Medicare Products
Medicare is the federal health insurance program for:
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease
You may be eligible to SAVE MONEY on your RX costs!
Contact us at 330.953.3722 to show you how!
Visit WRS Insurance Solutions Representatives at Hometown Pharmacy locations on select dates during Medicare Open Enrollment (October 15-December 7) to review your Medicare Plan options!
• Agency is not connected with the Federal Medicare program. Representatives will be available in-store on select dates. This is a solicitation for insurance and a licensed agent may contact you.
Medicare Advantage Products
A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits. Medicare Advantage Plans include:
- Health Maintenance Organizations
- Preferred Provider Organizations
- Private Fee-for-Service Plans
- Special Needs Plans
- Medicare Medical Savings Account Plans
If you’re enrolled in a Medicare Advantage Plan:
- Most Medicare services are covered through the plan
- Medicare services aren’t paid for by Original Medicare
Medicare FAQ
What are the different types of Medicare Advantage Plans?
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNPs)
There are other less common types of Medicare Advantage Plans that may be available:
- HMO Point of Service (HMOPOS) Plans: An HMO Plan that may allow you to get some services out-of-network for a higher cost.
- Medical Savings Account (MSA) Plans: A plan that combines a high health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year
How do you join, switch, or drop a Medicare Advantage Plan?
How to switch
Follow these steps if you’re already in a Medicare Advantage Plan and want to switch:
- To switch to a new Medicare Advantage Plan, simply join the plan you choose during one of the enrollment periods. You’ll be disenrolled automatically from your old plan when your new plan’s coverage begins.
- To switch to Original Medicare, contact your current plan.
Unless you have other drug coverage, you should carefully consider Medicare prescription drug coverage (Part D). You may also want to consider a Medicare Supplement Insurance (Medigap) policy. Remember, you may only be able to switch at certain times of the year.
If you have other coverage
Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose employer or union coverage. If you lose coverage for yourself, you may also lose coverage for your spouse and dependents.
In other cases, you may still be able to use your employer or union coverage along with the Medicare Advantage plan you join. Remember, if you drop your employer or union coverage, you may not be able to get it back.
What happens if my plan stop participating in Medicare?
At the end of the year, plans can decide to leave the Medicare Program. In recent years, however, very few plans have left. If this happens, your plan will send you a letter explaining your options.
Generally, you’ll be automatically returned to Original Medicare if you don’t choose to join another Medicare Advantage Plan. You will also have the right to buy a Medigap policy.
No matter what you choose, you’re still in the Medicare Program and will get all Medicare-covered services. If you choose to go back to Original Medicare, you need to decide if you want drug coverage. If so, you need to join a Medicare Prescription Drug Plan (Part D).
How do Medicare Advantage Plans work?
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have
Medicare is the federal health insurance program for:
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Covered services in Medicare Advantage Plans
Medicare Advantage Plans cover all Medicare services. Some Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage.
Rules for Medicare Advantage Plans
Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
Each Medicare Advantage Plan can charge different out-of-pocket costs. They can also have different rules for how you get services, like:
- Whether you need a to see a specialist
- If you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care
These rules can change each year.
Costs for Medicare Advantage Plans
What you pay in a Medicare Advantage Plan depends on several factors.
Drug coverage in Medicare Advantage Plans
Most Medicare Advantage Plans include prescription drug coverage (Part D). You can join a separate Medicare Prescription Drug Plan with certain types of plans that:
- Can’t offer drug coverage (like Medicare Medical Savings Account plans)
- Choose not to offer drug coverage (like some Private Fee-for-Service plans)
You’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply:
- You’re in a Medicare Advantage HMO or PPO.
- You join a separate Medicare Prescription Drug Plan.
How Medicare Supplement Insurance (Medigap) policies work with Medicare Advantage Plans
Medigap policies can’t work with Medicare Advantage Plans.