The A, B, C and D’s of Medicare

The Basics

PART A

Part A coverage is automatic on the first day of the month in which you turn 65 or earlier under certain circumstances, is premium-free for most and provided by the Federal Government. Part A helps pay for inpatient hospital stays and services associated with inpatient stays. There is an annual deductible with Part A and then per-day copayments for the inpatient stays.

PART B

Part B coverage is elective and has a monthly premium.  Part B helps pay for doctor visits and other medical services. Part B has a small calendar year deductible and then generally pays 80% of the eligible approved charges.  There is no maximum out-of-pocket cost to an individual.  It is very important to know when to elect Part B as there are ramifications for electing it too soon or too late.

PART C

Part C represents the contracts that can be purchased through private insurance carriers that either replace Medicare or supplement Medicare.

  • The Medicare Advantage plans replace Medicare – you continue to pay the Part B premium, but all claims are submitted through the private insurance carrier and coverage works similarly to non-Medicare health

Plans, like a traditional HMO plan with specific provider networks, deductibles, coinsurance, copays, etc.

  • Medicare Supplements do just that – they supplement Medicare. So if Medicare considers the claim eligible and approves, the amount not covered by Medicare is paid by the supplement purchased. There are no provider networks on supplement policies, therefore, they provide the most freedom but do have a higher cost than Medicare Advantage plans.

PART D

Part D Plans are the prescription drug component.  Some Medicare Advantage plans include a prescription drug benefit but none of the Medicare Supplement plans have drug coverage.  An evaluation of the individual’s specific drugs is essential to providing the best plan as each carrier in this market has their own formulary list of preferred drugs and pharmacies.

 

Medicare does not pay for every health care cost an individual incurs.  There are penalties and time frames to when an individual can elect Part B, C and D plans.  Please call us to book an appointment to discuss your options.

What Our Clients Are Saying

Client Testimonials

The levels of understanding and creativity that Kris and her associates have provided for our personal and company needs during the past 2+ decades has been overwhelming. From group medical requirements to a wide variety of individual and corporate coverage needs, Kris has continually raised the bar to ensure that our people and interests were, are and will continue to be- fully protected.

- Todd BergChairman & CEO, Liftomatic Material Handling, Inc.

... Kris Aufmann has been our insurance broker for 18 years, providing our company with health, dental and vision insurance along with short-term and long-term disability coverage. Kris has proven to be a valuable asset to our company, offering a wide arrange of benefits to our employees and is always available if we have questions or need help with anything.

- Edward StritchPresident & CEO, The Concord Group

Aufmann Associates have done an amazing job from guiding us through the best insurance coverage for our employees to the pricing out complete coverage in our area. I cant imagine an easier process than with Aufmann Associates. I Highly recommend Kris and the team as they go above and beyond what I've ever experienced before in complete insurance coverage. Thanks you!

- Sean McNamaraOwner, RLC Media
We are Always Here to Help!

Experienced

We have over 30 years experience providing expert insurance coverage.

Trusted

Aufmann Associates is an enthusiastic team of professionals that are always looking out for your best interest.

Professional

Our insurance agents guarantee you will be protected at the best rates and coverage possible.

Contact Us

1699 Wall Street, #506,
Mt. Prospect, IL
847.963.8807