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Helping Seniors Make Better-Informed Medicare Decisions
Trying to pick a health insurance plan can be a chore for anyone. For many people, just mentioning the word "open enrollment" sends shivers down the spine. It seems like there's always a nagging feeling that you're wasting money, choosing a plan with poor in-network care, or both. One would think that health insurance gets easier as you approach retirement age, but the truth is that picking an initial Medicare coverage plan can be daunting.
Unfortunately, the confusing process of signing up for Medicare causes many seniors to forego healthcare coverage altogether. After all, Medicare enrollment can involve several federal agencies, including the Social Security Administration (or SSA) and the Centers for Medicare and Medicaid Services (or CMS).
At Senior Medicare Insurance Services, our passion is guiding seniors through the confusion of Medicare. That way, they can enjoy retirement with peace of mind knowing they are protected and ready for life after 65. We work with dozens of insurance companies, giving our clients the chance to choose a plan that best fits their lifestyle.
We choose to design our senior insurance plans with a focus on optimal benefits structure, lower costs, and personalized service. Some independent insurance agencies see their aging customers as nothing more than a financial transaction waiting to happen. In contrast, we treat each of our clients with respect and dignity as we help them navigate the confusing waters of Medicare. Combined with individualized service, we help older Americans make well-informed decisions about insurance. Whether you're in need of senior Medicare Supplement Plan insurance in Bluffton or simply have questions about signing up for Medicare, our team is here to help.
- Helping Seniors Make Better-Informed Medicare Decisions
- What is Medicare?
- The amount of money you pay for your health care depends on several factors, including
- Senior Medicare Supplement Plan Insurance in Bluffton
- Important Information About Senior Supplement Plan Insurance
- Senior Medicare Advantage Plan Insurance in Bluffton, SC
- How Medicare Advantage Plans Work
- Medicare Advantage Plan Insurance Rules
- Paying for Your Senior Medicare Advantage Plan Insurance
- The Senior Medicare Insurance Services Commitment
What is Medicare?
If you're approaching the golden years of your life, it's important you understand what Medicare is if you don't already.
Medicare is a federal health insurance program reserved for people older than 65 who have worked full-time for at least ten years. The Medicare program is paid for by a combination of worker payroll tax, premiums paid by Medicare enrollees, and the U.S. government.
There are four parts of Medicare:
This type of Medicare is free for most U.S. citizens. Medicare Part A helps older adults pay for care in a nursing facility, hospital visits, and some forms of in-home senior care.
This tier costs around $100 per month. It covers different outpatient services like lab tests, preventative care, doctor's visits, mental health care, clinical trials, and some forms of surgery.
This type of Medicare is most often called Medicare Advantage. This tier of Medicare allows seniors to choose health plans provided by insurance companies like Senior Medicare Insurance Services. Individuals who use Medicare Advantage commonly use Medicare supplement plan insurance to help pay for health care costs that Original Medicare won't cover, like coinsurance, deductibles, and copayments.
Sometimes called "PDPs," these plans add drug coverage to standard Medicare, some Medicare Private Fee-for-Service Plans (PFFS), some Medicare Cost Plans, and Medicare Medical Savings Account Plans (MSA).
The amount of money you pay for your health care depends on several factors, including:
- What kind of care you need, and how often it is needed.
- The type of Medicare coverage you choose.
- Whether there are alternative insurance policies that will help fill gaps in your coverage
- Whether a doctor agrees to charge you the same amount that Medicare will cover for a medical service
At Senior Medicare Insurance Services, we offer a number of health insurance solutions for seniors. Two of our most used services include Medicare Advantage plan insurance and Medicare supplement plan insurance.
Senior Medicare Supplement Plan Insurance in Bluffton
Sometimes called Medigap, the purpose of Medicare Supplement Insurance is to help fill in "gaps" that might not be covered by Original Medicare. You can think of a Medigap policy as a supplement for your Original Medicare benefits.
Private companies like Senior Medicare Insurance Services sell this type of insurance right here in South Carolina. While Original Medicare will pay for much of the cost associated with health care services you need, it may not cover all of your expenses. Generally, Medigap policies do not cover costs stemming from eyeglasses, private-duty nurses, dental care, hearing aids, or long-term care.
