San Francisco Bay Area Medicare Insurance Plans
Local Licensed Medicare Insurance Agent To Help You Select The Right Plan
We specialize in Medicare Advantage Plans, Medicare Supplemental Plans, and Medicare Prescription Drug Plans. Serving The San Francisco Bay Area Including Alameda County, Contra Costa County, San Mateo County, San Francisco County, and Santa Clara County. We also do electronic applications via fax, mail, and email in the state of California.
Turning 65 ? Are you looking at plans during the government annual open enrollment periord ? Call To Discuss Your Needs
Paul Gordon, Local Licensed Insurance Agent for Health and Life 510-909-8552
The areas I service with direct contact are Alameda County, Contra Costa County, San Mateo County, San FranciscoCounty, and Santa Clara County. I can assist with Medicare plans anywhere in the state of California. So if you are looking for a California Medicare Plan, look no further. Call Paul Gordon today.We provide Medicare Advantage Plans, Medicare Supplement Plans (also known as Medigap Insurance), and Prescription Drug Plans. The Medicare insurance market can be confusing, and quite frankly overwhelming for many. As a local licensed agent, I provide a great deal of expertise and personal service in helping you and your loved ones find a Medicare plan that is right for you.
Understanding Medicare plans and coverage an be confusing. We are here to help you sift through the maze of information and jargon. For a short summary, when you turn 65 (or earlier for special cases such as disability), and you meet basic qualifications, you become qualified for Medicare Part A and Medicare Part B. These original Medicare plans cover various forms of hospitalization and doctor visits ( always consult the office U.S Government Medicare Website for exact details ). The standard government plan , referred to as Original Medicare, includes Part A and Part B, but does not include a prescription drug plan. You have to purchase a separate medicare prescription drug plan , referred to as Plan D if you want this coverage with the Original Medicare plans offered by the U.S. Government. If you meet basic eligibility requirements, Part A is provided at no additional cost, but you have to elect and pay for Part B.
So what are all the other plans about ? Simply stated, the Original Medicare plans provided by the government require that you pay certain portions of the expenses for medical care. For most people, this leaves a degree of financial responsibility and exposure that could be difficult to deal with financially. So there are additional insurance plans to help cover many of the expenses that are not provided for under Original Medicare. The major plans that you hear and read about are the Medicare Advantage Plans, and Medicare Supplemental Plans (also known as Medigap Insurance Plans ). These plans help reduce your financial exposure to the coverage gaps not included in Original Medicare.
Medicare Advantage Plans are referred to as Medicare Part C plans. If you sign up for one of these plans, it is with a private insurance carrier that combines the coverage that was included in your Original Part A and Part B. The insurance company is now providing your coverage. Frequently these Advantage plans include prescription drugs. Typical Medicare Advantage Plans have you use the plan’s network of doctors. The concept is that you have a primary care physician, and as needed you are referred to specialists that are in the network. Good Medicare Advantage plans will have a strong network of doctors to serve your needs. Medicare Advantage Plans typically have a list of co pays, co insurance, and deductibles that you have to pay. Better than the Original Medicare, buy you still have to pay for various items, although your out of pocket expenses are typically limited. For example, its not uncommon for a Medicare Advantage Plan to have a maximum of of pocket expense of $5,900. While a lot of money, its much better than potentially being exposed to many times that amount of financial liability with Original Medicare. That’s why people take Medicare Advantage Plans. The above information is a basic description, and there are exceptions to all of the above that change based on the insurance provider and the area you live in. That’s why I am here..to help you go through and understand all of this so you can make the best choice.
Medicare Supplemental or Medigap Insurance Plans help pay the costs that Part A and B don’t cover. Since there are “gaps” in the Original Medicare Plans, the insurance is called ”Medigap”. Medigap or Supplemental Plans are labeled with a designation of A through N. The difference between the plans is the amount of coverage and how much you pay. Plan F is typically a plan that costs more, but you may have no payments for the covered items (co pays, co insurance, deductibles, etc. ). With Medicare Supplemental Plans, you still keep your Medicare Plan A and Plan B, and the private insurance pays the missing parts. Since you are still using standard Medicare doctors, these plans allow you to select any Medicare doctor that is taking new patients…you are not limited to a network of providers that is typical of Medicare Advantage Plans. If you take a Medigap or Medicare Supplemental plan, they typically do not include prescription drug plans , Part D. Medicare Prescription Drug Plans Part D are available as separate stand alone polices. Many of the carriers that offer the Medicare Supplemental Plans also offer their own Medicare Prescription Drug Part D plans.
Medicare Prescription Drug Part D Plans provide coverage for the cost of you prescription drugs. Common elements of these plans include a list of covered drugs (call the forumulary), and a classification of of drugs, typically Tier 1, Tier 2, Tier 3, Tier 4, and Tier 5 . Depending on the classification, the cost and coverage changes. Most plans have an initial phase of coverage where you are provided the payment benefits up to a certain amount. After you reach certain expense in drug usage, then you fall in to the “donut hole” where you absorb a substantially greater amount of the drug costs. After you have reached a maximum of of pocket expense for the plan year, then you will fall into the catostrophic coverage phase where significant coverage picks up again. Plans vary, but the concepts remain the same. Again, look the actual plan details from the carrier.
The above information is is general description and may not accurately reflect your specific situation. Ultimately the information that matters is the details specified in the plans provided by the insurance carriers. All plans are not offered in all areas of the country, and costs vary depending on what state and what county you reside in. It’s a bit confusing, but there is a way to sift through all this, and that is by sitting down with an experienced Medicare Insurance specialist such as myself.
Enrollment Periods : The other crucial element is when you can enroll in these plans. Generally speaking, subject to qualifications, you can enroll in various plans with in certain time periods when you obtain Part A and Part B medicare plans (generally at age 65), during the government annual open enrollment period ( October 15 through Dec 7 for 2012) , or when your existing coverage status changes (example if your plan terminates you. For most people, the times to look at all this is the few months before you turn 65, and during annual open enrollment period. Do you need to change plans ? If you select a good plan from a good carrier, you will most likely stay with the plan for a long time. Your needs may change along the way, and that’s why open enrollment periods allow you to make adjustments during these time periods.
What I do is find out what your personal circumstances are, help assess your needs, then I can show you the plans would make the most sense. You can select the best options based on your needs.
Medicare Advantage Plans
Medicare Supplemental Plans (“Medigap Policies” )
Medicare Prescription Drug Plans
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Please call Paul Gordon at 510-909-8552 to discuss your needs.
CA Dept of Insurance License #OH80554
Disclaimer: To provide you with easy-to-understand information about your Medicare options, I have researched government websites and publications, such as those of Medicare.gov, USA.gov, HHS.gov (Department of Health and Human Services) and CMS.HHS.gov (Centers for Medicare & Medicaid Services). Paul Gordon is not associated with or endorsed by these government websites and publications. It our belief that the sources we use to provide this information are reliable. However, we do not guarantee or warrant the accuracy of this information. Paul provides the material on this website for informational purposes only. The contents of this website are subject to change without notice.
If you call my phone number, or fill out a information request form on this web site, you are authorizing me to contact you as licensed insurance agent to discuss and solicit your business. I respect your privacy and conduct myself in a professional manner as you would expect. These disclaimers are a necessary part of life in today’s world. The good news is that you found me, Paul Gordon, a trusted and reliable source of information. I look forward to working with you.