Medicare

It seems that every time you turn on the Television or Radio they are playing an urgent commercial about Medicare products.  With all the fast-talking announcers and dramatizing, it’s hard to know how much information is actually reliable.

Federally Required Disclaimer: We do not offer every plan available in your area. Currently we represent 13 organizations which offer 206 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.

Think about it.  Has anyone clearly explained all the different components of Medicare to you? 

Do you know if you need a:

• Medicare Supplement?

• Medicare Advantage Plan?

• Medicare Prescription Plan?

What are the differences?

Medicare coverage can be complex and the cost can vary widely from provider to provider.  Most people do not understand the difference between parts A, B, C and D.  There can also be a penalty if you don’t sign up for part B or D.  Choosing the right plan for you requires a careful assessment of your needs and up-to-date knowledge of regulations.

It is important to take the time to honestly and objectively evaluate your needs.   This upfront investment of time can save you hundreds and perhaps thousands in premiums per year.  

The experts at Creekstone Benefits can help.  Our goal is to provide coverage options that are aligned and appropriate for your specific needs.   We will gladly answer questions by phone. If you would like a Creekstone associate to perform a personal needs assessment, we frequently conduct these friendly sessions in the comfort of your own home. 

What is a Needs Assessment?

A needs assessment is a meeting in which we carefully and respectfully analyze your medical needs and financial abilities.  This information is then used to ensure that you only sign up for the services that you need. 

Your coverage needs can be impacted by factors such as:

• How often and far you travel.

• What are your current medical needs?

• Are you comfortable with a set network of medical providers or do you want the freedom to go to the doctor of your choice?

• What is your budget for premiums?

Medicare Costs

Part A (Hospital Insurance)
You usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes while working. This is sometimes called "premium-free Part A." Most people get premium-free Part A.  Click here for more detailed information on Part A costs.

Part B (Physician Insurance)

You pay a premium each month for Part B. If you get Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill. 

Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS). 

If you're in 1 of these 5 groups, here's what you'll pay:

In 2026 you pay $202.90 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-Approved Amount for these:

• Most doctor services (including most doctor services while you're a hospital inpatient)

• Outpatient therapy

• Ambulance Services

• Limited outpatient Prescription Drugs

• Durable Medical Equipment (DME)

If you're in a Medicare Advantage Plan or other Medicare plan, your plan may have different rules. But your plan must give you at least the same coverage as Original Medicare.  

Important Insulin Benefit!
If you use an insulin pump that's covered under Part B's durable medical equipment benefit, or you get your covered insulin through a Medicare Advantage Plan, your cost for a month's supply of Part B-covered insulin for your pump can't be more than $35. The Part B deductible won't apply. 

If you get a 3-month supply of Part B-covered insulin, your costs can't be more than $35 for each month's supply. This means you'll generally pay no more than $105 for a 3-month supply of covered insulin.

If you have Part B and Medicare Supplement Insurance (Medigap) that pays your Part B coinsurance, your Medigap plan should cover the $35 (or less) cost for insulin.

Part D (Prescription Drug Insurance)

You'll make these payments throughout the year in a Medicare drug plan: (The links below take you to Medicare.gov)

• Premium

• Yearly deductible

• Copayments or coinsurance

• Costs in the coverage gap

Your actual drug plan costs will vary depending on:

• The drugs you use

• The plan you choose

• Whether you go to a pharmacy in your plan's network

• Whether the drugs you use are on your plan's formulary

• Whether you get Extra Help

For more information, please click here to go to the Part D Medicare.gov page.

*Information above is from the Medicare.gov website 2022.

Creekstone Forms:

• Scope of Appointment

• Annual PDP Update

• Annual MAPD Update

Required Federal Medicare Disclaimer: We do not offer every plan available in your area. Currently, we represent 13 organizations which offer 206 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.