Depending on the Medicare Supplement Plan that you choose, it may cover out-of-the-country medical services when you travel abroad. Assuming you have Original Medicare coverage, your policy will cover its share of Medicare-approved health care costs. Once your Original Medicare coverage reaches its limit, your Medigap policy will pay its share of the fees.
Our Medigap policies are drafted to meet your specific needs, and can help cover remaining health care costs such as:
Deductibles
Copayments
Coinsurance
Important Information About Senior Supplement Plan Insurance
To dispel some confusion, you should know that a Medigap policy is not the same as a Medicare Advantage Plan. The latter helps you receive Medicare benefits, while the former supplements the benefits you obtain through your Original Medicare plan. As you begin to explore Medicare Supplement Insurance Plans, keep the following important information in mind:
As you begin to explore Medicare Supplement Insurance Plans, keep the following important information in mind:
- To qualify for a Medigap policy, you must first have Medicare Part A and Medicare Part B.
- Payments on your Medicare Supplement Insurance Plan will be made to the private insurance company that you choose, like Senior Medicare Insurance Services. These payments are made every month and are paid in addition to the monthly payment you make for Medicare Part B.
- If you are the holder of a Medicare Advantage Plan, it is illegal for an insurance company to sell you a senior Medicare Supplement Policy. If you plan on switching back to an Original Medicare plan, you may be able to purchase a Medigap policy.
- If you have health problems as you age, your standardized Medigap policy is guaranteed to be renewable. So long as you pay your monthly premium, your insurance provider cannot cancel your policy.
- Medigap policies only cover one person. If you have a spouse or family member that would like coverage, they must purchase a separate policy.
- You may only buy a Senior Medicare Supplement Plan from an insurance agent that is licensed to sell them in your state. Senior Medicare Insurance Services has been licensed to sell Medigap policies in South Carolina for years. We have helped countless seniors get the Medicare coverage they need and continue to do so to this day.
- In the past, Medigap policies were able to cover costs related to prescription drugs. As of January 1st, 2006, prescription drug coverage is not available on Medicare Supplement Plans. The best way to get coverage for your prescription drugs is to join a Medicare Prescription Drug Plan, often called Part D. Contact our office today to learn more about paying premiums on Medigap and Medicare plans.
For many people, the best time to buy senior Medicare Supplement Plan Insurance in Bluffton is during the 7 months Medigap Open Enrollment Period. This period starts the day you turn 65 years old, so long as you hold Medical Insurance (Medicare Part B). Generally, during the enrollment period, you get more policy choices and better pricing. Once the enrollment period is over, you may not be able to purchase a Medigap policy. Contact Senior Medicare Insurance Services today to determine if you qualify for a Medicare Supplement Insurance Plan.
Senior Medicare Advantage Plan Insurance in Bluffton, SC
A Medicare Advantage Plan is a kind of Medicare health coverage designed to provide seniors with all their Part A and Part B Medicare benefits. Many Medicare Advantage Plans will often include coverage of the following:
- Preferred Provider Organizations
- Special Needs Plans
- Private Fee-for-Service
- Medicare Medical Savings Account Plans
- Health Maintenance Organizations
In addition, most Medicare Advantage Plans give seniors coverage for their prescription drug needs. When you enroll in a Medicare Advantage Plan through Senior Medicare Insurance Services, your Medicare benefits are covered through your plan and will not be paid for by traditional Medicare.
How Medicare Advantage Plans Work
Sometimes called "MA Plans" or "Part C," Medicare Advantage Plans are considered an "all in one" solution to Original Medicare. Senior Medicare Advantage Plans are only offered by private companies that are approved, like Senior Medicare Insurance Services. Seniors who enroll in a Medicare Advantage Plan are still on Medicare. However, these individuals enjoy bundled plans that give seniors the benefits of hospital insurance (Medicare Part A), medical insurance (Medicare Part B), and sometimes drug coverage (Part D).
Medicare Advantage Plans are very popular because they cover all Medicare services and make life a little easier for seniors who have trouble understanding the nuances of Medicare.
