’s an ongoing journey, but with Wenatchee Insurance by your side, you’ll navigate it with ease and a smile.

Sample: “Your journey with Medicare Part D is just beginning. It’s like starting a new season of your favorite show—there will be twists, turns, and maybe a few cliffhangers, but Wenatchee Insurance is here to help you through every episode.”

Wenatchee Insurance: Your Trusted Sidekick

Enrolling in a Medicare Part D plan doesn’t have to be a chore. With Suzie & Wenatchee Insurance, it’s a fun and straightforward process, complete with guidance, support, and a few laughs along the way.

So, if you’re ready to join the secret society of Medicare Part D, let Wenatchee Insurance be Robin to your Batman. Together, we’ll make this journey as entertaining as it is rewarding.

Home Health Medicare Car Dental Prescription insurance corndog

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

How Do I Make the Most of My Medicare Benefits?

Medicare plan 65 Wenatchee Advantage medicare benifits

Hey Chelan County, It’s Suzie with Wenatchee Insurance. Today, we’re here to help you milk every drop of goodness out of your Medicare benefits – think of it as getting all the toppings on your sundae, without any extra charge!

Step 1: Embrace the Freebies (Preventive Services)

Medicare loves giving out freebies. Take advantage of preventive services like:

  • Annual Wellness Visits: Like a yearly tune-up for your car, but a lot less grease.
  • Screenings: For things like diabetes, heart disease, and certain cancers – think of it as an annual “What’s going on in there?” check.
  • Vaccinations: Stay flu-free and fabulous with covered vaccines.

Example Time!

Bob never misses his annual wellness visit. His doctor keeps him in tip-top shape, and Bob feels like he’s just had a makeover on a reality TV show.

Step 2: Manage Your Meds (Pharmacy Hacks)

Your Part D plan is your ticket to affordable meds, but let’s make sure you’re really saving:

  • Check the formulary: It’s like reading the menu before you order – know what’s covered.
  • Use preferred pharmacies: Some pharmacies are like that one pizza place that always has a deal.
  • Go generic: Just as tasty, but a lot cheaper – like getting the store-brand cereal.

Example Time!

Sally May loves a good bargain. By sticking to her plan’s preferred pharmacies and opting for generic meds, she saves enough each month to treat herself to something nice – like a day at the beauty salon.

Step 3: Use Extra Benefits (Hidden Gems)

If you have a Medicare Advantage plan, don’t ignore those extra benefits:

  • Vision, dental, and hearing: Routine exams, glasses, hearing aids – it’s like getting free sprinkles on your sundae.
  • Fitness programs: Many plans include gym memberships.
  • Telehealth services: See your doctor without leaving your couch – perfect for pajama days.
health or medicare enrollment suzie makes it easier for medicare benefits

Example Time!

Steve stays active with her plan’s including gym membership. He’s a regular at the gym, where he’s known as “The Silver Swole.”

Step 4: Know Your Out-of-Pocket Costs (Avoid Surprise Bills)

Keep an eye on your out-of-pocket costs. This includes:

  • Deductibles: The upfront cost before your plan kicks in – like the cover charge at a club.
  • Copayments/Coinsurance: Your share of the cost – think of it as splitting the dinner bill on a night out.
  • Out-of-pocket maximum: The most you’ll pay in a year before your plan picks up everything else–the save your farm number.

Example Time!

Tom keeps track of his medical expenses like a hawk. By understanding his plan’s costs, he avoids those “What the heck?!” moments when the bill arrives.

Wenatchee Insurance: Suzie is your Medicare Wingman

At Wenatchee Insurance, we’re here to help you get the most out of your Medicare benefits. Think of us as your trusty sidekick, always ready with the right advice and a corny joke.

Final Thoughts

Maximizing your Medicare benefits is like finding hidden treasures. By embracing the freebies, managing your meds, using extra benefits, and understanding your costs, you’ll make the most out of your coverage and keep your wallet happy.

Remember, dear readers, getting the most from your Medicare benefits doesn’t have to be a scavenger hunt. With Wenatchee Insurance by your side, you’ll be the Indiana Jones of healthcare savings world. Stay tuned for more insights, tips, and plenty of laughs!

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

Health Insurance Medicare  Advantage Wenatchee Suzie

How Do Medicare Supplement (Medigap) Plans Work?

Medicare Advantage or Medigap Suzie has you covered

Hey North Central Washington, it’s Suzie with Wenatchee Insurance. Today, we are talkin’ about  Medicare Supplement Insurance, or Medigap. Think of Medigap as the baked potato to your Medicare steak, helping cover the costs that Original Medicare doesn’t.

What is Medigap?

Medigap plans are sold by private insurance companies and are designed to fill the “gaps” in Original Medicare. These gaps include out-of-pocket costs like copayments, coinsurance, and deductibles.

Example!

Meet Barney, who’s enjoying his retirement but worried about potential healthcare costs. He decides to get a Medigap plan to cover expenses that Original Medicare doesn’t. Now, Barney can focus on detailing his Corvette instead of medical bills.

