Medicare Parts A & B
Is It Right For Me?

• If You’re New To Medicare You May Be Concerned About Your Coverage Needs Being Met.

• This Is The Place To Find Out If Original Medicare Will Suit Your Needs.

• We Know It Can Be Tough To Sort Through The Complexities Of Medicare.

• If You Ever Have Any Concerns Please Give Us A Call – We’re Happy To Help.

• We Want You To Have Your Coverage Your Way.

Learn More

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Medicare Parts A & B

• If You’re New To Medicare You May Be Concerned About Your Coverage Needs Being Met.

• This Is The Place To Find Out If Original Medicare Will Suit Your Needs.

• We Know It Can Be Tough To Sort Through The Complexities Of Medicare.

• If You Ever Have Any Concerns Please Give Us A Call – We’re Happy To Help.

• We Want You To Have Your Coverage Your Way.

The Basics
Part A Details
Part B Details
SPEAK WITH A LICENSED AGENT
816-436-2622

Frequently Asked Questions

You Qualify For Medicare If:

  • You have been a legal citizen & resident for more than 5 years in a row just before applying for Medicare.
  • You are 65 years or older.
  • You are younger than 65 with a qualifying disability.
  • Any age with end stage renal disease or ALS.

What If I Already Have Insurance?

  • Medicare generally does not coordinate with group insurance.
  • If you want to see if you’re an exception to this rule, Give Us A Call . We are more than happy to help!

How Much Does Original Medicare Cost?

  • The Costs Of Medicare Coverage Depends On Quite A Few Factors. You Can Read More About The Details Here.
  • We Would Love To Help You Figure Out Exactly What Your Costs Are. Please Give Us A Call And We’ll Walk Through It Together.

A Brief Overview Of Original Medicare – Part A & Part B Coverage

Part A Overview

  • This Part Of Medicare Covers your Inpatient Care & Hospital Stays.

  • Any Qualified Healthcare Provider In The US That Accepts Patients & Participates In The Medicare Program Must Accept This Coverage, You Cannot Be Denied.

  • Most People Do Not Pay A Premium For This Coverage (see exception)

  • You May Be Charged A Penalty Up To 10% (if you pay a premium) If You Don’t Sign Up When You Are First Eligible.

 

See Cost Details
See Coverage Details

Part A With Jeff David

Part B With Jeff David

Part B Overview

 

  • Primarily For Medically Necessary & Preventative Outpatient Services And Doctors Visits.

  • Any Qualified Healthcare Provider In The US That Accepts Patients & Participates In The Medicare Program Must Accept This Coverage, You Cannot Be Denied.

  • You May Be Charged A Penalty Up To 10% If You Do Not Sign Up When You Are First Eligible.

 

Part B With Jeff David

See Cost Details
See Coverage Details

What Is NOT Covered With Original Medicare

 

Prescription Drug Plans (Also Called PDP)

 

Long Term Care (Such As Nursing Homes)

 

Vision

 

Dental

Medicare Part A Details

You cannot be denied medicare part A, any qualified health care provider in the US that participates in the Medicare program and is accepting Medicare patients. You may be charged a 10% more on your monthly premium (if this applies to you) if you don’t buy when you are first eligible.

Covers:

  • A semi-private room (private room only if medically necessary)
  • Your hospital meals
  • Skilled nursing services
  • Care in special units, such as intensive care
  • Drugs, medical supplies & equipment
  • Lab test & x-rays
  • Operating room and recovery room services
  • Some blood transfusions
  • Rehabilitation services after qualified inpatient stay
  • Part time skilled care for the homebound
  • Hospice care for the terminally ill

** Special Tip: You or a family member should always ask if you are inpatient or outpatient every day during your hospital stay **

Usually you don’t need to pay a monthly premium for part A coverage if you’ve paid social security for the last 10 years or 40 quarters. If you have not, here are the monthly premiums (these figures represent 2019 data):

  • If you’ve paid the last 30 quarters social security tax: $437/mo (max cost)
  • If you’ve paid the last 31-39 the standard premium is $240

Deductible & co-insurance information: This differs based on the services being rendered

Deductible: $1,364 for each benefit period – only applies to an inpatient stay for hospital care or mental care.