When you contact Senior Medicare Insurance Services to choose your Medicare Advantage Plan, ask your agent about Medicare prescription drug coverage. Unless you already have drug coverage (Part D), you should seriously consider Part D coverage to help reduce costs associated with prescription drugs. You may also want to consider a Medicare Supplement Insurance Plan to help fill gaps in coverage that Original Medicare will not cover.
Medicare Advantage Plan Insurance Rules
Medicare works by paying a set amount of money to the companies that offer senior Medicare Advantage Plan insurance in Bluffton. That money is used to pay for the care services that you need. Because Medicare Advantage Plans are different, you should expect out-of-pocket costs to vary depending on the plan you choose.
Different plans have different rules for how you receive services, such as:
If you must go to facilities, suppliers, or doctors that belong to your Advantage Plan for non-urgent and non-emergency care.-
Whether you must get a referral to see a specialized doctor
Companies that offer Medicare Advantage Plans must follow strict rules, which are set by Medicare and can change every year.
Paying for Your Senior Medicare Advantage Plan Insurance
How much you pay for your Medicare Advantage Plan varies and depends on a few different factors. In most cases, if you need a kind of medical service, you will need to rely on the doctors and providers in your plan's service area and network to pay the lowest amounts. In some cases, if you choose to use a service outside of your plan's network of coverage, you may have to pay out-of-pocket.
We encourage you to contact our office today to learn more about Medicare Advantage Plans, how they work, what your options are, and how often you will have to pay out-of-pocket, if at all.
The Senior Medicare Insurance Services Commitment
Since our company was founded, we have led the insurance industry by providing our clients with the most valuable, helpful insurance solutions available. We are fully committed to our current and prospective clients by:
Choosing to focus on personalized, one-on-one service. When you work with our team, know that we will always design your health insurance plan with your best interests in mind.-
Listening to your specific needs. -
Responding to all inquiries and questions promptly and with a friendly attitude. -
Providing you with the best customer service in the senior health insurance industry, whether you have questions or are ready to move forward with a Medicare plan.
Our mission is to help give seniors the best Medicare assistance available so that they may understand the Medicare process and make an informed health coverage decision. We have the knowledge, skills, and experience to assist anyone interested in Medicare. Our personal goal is to become a lifetime resource for our clients and give them greater confidence in choosing their insurance plans.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 82 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Latest News in Bluffton, SC
Beaufort Memorial scrapped its hospital plans for Bluffton. Novant now will build $250M medical center.
Mitchell Blackhttps://www.postandcourier.com/beaufort-county/novant-health-hospital-announcement-bluffton/article_04362312-8033-11ef-8aba-d3065222657a.html
BLUFFTON — A local state senator called it "gamesmanship."The chief executive of a competing hospital said the developments were "very frustrating."Two weeks after a Lowcountry provider dropped plans to build a new hospital due to a lawsuit, one of the opponents proposed its own plans to create a new site nearby.On Sept. 10, Beaufort Memorial Hospital ...
BLUFFTON — A local state senator called it "gamesmanship."
The chief executive of a competing hospital said the developments were "very frustrating."
Two weeks after a Lowcountry provider dropped plans to build a new hospital due to a lawsuit, one of the opponents proposed its own plans to create a new site nearby.
On Sept. 10, Beaufort Memorial Hospital withdrew its application to open a 20-bed hospital, succumbing to a lawsuit backed by North Carolina-based giant Novant Health.
More than two weeks later, Novant unveiled plans to open a 50-bed site in Bluffton. In a Sept. 26 news release, the nonprofit said it plans to expand the hospital to 100 beds in the future.
The twin announcements continue the saga to expand health care access in Bluffton that has dragged on more than six years, intersected with a major legislative change and legal challenges. Novant now must navigate South Carolina's certification process, which could take years if there's legal opposition.
Asked whether Beaufort Memorial would challenge Novant's application to open the hospital, Chief Executive Officer Russell Baxley said the community medical provider is "looking at all of our options on the table at this point in time."
Beaufort Memorial initially announced plans to open a Bluffton hospital in 2018. The state health department approved its application to open the operation in July 2018, awarding a Certificate of Need for the $45 million project. While these certificates were designed to keep medical expenses down and control health services, the appeals process could also delay providers from opening new facilities.
