Sam Burgess

When it comes to decide on a Medicare Advantage plan , you have to make sure that you fully understand the coverage and its limitations.  Many people I speak to tell me that they have Medicare Supplement coverage when in fact they have a Medicare Advantage plan. There is a big difference. Medicare Advantage Plans are network driven health plans. There are 3 types of plans: HMO, PPO and PFFS. The 2 most common ones are HMO’s and PPO’s.  HMO require referrals to see specialists. With this type of coverage, your primary care provider(PCP)will “quarterback” your care.  Under PPO’s, referrals are not required to see specialists and you are covered both in and out of network. However, out of network  will cost more. Most Medicare Advantage plans include Part D drug coverage along with extra benefits like dental, vision, Silver Sneakers, etc… When selecting plan you need to make sure that your doctors accept the plan you are applying for. If there are important doctors that you need to se

If you are retiring or losing employer coverage and are in need of obtaining Medicare coverage, there are some simple steps that you will need to do to ensure that you get your coverage on time. If you went on Medicare while you were employed and you decided to only get Part A of Medicare, you will need to get your Part B started. You just can’t go online and apply for Medicare Part B . There are a couple of forms you will need to take down to Social Security or mail into Social Security.  You need to know that you need both Part A and Part B to obtain Medicare Supplement coverage or a Medicare Advantage plan (For Part D drug coverage you only need Part A OR Part B. You do need both) This is necessary because if you cannot prove “credible coverage” you cannot start Part B whenever you want and you will be penalized 10% per year that you went without “credible coverage”. To avoid this call or email me and I will provide you with both forms.  There is one form you to fill out another