FAQs

This is the type of question that our agents take the time to explain to our clients every day, especially those who are newly eligible for Medicare. We call it Medicare 101, and we’d be happy to do the same for you. In the meantime, the short answer is this:
 
Since Medicare covers 80% of a beneficiary’s medical costs, most people need help to cover the other 20%. They can choose either a Medicare Advantage plan OR a Medicare Supplement policy.
 
In addition to the usual medical benefits like doctor visits and hospital stays, Medicare Advantage Plans may also include coverage for Dental, Vision, Transportation, and other benefits that Medicare does not cover. These plans usually have copays but very low or no premiums.
 
On the other hand, Medicare Supplements, also known as Medigap, cover all or a portion of the 20% that Medicare does not cover. These policies have low or no copays but much higher premiums. At Grace Rose Health Consultants, we can help you decide which option is right for you.
 
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 your plan options.

Medicare and Medicaid are both government health care programs, but they are very different. Medicare is for people who are 65 or older, or who are younger but have a qualified disability. Medicaid is a state-governed program for people with limited income.
 
Some people are eligible for both Medicare and Medicaid. These people are considered “dual eligible” and are often qualified for special Medicare plans. At Grace Rose Health Consultants we have helped countless beneficiaries determine if they qualify for these plans that significantly lower their medical and prescription costs.

A copay is a set amount that you’ll pay for doctor visits or prescriptions. It’s always a set amount, so it’s easier to plan and budget for copays. On the other hand, a coinsurance is always a percentage. But percentage of what?
 
For Medicare Advantage plans, coinsurances are a percentage of the Medicare-approved amount for whichever service or procedure you’re receiving. For Marketplace plans, coinsurances are a percentage of whatever amount the provider charges for the service.
Let our agents help you find a plan that is right for your budget, as well as your specific health situation.