Coinsurance:

  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $341 coinsurance per day of each benefit period
  • Days 91 & Beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond Lifetime Reserve Days: All costs

Home health care deductible: $0 for home health care, 20% of medicare approved amount for durable medical equipment.

Hospice deductible: $0 for hospice care.

  • You may need to pay up to $5 copayment for each prescription drug and other similar pain relief medication when you’re at home.
  • You may need to pay 5% of the Medicare approved amount for inpatient respite care
  • Medicare doesn’t cover room and board when you get hospice care in your home or another facility where you live (like a nursing home)

Skilled Nursing Facility:

  • Days 1-20: $0 for each benefit period
  • Days 21-100: $170.50 coinsurance per day of each benefit
  • Days 100 & Beyond: All costs

Medicare Part B Details

You cannot be denied part B coverage. Any doctor or qualified health care provider (see if your doctor qualifies here) in the U.S. who participates in the Medicare program and is accepting patients must provide you this coverage. You may be charged a penalty if you don’t sign up when you are first eligible, unless you qualify for a special enrollment period.

Primarily for: Medically necessary and preventative outpatient services & doctor visits

Covers:

 

  • Doctor visits, including in the hospital
  • Annual wellness visit and preventive services, like flu shots and mammograms
  • Lab services, like blood tests
  • X-rays and some other diagnostic tests
  • Lab Services, like blood tests
  • Some health programs, like smoking cessation, obesity counseling and cardiac rehab
  • Physical therapy, occupational therapy and speech-language pathology services
  • Diabetes screenings, diabetes education and certain diabetes supplies
  • Metal health care
  • Durable medical equipment for use at home, like wheelchairs and walkers
  • Ambulatory surgery center services
  • Ambulance & emergency room services
  • Skilled nursing care and health aide services for the homebound on a part time or intermittent basis

 

The standard premium for Part B $135.50/mo, but may be higher depending on your income

 

  • Each income bracket has its own standard premium
  • Deductible & co-insurance
  • $185/yr. After your deductible is met you typically pay 20% of the Medicare-approved amount for most doctors services (including while you are a hospital inpatient), outpatient therapy, and durable medical equipment.
  • Clinical lab services: $0 for medicare approved services
  • Home health care: $0 for home health care services, with 20% of Medicare approved amount for durable medical equipment

Outpatient mental care:

  • Nothing for yearly depression screening if your doctor or health care provider accepts assignment
  • 20% of Medicare approved amount for visits to diagnose or treat your condition.
  • If you get services in in a hospital outpatient clinic or hospital outpatient department, you may to pay an additional co-payment or coinsurance amount to the hospital

Partial hospitalization mental health services: You’ll pay a percentage of the medicare approved amount for each service you get if your health care professional accepts assignment.

  • You also pay coinsurance for each day of partial hospitalization.

 

Outpatient Hospital Services:

 

  • Usually you’ll pay 20% of the Medicare approved amount for doctor or other health care provider’s services. For services that can also be provided in the doctors office that you receive at home, you may pay more. However, this additional co-payment will be capped for the service is capped at the inpatient deductible amount.
  • In addition to the amount you pay the doctor, you’ll also usually pay the hospital a co-payment for each service you receive in a hospital outpatient setting, except for certain preventive services that don’t have a co-payment. In most cases, the co-payment can’t be more than the Part A hospital stay deductible for each service.
  • The Part B deductible applies, except with preventive services.
  • If you get outpatient services in a critical access hospital your co-payment may be higher and may exceed the Part A hospital stay deductible.

 

We’ve Been Taking People From Hassled To Worry Free Since 93!

There Are Plenty Of Supplemental Coverage Options. Please See More Here, Or Give Us A Call And We’ll Guide You Through What Your Options Are!

  • We Will Get You Affordable, Quality Coverage.

  • A Friendly Agent Will Be There To Pick Up The Phone When You Call.

  • You’ll Be A Welcome Addition To The Jeff David Family.

  • Don’t Just Take Our Word For It, Check Out What Our Customers Are Saying!

Testimonial – Bridget Bristow

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