Medicare Options

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, also called ESRD).

To be eligible for Medicare, you must be a U.S. citizen or a permanent legal resident who has lived in the United States for at least five consecutive years.

If you are 65 or older and are already receiving retirement benefits from Social Security or the Railroad Retirement Board (RRB), you are automatically enrolled in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you are not receiving these benefits, you will need to apply for Medicare.

Certain people younger than 65 can also qualify for Medicare. These include individuals with disabilities who have received Social Security Disability Insurance (SSDI) for at least two years, and people with ESRD.

There are four parts to Medicare: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans), and Part D (Prescription Drug Coverage). Most people are automatically enrolled in Part A and Part B when they are first eligible, but they have the option to opt out of Part B if they do not want it. Parts C and D are optional and require people to enroll in them.

1. Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.

2. Part B (Medical Insurance) covers certain doctors' services, outpatient care, medical supplies, and preventive services.

3. Part C (Medicare Advantage Plans) is an alternative to Original Medicare (Part A and Part B). These plans are offered by private companies that are approved by Medicare and provide the same coverage as Part A and Part B, but may also offer additional benefits such as vision, hearing, and dental coverage.

4. Part D (Prescription Drug Coverage) helps cover the cost of prescription drugs. It is offered by private insurance companies that are approved by Medicare.

   Medicare beneficiaries can choose to receive their coverage through Original Medicare (Parts A and B) or through a Medicare Advantage Plan (Part C). They can also choose to add a Part D Prescription Drug Plan to their coverage.

The costs associated with Medicare can vary depending on the specific coverage you have and the services you use.

Premiums:

Part A (Hospital Insurance): Most people do not have to pay a premium for Part A because they or a spouse paid Medicare taxes while working. However, if you are not eligible for premium-free Part A, you may be required to pay a premium.

Part B (Medical Insurance): Most people will pay a premium for Part B. The standard Part B premium for 2021 is $148.50 per month, but your premium may be higher or lower depending on your income.

Part C (Medicare Advantage Plans): The premium for a Medicare Advantage Plan may be different from the premium for Original Medicare (Part A and Part B). Some Medicare Advantage Plans may have no premium, while others may have a higher or lower premium than Original Medicare.

Part D (Prescription Drug Coverage): The premium for a Part D Prescription Drug Plan may vary depending on the plan you choose.

Deductibles:

Part A (Hospital Insurance): For 2023, the Part A deductible is $1,600 per benefit period. A benefit period begins the day you are admitted to a hospital or skilled nursing facility and ends when you have not received inpatient care for 60 consecutive days.

Part B (Medical Insurance): For 2021, the Part B deductible is $226 per year.

Part C (Medicare Advantage Plans): The deductible for a Medicare Advantage Plan may be different from the deductible for Original Medicare (Part A and Part B). Some Medicare Advantage Plans may have no deductible, while others may have a higher or lower deductible than Original Medicare.

Part D (Prescription Drug Coverage): The deductible for a Part D Prescription Drug Plan may vary depending on the plan you choose.

Copayments:

Part A (Hospital Insurance): If you have to pay a premium for Part A, you may also be required to pay copayments for hospital stays and other services. The amount you pay depends on the type of service you receive.

Part B (Medical Insurance): If you have Part B, you may be required to pay copayments for certain services, such as doctor's office visits and outpatient care. The amount you pay depends on the type of service you receive.

Part C (Medicare Advantage Plans): Medicare Advantage Plans may have copayments for certain services, such as doctor's office visits and outpatient care. The amount you pay depends on the specific plan you have.

Part D (Prescription Drug Coverage): If you have Part D, you may be required to pay copayments for prescription drugs. The amount you pay depends on the specific plan you have and the type of drug you need.

It's important to note that these costs can change from year to year. You can visit the Medicare website to get more information on current costs and coverage options.

The enrollment process for Medicare depends on your individual circumstances. Here are the general steps for enrolling in Medicare:

Determine your eligibility: You are eligible for Medicare if you are 65 or older, or if you are under 65 and have a disability or End-Stage Renal Disease (ESRD).

Choose a coverage option: You can choose to receive your Medicare coverage through Original Medicare (Parts A and B), a Medicare Advantage Plan (Part C), or a combination of both. You can also choose to add a Part D Prescription Drug Plan to your coverage.

Enroll: If you are already receiving retirement benefits from Social Security or the Railroad Retirement Board (RRB), you will be automatically enrolled in Medicare Part A and Part B when you become eligible. If you are not receiving these benefits, you will need to apply for Medicare.

