Medicare Basics

Medicare is a health insurance program administered by the federal government, providing health insurance coverage to people who are 65 years of age or older, under age 65 with certain disabilities and at any age with End-Stage Renal Disease (ESRD – permanent kidney failure requiring dialysis or a kidney transplant). Medicare is broken down into four main categories:

HOSPITAL INSURANCE (PART A)

One category of the Medicare program is called Part A. You usually do not pay a premium for Part A coverage if you or your spouse paid Medicare taxes while working. In most cases, you will automatically be signed up for Part A. If you are not eligible for premium-free Part A, you may be able to buy Part A if you meet certain requirements.

Part A is a type of hospital insurance plan provided by Medicare. Hospital Insurance coverage includes inpatient care in hospitals, skilled nursing facilities and critical access hospitals. Part A does not include long term or custodial care. If you meet specific requirements, you may also be eligible for hospice or home health care.

Medicare does not cover everything, nor does it cover the total cost for many of the covered services or medical supplies.

MEDICAL INSURANCE (PART B)

Part B coverage offers medically necessary doctor’s services, outpatient care and most other services that Part A does not cover. These may include physical or occupational therapies and some home health care services. Part B also covers some preventive services. Though many services and products are covered, keep in mind that Part B is still not a complete insurance coverage plan. Original Medicare (Part A and Part B) covers many health care services and supplies; however, there are many costs (“gaps”) it doesn’t cover.

Most people have to pay a premium for Part B. You can check to see if you qualify to receive help from your state to pay for premiums and deductibles. If you don’t qualify for this, then the premiums are usually deducted from your Social Security, Railroad Retirement or Civil Service Retirement check. There are other payment options for premiums such as quarterly bills or check draft.

MEDICARE ADVANTAGE PLANS (PART C)

Medicare Part C is a combination of your Part A and Part B options and must cover at least all of the services that Original Medicare covers (Part A and Part B). One difference is that private insurance companies that are approved by Medicare provide this type of coverage. Part C is often a lower out-of-pocket risk alternative to the Original Medicare Plan, and usually provides extra benefits such as vision, hearing, dental, and/or health and wellness programs and may include prescription drug coverage (Part D). Part C plans often have networks in which you must use the doctors or hospitals that are contracted with the plan. Costs for items and services vary by plan and by insurance company. Medicare Advantage plans have several plan types available.

MEDICARE PRESCRIPTION DRUG COVERAGE (PART D)

Part D is Medicare regulated and approved prescription drug coverage offered by private insurance companies. Except for certain situations, you should enroll in Part D when you first become eligible to avoid penalties. Part D was designed in part, to aid Medicare enrollees lower their prescription drug costs and to protect against future costs. It also provides access to medically necessary drugs via a Medicare-approved prescription drug plan.

Keep in mind that a plan’s premium (monthly cost of the plan), drug formulary (list of covered medications) and copay amounts will vary by plan and by insurance company. Medicare Part D plans all follow the same structure designed by Medicare: Annual Deductible, Initial Coverage (prescription copays), the Coverage Gap or “donut-hole” (projected to be closed by 2020), and Catastrophic Coverage.

Medicare Part D coverage can be obtained by purchasing a “stand-alone” drug plan or by purchasing a Medicare Advantage plan that includes Part D coverage as part of the plan.

MEDIGAP OR MEDICARE SUPPLEMENTS

A Medigap (also called “Medicare Supplement Insurance” and more recently “Modernized Supplement Insurance”) is private health insurance policy that is designed to supplement Original Medicare (Part A and Part B). This means that it helps pay some of the health care costs, or “gaps” that Original Medicare doesn’t cover (like copayments, coinsurance and deductibles). Every Medigap policy must follow federal and state laws designed to protect you. Medigap insurance companies can only offer you a “standardized” plan. Each standardized plan must offer the same basic benefits, no matter which insurance company provides it. Under the new Modernized plans, insurance companies may offer innovative benefits in addition to the required standardized benefits. These “innovative” benefits may include things like eyewear or hearing aid coverage. Make sure to find out what innovative benefits are included in the plans you are considering.

Our Licensed Agents

  • Sara Evans Office Manager & Licensed Insurance Specialist

    Sara is our Office Manager & Licensed Insurance Specialist for our Everett, WA office.  She graduated from Edmonds Community College and has spent over 15 years in administrative support and customer service before joining our VibrantUSA team of insurance specialists in 2013.    When she is not assisting her clients navigate the world of Medicare, she enjoys spending her time outdoors hiking and camping as well as watching her favorite sport, NASCAR.  Sara has called the Lake Stevens area home for the last 24 years where she raised her two wonderful children and now resides with her little dog whose name is Baby.

