What to Know
At DNA Insurance Agency, we don’t believe in one-size-fits-all solutions. We start by listening — really listening — to understand your unique needs, your goals, and your concerns. Our process is not just about finding the right plan; it’s about finding the right plan for you.
We break down the jargon, demystify the options, and tailor our advice to match your life, your health, and your budget. We guide you step by step, making sure you understand each decision, and we’re always here for follow-up support. We pride ourselves on transparency, honesty, and making sure you feel supported every step of the way.
Getting Started with Medicare Health Insurance Plans
You’ve likely heard of Medicare but may not fully understand the program or how it differs from Medicaid. Our medical insurance agency is dedicated to helping you navigate Medicare options and choose the right health plans for your specific needs. We offer guidance on individual health plans, hospital insurance, and long-term care plans to ensure comprehensive coverage.
What is Medicare? Why should I care?
Medicare is a federal health insurance program primarily for individuals aged 65 and older. It also covers certain younger individuals with disabilities and those diagnosed with end-stage renal disease (ESRD), a permanent kidney failure condition requiring dialysis or a transplant. Our Medicare insurance agency is here to help you determine your eligibility and guide you in selecting the Medicare health insurance plan that best meets your needs.
Understanding Medicare and Its Coverage Options
Navigating your initial steps toward Medicare coverage can be overwhelming. Understanding numerous terms and evaluating potential expenses is essential. Carefully reviewing all available options is crucial to making the best decision. Fortunately, our Medicare plan insurance agency is here to help you simplify the complexities of Medicare and guide you through the process.
Medicare Part A, or hospital insurance, covers inpatient hospital stays, hospice, skilled nursing, and some home health care but does not cover long-term care. For extended care, separate long-term care plans are needed.
Medicare Part B is an individual health plan covering outpatient care, some doctor’s services, preventive care, and medical supplies. It typically does not include prescription drugs, which are covered under Medicare Part D.
Medicare Part A & B
Medicare Advantage Health Insurance
Medicare Advantage plans are designed to enhance the coverage provided by Medicare Parts A and B. These plans may offer benefits such as long-term care insurance, prescription drug coverage, special needs support, and additional services. Our team is available to help you understand the costs associated with Medicare Advantage plans and guide you toward the best option for your needs.
Medicare Part A: Hospital Insurance
Part A includes coverage for inpatient hospital stays, skilled nursing facility care, hospice services, and certain home health care. Typically, you won't be required to pay a monthly premium for Medicare Part A if you or your spouse have contributed to Medicare payroll taxes for at least 40 quarters.
Medicare Part B: Medical Insurance
Part B includes coverage for specific doctors’ services, outpatient care, medical supplies, and preventive services. Enrollment in Part B cannot be refused. You have the freedom to visit any doctor or eligible health care provider in the United States who accepts Medicare.
Medicare Part D: Prescription Drug Coverage
Provides coverage for prescription medication expenses, including many recommended vaccines and shots. Drug coverage is available either through a standalone Part D plan or included within a Medicare Advantage plan (Part C). Certain plans offer pharmacy networks and mail-order options.
Who can receive Medicare and how do I enroll?
U.S. citizens and legal residents
Legal residents are required to have continuously lived in the U.S. for a minimum of 5 years, including the 5 years immediately preceding their Medicare application. Additionally, applicants must satisfy at least one of the following criteria:
Be 65 years of age or older
Be under 65 with a qualifying disability
Be of any age with a diagnosis of end-stage renal disease or ALS
If you are receiving Social Security or Railroad Retirement Board benefits when you become eligible, you will be automatically enrolled. Your Medicare card will be mailed to you. If you are not receiving these benefits, you must actively sign up for Medicare upon eligibility. To enroll, visit SSA.gov/Medicare online, call, or visit your local Social Security office.
What are the coverage choices?
Original Medicare (Parts A & B) is administered by the federal government and covers hospital stays and doctor visits, but it does not cover all healthcare expenses. To enhance your coverage, you can enroll in one or more private Medicare or Medicare-related plans:
Medicare Supplement Insurance (Medigap) helps cover certain out-of-pocket costs associated with Original Medicare.
Medicare Prescription Drug Plans (Part D) assist with the cost of prescription medications, which are not covered by Original Medicare.
Medicare Advantage Plans (Part C) provide an alternative to Original Medicare by combining Part A and Part B coverage into a single plan. These plans often include prescription drug coverage and may offer additional benefits such as routine vision and dental care.