Pay premiums: Most people will have to pay premiums for Part B and, if applicable, Part C and Part D. The amount you pay may depend on your income.

The enrollment period for Original Medicare (Part A and Part B) is the seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. If you are not automatically enrolled in Original Medicare, you can enroll during this period.

If you have a Medicare Advantage Plan (Part C) or a Part D Prescription Drug Plan, you can enroll during the annual enrollment period, which runs from October 15 to December 7 each year. You can also enroll during the Medicare Advantage open enrollment period from January 1 to March 31 each year.

If you are eligible for Medicare due to a disability or ESRD, you can enroll during the initial enrollment period, which is a seven-month period that begins three months before the 25th month of disability or ESRD, includes the 25th month of disability or ESRD, and ends three months after the 25th month of disability or ESRD.

It's important to enroll in Medicare when you are first eligible to avoid paying higher premiums or having gaps in coverage. If you have questions about the enrollment process or need help enrolling, you can contact Medicare Options for additional information at (877) 777-3175.

Medicare Advantage Plans (also known as Part C) are an alternative to Original Medicare (Part A and Part B). These plans are offered by private insurance companies that are approved by Medicare and provide the same coverage as Part A and Part B, but may also offer additional benefits such as vision, hearing, and dental coverage.

Some Medicare Advantage Plans may also have lower out-of-pocket costs, such as copayments and deductibles, compared to Original Medicare. However, these plans may have different rules for using providers and may not cover all of the services that Original Medicare covers.

There are several types of Medicare Advantage Plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medicare Medical Savings Account (MSA) plans. Each type of plan has different rules for using providers and accessing services, so it's important to carefully review the details of the plan before enrolling.

Medicare Advantage Plans are required to provide at least the same level of coverage as Original Medicare (Part A and Part B), but they may not cover all of the services that Original Medicare covers. It's important to check with your Medicare Advantage Plan to understand what is and is not covered.

You can enroll in a Medicare Advantage Plan if you have Medicare Part A and Part B and you live in the plan's service area. You can also switch between Medicare Advantage Plans or return to Original Medicare during certain enrollment periods.

If you are interested in enrolling in a Medicare Advantage Plan, you can compare plans and enroll by calling (877) 777-3175

Medicare Part D is a prescription drug coverage plan that is offered by private insurance companies that are approved by Medicare. It helps cover the cost of prescription drugs for people with Medicare.

Part D plans have a list of covered drugs, called a formulary, which may change from year to year. Most Part D plans have a deductible, which is the amount you have to pay out-of-pocket before your plan begins to pay for your drugs. After you meet your deductible, you typically pay a copayment or coinsurance for your drugs.

Part D plans may have coverage gaps, also known as the "doughnut hole," where you have to pay a larger share of the cost for your drugs. Once you reach the out-of-pocket limit for the year, your plan will pay for your covered drugs for the rest of the year.

The cost of a Part D plan depends on the specific plan you choose and your location. Premiums, deductibles, and copayments may vary depending on the plan. You may also have to pay a late enrollment penalty if you do not sign up for a Part D plan when you are first eligible or if you go without creditable prescription drug coverage for a period of time.

It's important to review the details of a Part D plan before enrolling to understand the costs and coverage limits. You can compare Part D plans and enroll by calling (877) 777-3175

There are several types of Medicare plans available to eligible individuals across the United States. These include Original Medicare (Part A and Part B), Medicare Advantage (Part C), and Medicare Part D for prescription drug coverage.

Original Medicare is a federal fee-for-service program that provides hospital (Part A) and medical (Part B) coverage. It’s available to most people aged 65 and older, as well as certain younger individuals with qualifying disabilities.

Medicare Advantage plans (Part C) are offered by private insurance companies approved by Medicare. These plans include all the benefits of Original Medicare and often offer extra coverage for things like vision, hearing, dental, and wellness services. Medicare Advantage plans may also include lower out-of-pocket costs, though they typically have defined provider networks.

Medicare Part D provides prescription drug coverage and is available as a standalone plan for those with Original Medicare, or it may be included in some Medicare Advantage plans.

The availability of specific plans may vary based on your ZIP code and personal eligibility. To get help comparing options or enrolling, call us to speak with a licensed Medicare agent (877) 777-3175

• Some plans offer this benefit depending on your ZIP code and eligibility. We can check for you.

• Medicare Advantage combines coverage in one plan, often with extra benefits.
• Supplement plans fill in the gaps of Original Medicare and work alongside it.

No — our services are 100% free. We’re compensated by the carriers, not by you.