Standardized Medigap Plans: One Size Fits Most

Medigap plans are standardized, meaning each plan offers the same basic benefits regardless of the insurance company. There are ten standardized plans (Plan A, B, C, D, F, G, K, L, M, and N), each offering a different level of coverage.

Standardized plans allow a client to shop based on price in the middle of the year.

Example!

Imagine Joan, who travels frequently. She chooses Medigap Plan G because it covers emergency care when traveling outside the U.S., giving her peace of mind on her adventures.

What’s Covered?

Medigap plans help cover costs like:

  • Part A coinsurance and hospital costs
  • Part B coinsurance or copayments
  • First three pints of blood
  • Part A hospice care coinsurance or copayments
  • Skilled nursing facility care coinsurance
  • Part A and B deductibles (depending on the plan)
  • Foreign travel emergency care

Example Time!

Consider Bob, who needs regular blood transfusions. His Medigap plan covers the cost of the first three pints of blood each year, saving him from unexpected expenses.

How to Enroll?

To enroll in a Medigap plan, you must already have Medicare Part A and Part B. The best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which lasts for six months and starts the month you turn 65 and are enrolled in Part B. During this period, you can buy any Medigap policy sold in your state, regardless of your health status.

Protip: We have a lot of members who review their Medigap plan and switch in early summer to reduce inflation.

Example!

Imagine Sally, who just turned 65 and enrolled in Medicare Part B. She takes advantage of her Medigap Open Enrollment Period to get a policy without worrying about being denied coverage due to her pre-existing conditions. The Guarantee Issue is a game changer for people who have struggled with co-payments for under 65 healthcare.

Suzie @ Wenatchee Insurance

We’re here to help you navigate the world of Medigap with ease. Our knowledgeable agents can explain the different plans, help you compare options, and ensure you choose the coverage that best fits your needs.

Remember, understanding Medigap doesn’t have to be a daunting task. With Suzie helping out, you’ll find the perfect potato for your Medicare steak in no time.

Stay tuned for more tips, tricks, and helpful advice from Suzie!

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

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What Are the Differences Between Medicare and Medicaid?

Medicare or Medicaid a conversation about the differences

Hey, it’s Wenatchee Insurance! We are answering a classic question today, what are the differences between Medicare and Medicaid. We are going to use a Golden example:

It’s 2024, you’re sitting with Blanche, Dorothy, Rose, and Sophia in Miami, and you’re scratching your head over the differences between Medicare and Medicaid. Sit tight and grab a cheesecake because we’re about to unravel this mystery Golden Girls style!

Medicare: The Senior Superstar

Dorothy: “Alright, let’s start with Medicare. It’s like Stan – it’s been around forever. Medicare is a federal program mainly for folks aged 65 and older. It also covers younger individuals with certain disabilities and those with End-Stage Renal Disease (ESRD). Think of Medicare as the golden ticket for our seasoned citizens.”

Medicaid: The Need-Based Nurturer

Blanche: “Oh honey, Medicaid is a whole different ball game. It’s a joint federal and state program that helps people with limited income and resources. It’s like that nice gentleman who insists on paying for your drinks at the Rusty Anchor – it’s there to lend a hand when you need it most.”

Who Qualifies?

Medicare:

Rose: “If you’re 65 or older and worked your credits, congratulations, you qualify! But even if you’re younger and have disabilities or ESRD, you’re still in the club.”

Medicaid:

Sophia: “Eligibility for Medicaid is trickier than finding a good cannoli in Miami. It depends on your income, family size, and sometimes disability or other factors. Each state has its own rules – it’s like trying to follow Rose’s stories about St. Olaf.”

Example Time!

Dorothy: “Meet George, a 68-year-old retiree. He’s eligible for Medicare because he’s over 65. Now, consider Anna, a single mother with a low income. She qualifies for Medicaid to help cover her children’s medical expenses. Simple as pie, right?”

health or medicare enrollment suzie makes it easier

What Do They Cover?

Medicare:

Blanche: “Medicare’s got you covered for hospital stays (Part A), doctor visits and outpatient care (Part B), Medicare Advantage (Part C), and prescription drugs (Part D). It’s like having a fabulous wardrobe – everything you need, you just have to mix and match beforehand .”

Medicaid:

Rose: “Medicaid covers a broader range of services, including hospital and doctor visits, long-term care, and sometimes even dental and vision care. It’s like the St. Olaf Cheese Festival – there’s something for everyone!”

Example Time!

Sophia: “Imagine Sue, who has both Medicare and Medicaid (dual eligibility). Medicare covers her hospital and medical expenses, while Medicaid helps with additional costs like long-term care and some out-of-pocket expenses. Sue’s got the best of both worlds – like having cheesecake for dinner and dessert!”

How Are They Funded?

Medicare:

Dorothy: “Medicare is funded by payroll taxes, premiums, and general revenue. It’s as straightforward as Blanche’s love life – always funded by someone.”

Medicaid:

Sophia: “Medicaid, on the other hand, is jointly funded by the federal government and the states. The feds match state spending, with the match rate varying by state. It’s like a family potluck – everyone brings something to the table.”