That proved true for Beaufort Memorial. The community hospital's certificate was challenged in court by Tenet Health, which owned facilities in Hilton Head and Hardeeville, and Candler Hospital in Savannah. Each of these entities raised questions about the project's financial feasibility and the need for a new hospital in the region. The case that began in October 2018 endured a stay that approached three years, while a related case was pended in a higher court.
A change to state law altered the complexion of the litigation. Gov. Henry McMaster signed a bill in May 2023 that would sunset the hospital certification requirement by 2027.
State Sen. Tom Davis, R-Beaufort, helped sponsor the bill. He said in a message that he wished there was no sunset, and that the repeal was immediate, but added that passing major legislation is difficult.
Citing the legislation, Candler dropped its legal challenge in September 2023. The S.C. hospitals continued to pursue the case through a December trial. Novant purchased the facilities in February.
Baxley said Beaufort Memorial met with Novant shortly after the nonprofit's acquisition to see if the organization would relinquish its legal challenge, which Novant declined.
Novant S.C. Regional President Jason Bernd said in an interview that the organization did not want to make any major strategic decisions while it assessed what the community needed. Dropping the lawsuit would qualify as a major strategic change.
Seeing that the litigation could continue well into the future, preventing Beaufort Memorial from achieving its January 2025 timeline for ground breaking, the community hospital opted to withdraw its certificate. Instead Beaufort Memorial intends to build a medical office building, freestanding emergency department, and ambulatory surgery center in its place.
"We felt forced to drop our CON in order to continue to avoid significant delays to build a hospital in the Bluffton area ... so we could move forward with a facility to meet the needs of the community" Baxley said. After dropping the CON, "(Novant) announced that they're going to build a hospital to meet the needs of the community. And I just find it very frustrating to say the least."
Davis called Novant's efforts "gamesmanship" and said the dispute between the two facilities showed why the state needed to repeal its CON requirement.
"There should not be artificial impediments to the flow of private capital into the development of new health care facilities," he said.
Bernd said the timing of the announcement about building the new hospital was not affected by the lawsuit. He said the plans were in the works for around the past half year.
Novant will need to submit a CON application to the state's health department, which Bernd said the organization plans to file imminently. According to state regulations, the department will make a decision on the effort between one and four months after the agency deems the application is complete, a process that can also take several months. Facilities and individuals affected by the nonprofit's plans can appeal an approval, potentially further delaying a groundbreaking.
Bernd said that construction for a hospital this size typically costs between $250-$300 million. Funds will come from Novant's organization, he said. The nonprofit also plans to open additional facilities, including its own ambulatory surgery and freestanding emergency department.
Baxley, of Beaufort Memorial, said it has been trying to fulfill the community needs all along.
"There's a need for beds there," Baxley said. "Somebody else decided that it wasn't going to be Beaufort Memorial beds."
Poke, pasta and porterhouse are coming to western Bluffton’s New Riverside Village
Chloe Applebyhttps://www.islandpacket.com/news/business/real-estate-news/article293012974.html
At the southeast corner of New Riverside Road and S.C. 46, “coming soon” signs are popping up throughout the New Riverside Village, a 35-acre development of homes, shops restaurants and a park. In February 2020, Bluffton Town Council approved the initial master plan for the development, and now, the majority of storefronts have been secured by tenants.The town-owned village pond, surrounded by a paved walking path, s...
At the southeast corner of New Riverside Road and S.C. 46, “coming soon” signs are popping up throughout the New Riverside Village, a 35-acre development of homes, shops restaurants and a park. In February 2020, Bluffton Town Council approved the initial master plan for the development, and now, the majority of storefronts have been secured by tenants.
The town-owned village pond, surrounded by a paved walking path, separates two sides of retail and restaurant development. On one side, Compass Commons at New Riverside, a development of The Richardson Group, a real estate development and management firm, will expand across four buildings and 16,000 square feet. The seven tenants, five of which have confirmed leases, are each businesses that have already established roots in the Lowcountry.
