Lesa Inglis Insurance | Dallas, GA
Medicare

Medicare

Medicare Options and Solutions

Turning 65, Retiring, Disabled on Medicare, and Beyond

Medicare is confusing to most people and health care can be expensive. Our goal is to help you find the plan that offers the highest level of protection at the lowest cost.

First, we sit down with you and show you how everything works and explain all of your options because Medicare is not “one size fits all”. Every beneficiary has a unique set of circumstances. The right fit for one person, may not be the right fit for you. And that “right fit” may change from year to year.

Next, we’ll help navigate your choices, and show you all the plans available to you. The decision is always yours.

Currently, we’re licensed in several states including Alabama, Delaware, Florida, Georgia, Mississippi, North Carolina, Ohio, Tennessee and Virginia.

How To Choose Medicare Plans

Original Medicare Only

Part A (Inpatient Hospital) 2024-

$1632 Deductible Every 60 Day Benefit Period

  • Days 1-60: $0 copayment
  • Next 30 Days: $408 copayment each day
  • Lifetime Reserve of 60 Days: $816 copayment each day
  • After a total of 150 days: You pay all costs

Inpatient Hospital Care includes semi-private room, meals, drugs as part of treatment

Skilled Nursing Facility up to 100 Days

  • Days 1-20: $0 copayment
  • Days 21-100: $204 copayment each day
  • Days 101 and beyond: You pay all costs

Hospice Care

Home Health

20% for durable medical equipment

Part B (Medical) 2024 –

$240 Annual Deductible

80/20 Coinsurance – No cap on the 20% you pay

Medically necessary doctors’ services including those received as hospital inpatient

Preventative Services

Labs, X-rays, MRIs and some other diagnostic tests

In some circumstances, medications administered in an outpatient setting may be included in Part B

Out-of-Pocket Limitations

Medicare pays a percentage of approved amounts after certain deductibles have been met. There is no maximum out of pocket limit, meaning there is nothing that limits what a person pays. This does create financial exposure.

Medicare does not pay for prescription medications you pick up at the pharmacy and administer yourself.

How to Limit Out of Pocket Expenses

Medicare only pays so much, and the rest is up to you. There are two ways to limit the financial exposure. You may purchase a Medicare Supplement Plan aka Medigap, or you may purchase a Medicare Advantage Plan aka Part C. Either of these choices will limit how much you pay. They work very differently, and you will find that one may work better than the other for you. The only caveat is understanding the choice you are making and why you are making that choice.