Choosing a Medicare Advantage plan can be a confusing process, especially for those who are new to the Medicare system or who live in areas with many different plan options. If you live in Las Cruces, New Mexico, you may be wondering how to choose the right Medicare Advantage plan for your needs.

In this article, we will go over some important considerations to keep in mind when selecting a Medicare Advantage plan in Las Cruces, New Mexico. We will also cover some of the top Medicare Advantage plans available in this area, and explain how to enroll in a plan that is right for you.

Consider Your Health Care Needs

The first step in choosing a Medicare Advantage plan is to consider your health care needs. This includes thinking about the doctors and hospitals you prefer, any prescription medications you take, and any chronic health conditions you have.

For example, if you have a specific doctor or hospital you want to continue seeing, you will need to make sure that provider is in the network of the Medicare Advantage plan you choose. Likewise, if you take prescription medications, you should make sure that the plan you select covers those medications.

It's also important to think about any chronic health conditions you have, such as diabetes or heart disease. If you have a chronic health condition, you may need to see a specialist or receive additional medical services. Make sure that the Medicare Advantage plan you choose covers the services you need to manage your health condition.

Compare Plan Costs

Another important consideration when choosing a Medicare Advantage plan is the cost. Medicare Advantage plans can have different costs, including premiums, deductibles, and co-pays or coinsurance.

When comparing plan costs, it's important to look beyond just the monthly premium. You should also consider how much you will have to pay out-of-pocket for services like doctor visits, hospital stays, and prescription drugs.

Some Medicare Advantage plans may have lower monthly premiums, but higher out-of-pocket costs. Others may have higher monthly premiums, but lower out-of-pocket costs. It's important to compare the total cost of each plan to find the one that best fits your budget.

Check Plan Ratings

Medicare Advantage plans are rated on a five-star scale based on quality and performance. You can check plan ratings on the Medicare website or by using the Medicare Plan Finder tool.

A plan with a higher star rating may be a better choice, as it indicates that the plan has a good track record of providing quality care and service to its members. However, it's important to remember that a higher rating doesn't necessarily mean a plan is right for you. Make sure to consider your individual needs when comparing plan ratings.

Consider Extra Benefits

Medicare Advantage plans may offer extra benefits beyond what is covered by Original Medicare. These can include things like vision and dental care, fitness programs, and transportation to medical appointments.

When comparing Medicare Advantage plans, it's important to consider the extra benefits that each plan offers. If you have specific health care needs or preferences, such as regular dental cleanings or transportation to medical appointments, make sure that the plan you choose offers these benefits.

Top Medicare Advantage Plans in Las Cruces, New Mexico

Now that you know what to consider when choosing a Medicare Advantage plan, let's take a look at some of the top plans available in Las Cruces, New Mexico.

Blue Cross Blue Shield of New Mexico offers several Medicare Advantage plans in Las Cruces, including plans with $0 premiums and extra benefits like dental and vision care.

Aetna Medicare offers several Medicare Advantage plans in Las Cruces, including plans with $0 premiums and extra benefits like transportation to medical appointments.

Humana offers several Medicare Advantage plans in Las Cruces, including plans with $0 premiums and extra benefits.

The Initial Enrollment Period (IEP) is a seven‑month window that begins three months before the month you turn 65, includes your birthday month, and ends three months after. During this time you can sign up for Medicare Parts A and B.

The Initial Enrollment Period (IEP) is a seven‑month window that begins three months before the month you turn 65, includes your birthday month, and ends three months after. During this time you can sign up for Medicare Parts A and B.

Yes. Medicare covers a wide range of preventive services such as annual wellness visits, certain vaccinations, cancer screenings, and cardiovascular screenings at no cost to you when you use providers who accept assignment.

A Special Enrollment Period (SEP) lets you sign up for or change Medicare coverage outside the usual time frames if you experience certain life events, such as losing employer insurance, moving, or qualifying for Medicaid.

Original Medicare does not cover custodial long‑term care. It may cover short stays in a skilled nursing facility after a qualifying hospital stay, but ongoing nursing‑home or assisted‑living costs are generally not covered. Long‑term care insurance or Medicaid may help.

Original Medicare does not cover custodial long‑term care. It may cover short stays in a skilled nursing facility after a qualifying hospital stay, but ongoing nursing‑home or assisted‑living costs are generally not covered. Long‑term care insurance or Medicaid may help.

Each Part D plan has a formulary—a list of covered drugs—organized into cost tiers. Lower tiers (e.g., Tier 1) usually include generic drugs with lower copays, while higher tiers contain brand‑name or specialty drugs that cost more.