Know the basics

If your client asks about Medicare, be prepared so they don’t look elsewhere for advice.

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WHAT is Medicare?

A federal health insurance program that pays a variety of healh care expenses. It’s administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).

WHO is it for?

- People 65 years and older

- Some people with disabilities under age 65

- People with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant)

Medicare has FOUR parts

Part A

(Hospital Insurance)

Part B

(Medical Insurance)

Part C

(Medicare Advantage Plans)

Sold by private insurance companies
and take the place of Original Medicare

Part D

(Medicare Prescription Drug Plans)

Sold by private insurance companies
and take the place of Original Medicare

Your Medicare-eligible clients have several options, depending on where they live.

They can:

  • Elect Original Medicare
  • Elect Original Medicare and add drug coverage with a Medicare Part D Prescription Drug Plan
  • Substitute a private Medicare Advantage plan for Original Medicare
  • Substitute a private Medicare Advantage plan that also includes Medicare Part D Prescription Drug coverage in place of Original Medicare (resulting in an "MA-PD" plan)
  • Elect Original Medicare, add a Medicare Supplement insurance plan to pay for any gaps in coverage and add drug coverage with a Medicare Part D Prescription Drug Plan

What are Medicare Supplement policies?

Medicare does not cover all health bills. So Medicare Supplement policies offered by private health insurers help fill in those gaps: things like co-pays, deductibles for hospitalization and doctor visits. That’s why you’ll hear "Med Supp" called "Medigap." There are a variety of plans — Plan A through N — but each plan is standardized. Every carrier’s Plan F, for example, offers the same benefits. But prices vary by carrier.

Why refer your clients to Medicare BackOffice?

Medicare BackOffice has dedicated insurance advisors who are licensed, contracted and certified in all 50 states to provide Medicare advice and products. We’re the experts, with an excellent reputation. Our goal is to analyze your clients’ needs and find the Medicare health plan from an "A"- rated or better insurance carrier that is right for them, at a competitive rate.

Fast facts

Product offerings

Medicare Supplement Plans

  • Feature predictible monthly premiums that help budget yearly out-of-pocket health care expenses
  • Cover 100 percent of Medicare deductibles and co-insurance
  • Do not restrict clients from continuing to see their current physician, as long as doctor accepts Medicare assignment
  • Offer year-round enrollment

Medicare Advantage Plans

  • Feature monthly premiums as low as $0 per month in some areas
  • Require co-pays and deductibles when treatment is received
  • Some reduce out-of-pocket expenses when treatment is through a network provider
  • Limit enrollment to certain times of the year, unless there is a qualification for an exception
  • Most include Medicare Part D Prescription Drug coverage

Medicare Part D Plans

  • Provide stand-alone prescription drug coverage
  • Limit enrollment to certain times of the year, unless there is a qualification exception
  • Already included in some Medicare Advantage plans
  • Can limit clients’ options and penalize them if enrollment is delayed