Medicare insurance throughout Milwaukee, Waukesha, Racine and Washington Counties.

Medicare insurance can be a complicated topic. Our experts can help you to determine which plan is the best fit for you.

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Medicare insurance is a government-sponsored health insurance program available to most people aged 65 or older or who qualify due to disability. It’s divided into several sections with differing costs and choices.

Part A covers hospital treatment costs. In most cases there’s no premium payment, but recipients pay a deductible and also pay some coinsurance depending upon their medical treatments throughout the year.

Part B covers medical treatments outside of hospitals. Part B has an annual premium that is dependent on the recipient’s income and Social Security benefits. Recipients also pay a deductible and coinsurance.

Medicare recipients can also opt to take out a Medicare Advantage plan—sometimes called Part C. This means that the recipients will still pay for the Part B premium, but will get more choice over the balance of costs (premium, deductible and coinsurance) and coverage. They may also get coverage for services such as vision, hearing and dental that aren’t covered by ordinary Medicare.

Whichever plan you choose, the costs of prescription drugs are covered by Part D.

Medicare insurance can be a complicated issue, so please contact us today if you want to talk about your options.

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One of our insurance advisors will reach out to you to review your information and present you with the appropriate medicare insurance solution. There’s no obligation, just good-old-fashioned advice.
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Unisource Insurance Associates offers comprehensive medicare insurance throughout Wisconsin including, Milwaukee, Waukesha County, Washington County and Racine County.

Enroll in Original Medicare

Are you eligible?

People eligible for Medicare are 65 years of age or you’re under 65 and qualify on the basis of disability or other situation. AND you are a legal resident who has lived in the US for at least 5 consecutive years.

When can you enroll?

2021 Annual Enrollment Period Dates

The Annual Enrollment Period: October 15 – December 7
During this period you are able to add, drop, or switch your Medicare coverage.

Medicare Advantage Open Enrollment Period: January 1 – March 31
If you are already a Medicare Advantage plan member, you may disenroll from your current plan and switch to a different Medicare Advantage plan one time only during this period.

Special Enrollment Period

Depending on certain circumstances, you may be able to enroll in a Medicare plan outside of the initial enrollment or annual enrollment time frames. Some ways you may qualify for a special enrollment period are if you:

  • Retire and lose your employer coverage
  • Move out of the plan’s service area
  • Receive assistance from the state
  • Have been diagnosed with certain qualifying disabilities or chronic health conditions
  • Qualify for extra help

Medicare Choices

Part A: Helps pay Hospital and inpatient care

Medicare Part A

  • Most people don’t pay a monthly premium
  • Inpatient hospital care
  • Inpatient mental health care
  • Hospice care
  • Some blood transfusions
  • $1,408 deductible/admission for a hospital stay of fewer than 60 days
  • Stays of more than 60 days require additional daily copays
  • Multiple Stays may mean Multiple deductible
  • You can go to any qualified hospital in the US that accepts new Medicare patients
  • Hospital care outside US isn’t usually covered

Part B: Helps pay for doctor visits and outpatient care

Medicare Part B

  • $144.60 monthly premium (May be higher based on income)
  • Physician services
  • Outpatient hospital services
  • Ambulance
  • Outpatient mental health
  • Laboratory Services
  • Durable medical equipment (wheelchairs, oxygen, etc)
  • Outpatient physical, occupational therapy
  • Some preventive care
  • You can get care throughout the US but generally not outside the country
  • Participating physicians who accept Medicare patients
  • $198 annual deductible for 2020
  • Medicare pays 80%, you pay 20% of Medicare-approved costs
  • No Maximum out of pocket (MOOP)
  • No Rx Coverage
If you want additional coverage, there are two ways to get it:

Option 1: Medicare Supplement Insurance (Medigap) and Medicare Part D plan

Medicare Supplement (Medigap)

  • Designed to cover some of what Medicare Parts A and B doesn’t – such as deductibles, copayments and coinsurance
  • Plans are named A,B,C,D,E,F,G,K,L,M,N, and a HDF (except WI,MN,MA)
  • Pay-Upfront Type of Plan

Pros

  • If plan is put together correctly, you will have little to no out-of-pocket costs for medical care
  • Goes with you anywhere in the US
  • No networks
  • Guaranteed renewable as long as you pay your premium on time and have not made any material misrepresentation on your application for insurance.

Cons

  • Premium at age 65 for full coverage can cost $160+/month
  • In most cases, premiums are based on gender, zip code, and age
  • Average increase – 6-7% /year
  • Premiums nearly double every 10 years
  • No RX coverage included

Medicare PDP (Part D)

  • Helps with the cost of prescription drugs
  • Only offered through private insurance companies
  • Most states have 25 – 30 plans
  • Each plan has a list of drugs are covered before you enroll in a plan. The list of drugs can change eachother.
  • Coverage is not automatic
  • Penalties may apply if you enroll late (1% per month accumulating)
  • Average cost for Part D is $35-$40/month

Option 2: Part C

Medicare Supplement (Medigap)

  • Combines Part A and Part B and, in many cases, includes part D into one plan
  • Offered by private insurance companies (HMO, PPO, PFFS, SNP, MSA-No Rx)
  • Pay-As-You-Go type of plan

Pros

  • Plan premiums start as low as $0/month
  • Eliminate all deductibles associated with Medicare Part A & Part B
  • All plans have a Max-out-of-pocket
  • Some plans offer additional benefits not covered by Medicare like dental vision, hearing, preventive care and gym memberships

Cons

  • Copays for most medical services
  • Most plans use networks of doctors and hospitals
  • Coverage may be limited outside the networks unless ER or Urgent Care
  • Possible to spend more if you reach OOP Maximum

* There are special rules for ESRD. People with ESRD may be able to join a Medicare Special Needs Plan(SNP) if one is available in their area.

Example of the 2020 Medicare card