  • Renee Marr Vice President & Licensed Insurance Specialist

    Renee has spent more than 20 years in the fields of insurance, investments, health care reimbursement and tax law. She has been with VibrantUSA since its inception and has played an essential role in moving the company forward. She is the first recipient of the company’s Cornerstone Award in recognition of outstanding performance and achieving sales in excess of 2,000. Renee is a graduate of Western Washington University majoring in English. She enjoys reading, cooking, boating, good wine and spending time with her loved ones. Renee lives with her husband and son in Bellingham, WA.

  • Miranda Satterfield Licensed Insurance Specialist

    Miranda is a Licensed Insurance Specialist in our Vancouver, WA office.  Prior to joining the VibrantUSA family, Miranda spent a few years supporting working in customer service for a major car dealership in the greater Portland, OR area.  As a life long Clark County resident, Miranda enjoys all the beauty of the Pacific Northwest and all that comes with it.  In her free time she can be found hiking and camping throughout the mountains while likely taking photographs of her dog.

  • Marsha Neal Vice President & Licensed Insurance Specialist

    Marsha has more than 25 years of experience as a successful sales professional. Having been with VibrantUSA since 2005, she has been instrumental in the growth of the company. In addition to her sales role, Marsha manages VibrantUSA’s agent training program.  Prior to her sales career, she served in the US Armed Forces for eight years, specializing in Communications. She is very involved with her community and remains active in the Veterans of Foreign Wars, Bellingham Eagle’s FOE #31, and is on the Board of Directors for the WCUSBC Bowlers Association.  During her free time, Marsha loves to bowl and travel with her husband, and is involved in activities with her church.

  • Katie Morgan Licensed Insurance Specialist

    After a brief stay in the Upper Northwest Katie is excited to move her family to the Arlington area as she transfers to the Everett office. Her family is still growing. Currently her 3 boys plus her 2 nephews outnumber the adults in the household; Katie, her husband Will and her sister-in-law Patti. She owns property in Acme which will one day be her retirement location where she can rescue multiple cats and dogs. Katie is looking forward to new hiking locations to take her family on around the Northern Seattle area. She is excited to learn something new from her clients daily.

  • Kailie Roosma Licensed Insurance Specialist & Operations Manager

    Kailie attended the University of Washington and graduated from Western Washington University in 2007. In 2008, she began her career with VibrantUSA as a customer service representative and then worked her way up to be an agent as well as the Operations Manager of the Bellingham office. Kailie is very active in the community and served as Chairperson for the Alzheimer Society of Washington’s 2011 and 2012 Miles for Memories 5k Walk/Run. She is also a member of Elder Service Providers and sits on the Board of Directors. She lives in Glacier, WA with her husband, son and two dogs.

  • Juan Farias Licensed Insurance Specialist

    Juan joined VibrantUSA in 2011 and quickly fell in love with helping people understand the very confusing world of Medicare and interacting with his clients.  Prior to joining VibrantUSA, Juan attended Bellevue College.

    Outside of the office Juan loves to spend time with his wife, four children and two pet dogs (one very energetic boxer and a shihtzu).  Juan enjoys spending time in the community as a soccer coach but also enjoys traveling. Juan is currently resides in San Antonio with his family and works in our Bulverde office.  Juan has fallen in love with the warm and dry weather in Texas that remind him of his roots in Eastern Washington.

  • Hillary Thomsen Licensed Insurance Assistant

    Hillary joined our team as a Licensed Insurance Assistant in Spring 2015, bringing over a decade of administrative and client relations experience and a background in advertising and events coordinating.  Born and raised in Whatcom County, she is excited to settle back in Bellingham after spending a few years in southeastern Washington.  She is eager to use her gifts to serve clients at VibrantUSA.  Outside of the office, Hillary loves exploring local parks and trails, supporting local restaurants, music, and theater, and enjoying great wine with family and friends.

  • Darlene DeBoer Licensed Insurance Specialist

    Darlene is a Licensed Insurance Specialist in our Bellingham office with over 30 years of experience in the travel industry.  Outside of the office, Darlene enjoys sports, travel, being outdoors, and spending time with her family and grandchildren.  She resides in Lynden with her husband.

  • Daniel DelBosque Licensed Insurance Specialist

    Dan has spent more than 25 years in customer service and management roles including nearly 8 years in the Medicare field, 5 of those with Sterling Insurance in Bellingham, WA. Dan joined VibrantUSA in 2015 as a Licensed Insurance Specialist in our Vancouver office. During his downtime, Dan enjoys hiking and exploring the great outdoors as well as working with his hands on his Ford Falcon.

    Dan is a graduation from Western Washington University and a lifelong resident of the Pacific Northwest. Prior to moving to Camas, WA in 2014, Dan along with his wife and four kids resided in Birch Bay, WA.

Our Carriers

  • Aetna
  • GroupHealth
  • Humana
  • Mutual of Omaha
  • Premera Blue Cross
  • Regence BlueShield
  • Soundpath Health
  • United Healthcare (AARP)

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