Notes

Why purchased health insurance?
We want to have someone that covered our medical expenses.
COPAY- fixed amount that you need to pay while COINSURANCE is the percentage what you get after you've met your deductible.
Deductible - you need to pay out of your own pocket.
Out-of-pocket - this is the thousand of dollars that you need to spend for your medical insurance to fully cover your medical expenses.
In-Network
*you can't choose your own doctor
*you can't use outside your state
*limited use of facilities
Out-of-Network
*opposite of in-network
*expensive
Don't deal with people having TRICARE FOR LIFE insurance.
VA - partial or fully covered
- can purchase if that VA is not connected with TRICARE FOR LIFE by instance like being a dependent/s of someone who had TRICARE FOR LIFE health insurance.
Medicare - 65 years old and up and under certain disability.
Medicaid - no age limit/people with limited income or resources.
Parts of Medicare
A- Hospital Insurance (for free)(provided by the gov't)(no monthly premium)
B- Medical Insurance - provided by the gov't but prescritption of drug, dental, vision and hearing or DVH are not covered.
- premium monthly of $170.10
C- Medicare Advantage (provided by private insurance company only if you have sign up for A and B - original medicare(80%)).
- protect you from huge fees.
- alternative for original medicare card
- reimbursement or refund for the premium (give backs)
- majority is HMO

D- Prescription drug
E- Supplement (Medigap)
- provided by private gov't
- no copays, coinsurance and deductibles.
- no reimbursement
- no coverage for dental, vision and hearing.
- no coverage for prescription of drug.
- just pay the monthly premium.

*How? Deducted from their Social Security Cheque automatically.
*The reimbursement depends on the insurance provider, zipcode and the plan.
Red, white and blue card - has Part A and Part B.
*Dual Special Needs Plan - no reimbursement because the gov't is paying the monthly premium for you so you can't get something you're not paying for.
*We can only change the plan from 15th of Oct and ends on 7th of December.
*We work with those people enrolled in Medicare Advantage plan on the 1st of January and ends on 31st of March.
*OEP - One time open enrollment
*AEP - Annual Enrollment Health Insurance