What you need to know about Memphis Medicare Plans

Living in Memphis, TN can be an incredible experience. With its dynamic culture, deep-rooted history, and a plethora of attractions, it's no surprise why so many people choose to call this amazing city home. From the classic blues music of Beale Street to the lively downtown area of Overton Square, there is something for everyone in Memphis.

Memphis is also full of thrilling attractions and activities, from outdoor recreation like kayaking or hiking at Shelby Farms Park to exploring the National Civil Rights Museum or shopping at one of the many malls throughout the area. It's not hard to understand why so many people find Memphis an attractive place to live.

Part A in Memphis

If you're looking for Medicare services in Memphis, TN, you'll want to know what Part A of Medicare covers. Part A of Medicare is one of the most critical parts of the program, as it covers various medical services and supplies, such as inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Additionally, it helps keep the cost of specific medical equipment and supplies down.

Most people on Medicare don't pay for Part A because either they or a spouse paid into it while working. But it's not free. You'll pay a deductible for the first 60 days of hospitalization and a copay for days 61-90. The copay for days 90-150 is called Lifetime Reserve Days (LRD), and just like the name implies, you can only use those days once.

In 2023, the deductible was $1600, and the daily copay was $400. The LRD was $800 per day. Medicare won't pay for hospitalization beyond that.

You're in luck if you need to use your Part A Hospitalization benefit! The city of Memphis is home to various hospitals, including major institutions such as Methodist Le Bonheur Healthcare and Regional One Health. These hospitals offer comprehensive medical services, including emergency care, surgery, rehabilitation, intensive care units, and outpatient and mental health services. Many of these hospitals also provide specialized care for particular conditions or diseases.

For Skilled Nursing Facility Care (SNF), Medicare covers the first 20 days, provided you have a qualifying hospital stay. You'll pay a daily copay for days 21-100; Medicare won't pay for SNF beyond 100 days.

In 2023 the daily copay was $200.

According to Medicare.gov, there are four inpatient SNF in Memphis. As of July 21, 2023 there weren't any star ratings on these facilities, but they are listed below:

Memphis Part B

Medicare Part B is a crucial program that helps cover medical costs for people 65 and older and certain younger individuals with disabilities. Understanding what Part B covers and how to access it in Memphis, TN is essential. Part B covers various services from doctors and other healthcare providers, such as outpatient care, home healthcare, durable medical equipment, and preventive services.

People with Part B generally pay a premium; in 2023, it was $164.90 per month. Some people paid more, and some paid less based on income.

Additionally, there is an annual deductible; in 2023, it was $226. Once you pay the deductible, you're responsible for 20% of the approved costs, and Medicare covers 80%.

Finding a medical group of doctors in Memphis, TN that provides Medicare services can seem daunting. Fortunately, several excellent healthcare providers offer comprehensive coverage under the Medicare program. You can find a Medicare-covered provider near you whether you need regular check-ups or specialized care for a specific condition. In this blog section, we'll look at some of Memphis's top medical groups and physicians that offer Medicare services.

First up is Methodist Le Bonheur Healthcare (MLH), which provides primary care and specialty services at multiple locations across the city. MLH offers an extensive network of experienced physicians certified to provide Medicare-sponsored services. You'll also find plenty of helpful educational resources on their website to help you better understand your options for choosing the right plan for your health needs.

Next is Baptist Memorial Health Care (BMHC), which offers comprehensive coverage for both traditional Medicare and its managed care programs. BMHC has board-certified physicians and specialists to provide quality medical care for all your needs. Additionally, they have dedicated staff members who can help guide you through the process of finding the best plan for your needs.

Finally, we have Regional One Health, the largest healthcare provider in the Memphis area. Regional One Health offers a wide range of services, from primary care to specialty care, and they accept Medicare and Medicaid. They also have a dedicated team of financial counselors who can help you understand your coverage options and ensure you get the most out of your benefits.

Part D in Memphis

For those living in Memphis, TN, it is important to understand Part D of Medicare. It is designed to help seniors with the costs of prescription drugs.

The program is run by private insurance companies approved by Medicare to offer their programs.

Part D covers most of the costs until the beneficiary meets their initial threshold limit (donut hole), which is determined by Medicare and changes each year. Once you reach the donut hole, you pay 25% of the cost of the medication until you reach catastrophic coverage.

It is crucial for those living in Memphis, TN to be aware of their Part D coverage options and to make sure they are taking advantage of them when needed. By understanding Part D (or working with a Medicare broker who does), Memphis residents can ensure they have access to prescription medications at the best possible rates. With this knowledge, seniors can feel confident about their healthcare decisions and know their Medicare coverage works for them.

Memphis Medicare Advantage

Medicare Advantage Plans (MA) are run by private insurance companies. MA plans offer the same benefits as Original Medicare (Part A and Part B) and often have additional benefits like prescription drug coverage, vision care, and dental care at no extra cost. Many plans also include extras like gym memberships, meal delivery services, and transportation to medical appointments.

Unlike original Medicare, MA plans have a Maximum Out of Pocket amount (MOOP). When you reach the MOOP, you will not have additional out-of-pocket expenses for covered services (medications are exempt) through the end of the calendar year.

To have an MA plan, you must keep (and pay for) Medicare Parts A and B. Additionally, you'll have to follow the insurance company's rules, which are often more restrictive than original Medicare.

Premiums, deductibles, copayments, and Maximum Out of Pocket amounts vary by plan, so you can find one that fits your budget and needs.

Medicare Supplement Plans in Memphis

Medicare Supplement Plans (Medigap) don't replace original Medicare. Instead, they supplement it. Because of this, you won't be subject to additional rules (like preauthorization) or networks. If a doctor accepts original Medicare, they must accept your plan. If Medicare covers it, the Medigap MUST pay their portion.

Supplement Plans are standardized, meaning that your coverage is the same regardless of what insurance company you select to provide the coverage of the same letter. Plan G coverage is the same irrespective of whether you choose Company 1 or Company 2 to provide it.

The most popular plan is Plan G, which covers 100% of approved services once you pay the Part B deductible. After that, you won't have to pay approved service copays or coinsurance amounts.

Plan N is a close second. You'll pay the Part B deductible, $20 to see the doctor, and $50 for Emergency Room Services. You'll also cover any Excess Doctor Fees.

What matters when buying a Medigap plan is the premium amount, how often and how much your rates go up, and how good customer support is. Your licensed Medicare insurance agent can help you select which company and which plan to go with.

Working with a Medicare Agent in Memphis, TN

Working with a Medicare agent in Memphis, TN can be a great way to maximize your Medicare coverage. They are knowledgeable about the ins and outs of Medicare and can provide helpful advice on maximizing your benefits.

Medicare agents are also excellent resources for understanding what plans are available in your area and what options best suit your needs.

They can help you compare plans from different providers to ensure you get the best value for your money.

Finally, working with a Medicare agent gives you peace of mind knowing that you're working with someone knowledgeable and experienced in the field of Medicare. This means fewer headaches as you navigate through the enrollment process and more time enjoying all that Memphis has to offer!