Lee Lucier, Chief Operating Officer of The Richardson Group, said that their goal was to help local businesses that “were part of the thread of the community already” to continue building their portfolio:
According to Lucier, two additional tenants will join the confirmed five, but logistics are still being worked out. There is also one additional space available for lease that has yet to be filled, Lucier said.
Lucier predicted that the majority of the shops would open up after the new year in January. The Frosty Frog and Local Pie will come on board by March.
AVTEX Commercial Properties, led by Tex Small, is developing on the opposite side of the pond.
So far, according to Small, these tenants include:
The Bluffs Spa is set to open by next week. Depending on permitting from the town, they are aiming for all of the stores and restaurants to be open by the first quarter of 2025, Small said.
Despite “coming soon” signage, Olive & Fig will not be opening up its second location in the New Riverside Village community according to Small. There has been great interest in the storefront from other potential tenants, but no official letter of intent has been signed, he said.
This story was originally published September 26, 2024, 9:05 AM.
The Island Packet
Chloe Appleby is a general assignment reporter for The Island Packet and The Beaufort Gazette. A North Carolina native, she has spent time reporting on higher education in the Southeast. She has a bachelor’s degree in English from Davidson College and a master’s degree in journalism from Columbia University.
‘Likely’ tornado touchdown in Bluffton ahead of Hurricane Helene making FL landfall
Sarah Haselhorsthttps://www.islandpacket.com/news/weather-news/article293074274.html
READ MOREExpected to reach Florida’s Big Bend region late Thursday, the predicted incoming impacts for Hurricane Helene triggered a tropical storm watch for the Lowcountry.Expand AllSeveral hours before Hurricane Helene was expected to hit Florida’s Big Bend region, radar indicated that it was “likely” a brief tornado touched down in Beaufort County.National Weather Service Meteorologist Emily McGraw said the service had seen some damage like snapped trees and debris early Thursday morn...
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Expected to reach Florida’s Big Bend region late Thursday, the predicted incoming impacts for Hurricane Helene triggered a tropical storm watch for the Lowcountry.
Expand All
Several hours before Hurricane Helene was expected to hit Florida’s Big Bend region, radar indicated that it was “likely” a brief tornado touched down in Beaufort County.
National Weather Service Meteorologist Emily McGraw said the service had seen some damage like snapped trees and debris early Thursday morning. However, whether a tornado caused the damage is not confirmed, McGraw said. The NWS issued a tornado warning at 7 a.m. Thursday and it was lifted at 7:45 p.m.
At about 7:03 a.m., tree damage was seen on Daufuskie Island, McGraw said, and at 7:15 a.m., trees were snapped and minor debris shown around Palmetto Bluff in Bluffton.
The NWS will confirm possible twisters and make an official statement at a later date, McGraw said. Any damage can be reported to the National Weather Service at inws.ncep.noaa.gov/report/.
A tornado watch was issued for Beaufort County at about 8:35 a.m. It’s set to expire at 9 p.m.
The area has the potential to get “many tornadoes.” The highest level of tornado activity is expected Thursday evening and overnight.
Frank Strait, the state’s severe weather liaison, said a tornado outbreak at night is “never a good thing,” as people are usually sleeping and miss warnings.
“It’s important to have tornado preparations in place ahead of Helene,” Strait said. “Decide on your best shelter area in advance, as you might not get much lead time. Tropical tornadoes often hit fast without much lead time on warnings.”
There are no tornado sirens in Beaufort County, so it’s vital to ensure residents and visitors have a system to get alerts — a reliable phone app, television, radio or access to an online newspaper.
CodeRED: Download the free CodeRED Mobile Alert app from the Google Play or iTunes store.
Everbridge: Download the free Everbridge app from the Google Play or iTunes store.
Other options: NOAA weather radio, news media coverage, Emergency Alert System on radio and TV broadcasts.
This story was originally published September 26, 2024, 11:17 AM.
The Island Packet
Sarah Haselhorst, a St. Louis native, writes about climate issues along South Carolina’s coast. Her work is produced with financial support from Journalism Funding Partners. Previously, Sarah spent time reporting in Jackson, Mississippi; Cincinnati, Ohio; and mid-Missouri.
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