Medicare Help

Medicare

Montefu Consulting is now offering Medicare enrollment assistance! We are here to provide services custom-fit to your needs, whether you are turning 65, want to choose a new plan, or if you simply want to discuss the options that you have. Medicare is a wonderful benefit to seniors and others who qualify, but it can be confusing to understand. That is why Montefu Consulting is ready to guide you through each and every step of the way.

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What is Medicare?

Medicare is a federally-administered health insurance program for those 65 and older. While every senior is required to enroll in Medicare, it is not a one-size-fits-all program. Medicare coverage is divided into different parts. We love to call it the "ABCs of Medicare". 

Original Medicare has two parts - Part A and Part B. 

Part A covers inpatient hospital care, skilled nursing facility services, hospice care, and home health care.

Part B covers doctor appointments, outpatient care, preventive services, occupational/physical therapies, and home health care.

Separate from Original Medicare, there are two other types that may better suit your needs - Part C and Part D

Part C also referred to as Medicare Advantage, is offered by private insurance companies approved by Medicare. These plans are an "all in one" alternative to Original Medicare and include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). It is common for these plans to include Part D coverage as well.

Part D Medicare is coverage offered by private insurance carriers that includes prescription drug costs. This can be purchased separately for those who have Original Medicare but can also be included as part of a Medicare Advantage Prescription Drug plan.

There are also Medicare Supplements that can be added with the help of an agent. These supplements help to offset any missing coverage from Original Medicare plans.

New to Medicare? Ready to enroll?

What is Medicaid?

Medicaid is a joint federal and state program that helps pay healthcare costs for certain individuals and families with limited income and resources. Coverage varies from state to state. However, it must abide by federal guidelines. Some of the benefits Medicaid programs have to include are:

Hospital or Nursing Facility Services

Services received in a federally-qualified health center, rural health clinic, or freestanding birth center (licensed or recognized by your state)

Doctor, Nurse Midwife, and certified pediatric and family Nurse Practitioner services

Dual Eligibility

Those who are eligible for both Medicare and Medicaid are called “dual eligibles" or Medicare-Medicaid enrollees. To be considered dually eligible, one must be enrolled in Medicare Part A (hospital insurance), and/or Medicare Part B (medical insurance). As an alternative to Original Medicare (Part A and Part B), one may opt for Medicare Part C (Medicare Advantage).

To be dual eligible, the beneficiary must also be enrolled in either full coverage Medicaid or one of Medicaid's Medicare Savings Programs (MSPs).

What are the benefits of dual eligibility? Those who are enrolled in both Medicaid and Medicare may receive greater healthcare coverage and have lower out-of-pocket costs. For Medicare covered expenses, such as medical services and hospitalization, Medicare is always the first payer (primary payer). If Medicare does not cover the full cost, Medicaid (the secondary payer) will cover the remaining cost, given they are Medicaid covered expenses.

Medicaid also covers some expenses that Medicare does not, such as personal care assistance in the home and community and long-term skilled nursing home care. (Medicare limits nursing home care to 100 days). The one exception, as mentioned above, is that some Medicare Advantage plans cover the cost of some long term care services and supports. Medicaid, via Medicare Savings Programs, helps to cover the costs of Medicare premiums, deductibles, and co-payments.

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Keep in Mind

Medicare and Medicaid are not always easy programs to fully understand. At Montefu Consulting, we have the knowledge and experience to help you understand your options and guide you through the enrollment process.

So if you have any questions, don't hesitate to reach out today!

Contact form or links to calls to action:

Calls to Action:

New to Medicare?

Need to Switch Your Plan?

Need Help Understanding Your Eligibility?

Think You May be Dually Eligible?

We work with most major insurance carriers. However, we do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.