Medicare

Navigating Your Options with a Trusted Guide

Welcome! If you’re approaching age 65 or are already a Medicare beneficiary, you’ve probably realized that it can be a bit overwhelming. With all its different “parts,” enrollment periods, and plan choices, it’s easy to feel lost in a sea of information. That’s where I come in. My name is Judy Pratcher, and my job is to be your personal guide through the Medicare maze, helping you understand your choices so you can select a plan with total confidence. The best part? My guidance and expertise come at no cost to you.

Understanding the Building Blocks: Original Medicare (Part A & Part B)

Let’s start with the foundation. Original Medicare is a federal health insurance program primarily for people 65 or older and for some younger people with disabilities. It’s broken into two main parts:

• Medicare Part A (Hospital Insurance): Think of Part A as your hospital coverage. It helps pay for things like inpatient care in a hospital, skilled nursing facility care (but not long-term custodial care), hospice care, and home health care. For most people who have worked and paid Medicare taxes for at least 10 years, Part A is premium-free.
• Medicare Part B (Medical Insurance): Part B is your coverage for doctor visits and outpatient care. It helps pay for services from doctors and other healthcare providers, outpatient hospital care, durable medical equipment (like walkers and wheelchairs), and many preventive services, such as flu shots. You will pay a monthly premium for Part B, which is often deducted directly from your Social Security benefits.

While Original Medicare provides a solid base, it was never designed to cover everything. It leaves gaps in coverage, including deductibles, coinsurance, and copayments. Most importantly, it does not include coverage for most prescription drugs. This is why most people choose to get additional coverage.

Enhancing Your Coverage: Medicare Advantage & Part D

This is where your choices really begin to open up. You have two primary paths to enhance your Original Medicare coverage and protect yourself from unpredictable out-of-pocket costs.

Medicare Advantage (Part C): The All-in-One Approach
Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. Think of them as a bundled package that combines your Part A and Part B benefits into one convenient plan. Most Medicare Advantage plans also include prescription drug coverage (these are often called MAPD plans).

A key feature of these plans is that they often include extra benefits that Original Medicare doesn’t cover. You can find plans that offer routine dental, vision, and hearing coverage, as well as fitness program memberships (like SilverSneakers), and allowances for over-the-counter health products. These plans typically operate with a network of doctors and hospitals, such as an HMO or PPO, and they have an annual maximum out-of-pocket limit, which protects you from catastrophic medical bills.

Medicare Part D: Your Prescription Drug Coverage
If you decide to stick with Original Medicare, you will almost certainly want to add a standalone Medicare Part D plan. These plans, also offered by private insurers, help cover the cost of your prescription medications. Each plan has its own list of covered drugs, called a formulary. It is critically important to choose a Part D plan that covers the specific medications you take. Choosing the wrong plan can lead to thousands of dollars in unexpected costs throughout the year. Even if you don’t take any prescriptions now, it’s wise to enroll in a Part D plan when you’re first eligible to avoid a permanent late-enrollment penalty.

Why Work With Me, Judy Pratcher?
You could spend hours trying to research all of this on your own, but you don’t have to. As an independent agent, I represent multiple insurance carriers. This means I’m not tied to a single company; my focus is solely on finding the right plan for you.

Here’s how I help:

• Personalized Needs Analysis: We’ll sit down and talk about your specific situation. Which doctors do you see? What prescriptions do you take? What is your budget? What extra benefits are important to you?
• Simplified Explanations: I’ll explain the pros and cons of each option—Original Medicare with a Part D plan versus a Medicare Advantage plan—in simple, easy-to-understand language.
• Finding the Perfect Fit: Using this information, I can quickly compare the plans available in your area to find the one that covers your doctors and drugs at the lowest possible cost.
• Year-Round Support: My job isn’t done after you enroll. I’m your resource throughout the year for any questions or issues you have with your plan.

Navigating Medicare doesn’t have to be a stressful journey. Let me help you find the path that gives you peace of mind.