Example Time!

Rose: “Think of Medicare as a national program with uniform rules. Medicaid is more like St. Olaf’s festivals – each state adds its own unique twist to the overall picture.”

Wenatchee Insurance: Your Dual Eligibility Expert

Blanche: “Navigating the differences between Medicare and Medicaid can feel like one of Rose’s long stories. But don’t worry, darling, Suzie at Wenatchee Insurance is here to guide you through every twist and turn.”

Dorothy: “Our knowledgeable agents can help you understand which program you qualify for and how to make the most of your benefits. Remember, understanding Medicare and Medicaid doesn’t have to be a puzzle.”

Sophia: “With Wenatchee Insurance by your side, you’ll find your way in no time. So stay tuned for more insights, tips, and helpful advice. And always remember – thank you for being a friend!”

calling suzie for medicare or health insurance help

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability, Dual Eligible, Dual SNP,

How Do I Choose the Right Medicare Plan for Me?

Medicare plan 65 Wenatchee Advantage

Hey it’s Suzie with Wenatchee Insurance coming in from 413 Mission Street! Today, we’re tackling the question that’s as tricky as choosing the right toppings for your pizza: “How do I choose the right Medicare plan for me?” Like finding the perfect slice, selecting the right Medicare plan requires a bit of thought, a touch of flair, and maybe a dash or two of pepperoni.

Step 1: Know Your Cravings (er, Needs)

First up, you need to understand your healthcare cravings – I mean, needs. Ask yourself:

  • How often do I visit the doctor? Does your doctor’s office know your cat’s favorite toy, or do you just drop by for an annual tune-up like a leaf in the wind?
  • What meds am I taking? Is your nightstand a mini-pharmacy, or do you have a couple of trusty prescriptions?
  • Who are my favorite healthcare providers? Do you have a doc you’d follow to the ends of the earth (or at least across town)?

Example Time!

Take Rita. She’s got more doctor appointments than a socialite has lunch dates and takes a medicine cabinet’s worth of prescriptions. She needs a plan that covers all her meds and keeps her favorite doctors in-network. Rita’s Medicare plan hunt is like finding the perfect pair of shoes: practical, stylish, and something you can walk miles in.

Step 2: Check Out the Menu (Plan Options)

Here’s the Medicare menu:

  1. Original Medicare (Parts A & B): The classic. Like a good cheese pizza, it’s dependable and straightforward.
  2. Medicare Advantage (Part C): The supreme combo. These plans, offered by private companies, bundle Parts A, B, and usually Part D, plus extra toppings like vision, dental, and gym memberships.
  3. Medicare Part D: Standalone prescription drug plans. It’s like adding a side of garlic knots.
  4. Medigap (Medicare Supplement): These plans cover costs that Original Medicare doesn’t. Think of it as the Ranch dipping sauce for your crust.

Example Time!

Picture John. He’s a minimalist at heart. Original Medicare with a side of Medigap is his go-to. No frills, just solid coverage that gets the job done, like a perfectly baked Margherita pizza.

Step 3: Compare the Costs (Count the Dough)

Don’t get caught with an empty wallet. Here’s what to look at:

  • Premiums: Your monthly fee – like your subscription to that pizza-of-the-month club.
  • Deductibles: The amount you pay before coverage kicks in. Consider it your ante at the poker table.
  • Copayments/Coinsurance: Your share of the bill – like splitting the tab on pizza night.
  • Out-of-pocket maximums: The most you’ll pay in a year before insurance takes over. Think of it as your “all-you-can-eat” cap.

Example Time!

Meet Mary. She’s on a tight budget but loves a good value. She compares plans to find one with low premiums and reasonable out-of-pocket costs, ensuring she doesn’t end up eating ramen instead of pizza.

We love our senior insurance customers
Why be boring, life is short.

Step 4: Star Ratings (Yelp for Medicare)

Medicare plans come with star ratings (1 to 5 stars). Think of it as checking Yelp reviews before trying a new pizza joint.

Example Time!

Tom wants the best of the best. He checks out the 5-star Medicare Advantage plans, ensuring he’s getting top-notch service, like dining at a five-star pizzeria.

Get Expert Help (Call the Pizza Hotline)

Feeling overwhelmed? Don’t worry! Wenatchee Insurance agents are like your personal pizza hotline. We’ll help you compare plans, answer your questions, and find the perfect Medicare pie for you.

Example Time!

Jane was lost in the sauce until she called Wenatchee Insurance. With expert guidance, she found a plan that fit her health needs and budget, like a pizza made just for her.

Final Thoughts

Choosing the right Medicare plan is like finding your favorite pizza: once you get the right combo, it’s pure bliss. With Wenatchee Insurance by your side, you’ll be enjoying your perfect Medicare slice in no time. Stay tuned for more insights, tips, and plenty of cheesy puns!

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, SSDI, ESRD, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability,

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Health & Medicare

For nearly a decade we have assisted with Health & Medicare Solutions. We are proud to be selected by the Washington Healthplanfinder to be one of ten Enrollment Centers located in Washington State.

We work with all ages and charge no fees.

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