Hospital Coverage
The side that picks up an inpatient stay, a stretch in a skilled nursing facility, hospice support and some care brought into your home after an admission.
Medicare Services
What each piece of Medicare actually pays for, and what gets checked against your own doctors and prescriptions before you choose.
The pieces and what they do
Medicare Arrives in Pieces, and They Fit Together More Than One Way
None of it is a single product you either have or do not have. Some pieces come straight from the government, some are sold by private insurers, and a few of them overlap. Here is what each one is responsible for, so you can tell what you already hold and what may still be missing.
Medical Coverage
Office visits, lab work, screenings, outpatient procedures and durable equipment sit here. Most of what happens outside a hospital bed lands on this side.
Bundled Private Plans
A private insurer delivers the hospital and medical sides together in one plan, usually inside a provider network and often with prescriptions folded in.
Prescription Coverage
Sold on its own or built into a bundled plan. Each one keeps its own list of covered medicines, so yours has to be looked up by name rather than assumed.
Supplement Policies
These sit beside the original coverage and absorb part of the deductible and coinsurance you would otherwise owe. They are standardized, so the same type buys the same benefits wherever you buy it.
Added Benefits
Some bundled plans include dental, vision, hearing or a fitness membership. Pleasant to have, though worth reading closely before it becomes the reason you switch.
What a review covers
Four Things I Work Through Before You Enroll in Anything
Networks
Your Doctors, Checked by Name
You give me the providers you want to keep and I hold each one against the networks of the plans open to you. If a name is missing, you hear that from me while you can still do something about it.
Pharmacy
Every Refill Priced Out
Each medicine you take is matched to a plan's covered list and to the pharmacy you actually use. Two plans can quote the same monthly premium and still price your refills very differently.
Budget
A Whole Year of Spending
Premiums are the easy part. Deductibles, copays and the share you carry on the care you already expect get added in, so the figure you look at resembles a real year rather than a headline.
Timing
The Window That Applies to You
There is more than one enrollment window and they do not all open for the same reason. I work out which one is yours and flag when it closes while there is still room to act.
Bring Your Doctors and Your Prescriptions
Create an account and tell me who you see and what you take. The comparison that comes back is built on your own care, not on a plan somebody wants to move.
Your Doctors, Looked Up
Send me the names of your doctors and clinics, and I check every plan's network before you choose.
Refills Checked by Name
Tell me what you take, and I match each medicine to the plan's drug list and the pharmacy's price.
A Full Year of Costs
Premiums, deductibles and copays get added together, so you see a likely total for the whole year.
Deadlines Pointed Out
You hear from me about which enrollment window applies to you and when it closes, well in advance.