Did you know that many people don’t have a clear understanding of how Medicare works? At Health Plans of America, we believe that having accurate information is the first step toward choosing the right coverage. Let’s clear up some of the most common myths about Medicare.

Myth #1: Medicare Part B Is Free

A common misconception is that Medicare Part B comes at no cost. In reality, Part B requires a monthly premium and also includes a deductible, copayments, and coinsurance just like other parts of Medicare.

Myth #2: You Can Enroll in Medicare Anytime

Medicare enrollment is limited to specific time periods. While there are certain qualifying situations that allow for Special Enrollment Periods, most people must enroll during designated enrollment windows. Open Enrollment is a great time to review your options and sign up if you’re eligible.

Myth #3: Medicare Costs the Same for Everyone

Medicare costs can vary from person to person. Premiums, out-of-pocket expenses, and coverage differ depending on the Medicare plan you choose and the healthcare services you use.

Myth #4: Medicare Covers Everything

Unfortunately, Medicare does not cover all healthcare needs. Medicare Part A primarily covers hospital stays and inpatient care, while Part B covers doctor visits and outpatient services. Prescription drugs, dental, vision, hearing care, and fitness programs are typically not covered under Original Medicare.

Myth #5: Medicare and Medicaid Are the Same

While both are government-sponsored programs, Medicare and Medicaid serve different populations. Medicare is primarily for individuals age 65 and older or those with certain disabilities, while Medicaid assists people with limited income and resources. Medicare is federally administered, whereas Medicaid programs are run by individual states. Some individuals qualify for both programs, and this is known as being dual eligible.

Ready to Learn More?

Choosing the right Medicare plan doesn’t have to be confusing. Now is the perfect time to connect with an insurance professional at Health Plans of America. We make it easy by connecting you with a licensed insurance agent who can help you find the plan that best fits your needs. Contact us today to get started!

Many Americans worry about how they’ll cover the cost of medical care, and for good reason. Healthcare expenses can add up quickly without the right coverage. At Health Plans of America, our goal is to help you find a health insurance plan that fits both your needs and your budget. The good news? A few smart choices can make a big difference. Here are five practical tips to help you save on health insurance and healthcare costs.

1. Choose the Plan That Truly Fits Your Needs

It’s tempting to judge a health insurance plan by its monthly premium alone, but the lowest price isn’t always the best value. Your family’s healthcare needs should guide your decision. Be sure to consider deductibles, copays, coinsurance, and out-of-pocket maximums to understand the true cost of a plan before enrolling.

2. Take Advantage of a Health Savings Account (HSA)

If you qualify, opening a Health Savings Account can be a powerful way to save. HSAs allow you to set aside pre-tax dollars specifically for healthcare expenses, helping lower your taxable income while preparing for medical costs now and in the future.

3. Learn the Basics of Health Insurance

Understanding common insurance terms can save you money in the long run. Concepts like copays, coinsurance, deductibles, and out-of-pocket limits directly affect what you pay for care. The more you know, the more confidently you can choose and use your coverage.

4. Save on Prescription Medications

If you take prescription medications regularly, ask about generic alternatives. Generic drugs often provide the same benefits as brand-name medications at a much lower cost. Your insurance provider or pharmacist can help you identify cost-saving options.

5. Compare Your Care Options

Depending on your insurance plan, you may have flexibility in where you receive care. For non-emergencies, visiting an urgent care center or local clinic is often far less expensive than a trip to the emergency room. Knowing your options ahead of time can help you avoid unnecessary costs.

The more you understand your healthcare savings options, the better prepared you’ll be to manage your medical expenses. Connect with a licensed health professional at Health Plans of America today and discover how you can save while getting the coverage you deserve.

Ever wonder which Medicare plan is the right fit for you? Choosing coverage can feel overwhelming, especially with all the options and terminology involved. At Health Plans of America, we’ve broken the process down into four key tips to help you feel confident as you compare plans and make the choice that works best for your health and your wallet.

Tip 1: Don’t Focus Only on the Premium

It’s common for people to zero in on a plan’s monthly premium, but that number only tells part of the story. A plan with a low premium may come with higher out-of-pocket costs throughout the year, while a slightly higher premium might offer lower copays, deductibles, or coinsurance.

When comparing plans, be sure to look at the total cost of care, including:

• Monthly premium
• Annual deductible
• Doctor and specialist copays
• Hospital coinsurance
• Prescription costs

Evaluating the big picture can save you money in the long run and help you avoid surprises once you begin using your coverage.

Tip 2: Review the Drug Formulary Carefully

Prescription drug coverage can differ dramatically from one plan to another. Each Medicare plan maintains its own formulary, or a list of the medications it covers. These lists aren’t permanent; they can change every year, sometimes even mid-year.

Before enrolling, take a moment to:

• Confirm that your prescriptions are included
• Check which tier your drugs fall under (tiers affect cost)
• Look for any restrictions like prior authorization or step therapy

A little research upfront ensures that you won’t pay more than expected for the medications you rely on.

Tip 3: Consider Which Benefits Matter Most to You

Original Medicare (Parts A and B) provides essential coverage for hospital and medical services, but it doesn’t include benefits like:

• Prescription drug coverage
• Dental
• Vision
• Hearing
• Wellness extras like gym memberships

If those services are important to you, you may want to explore Medicare Advantage plans or stand-alone Part D and supplemental options. Choosing a plan that aligns with your personal health needs and lifestyle can make a big difference in both cost and convenience.

Tip 4: Take Your Time—There’s a Lot to Consider

There’s no one-size-fits-all Medicare plan. Your health needs, budget, prescriptions, and preferred doctors all play a part in determining the right option.

Take the time to:

• Compare plans side by side
• Make a list of “must-have” benefits
• Think about any upcoming medical needs
• Ask questions if something isn’t clear

A thoughtful approach will help you feel confident that you’re selecting the plan that fits you best—not just for today, but for the year ahead.

Tip 4: Take Your Time — There’s a Lot to Consider

There’s no one-size-fits-all Medicare plan. Your health needs, budget, prescriptions, and preferred doctors all play a part in determining the right option.

Take the time to:

• Compare plans side by side
• Make a list of “must-have” benefits
• Think about any upcoming medical needs
• Ask questions if something isn’t clear

A thoughtful approach will help you feel confident that you’re selecting the plan that fits you best, not just for today, but for the year ahead.

Let Health Plans of America Help You Choose With Confidence

You don’t have to sort through Medicare on your own. Health Plans of America makes the process simple by connecting you with a licensed insurance agent who can walk you through your options, answer your questions, and help you enroll in a plan that truly meets your needs.

Reach out today and get the Medicare coverage you deserve designed for your health, your budget, and your peace of mind.

HMOs, PPOs, EPOs… oh my! With so many types of health insurance plans out there, it’s easy to feel overwhelmed. Understanding what each plan offers, and the potential drawbacks, can help you make a confident, informed decision about your health coverage.

With open enrollment just around the corner, now’s the perfect time to review your options. To make things easier, we’ve broken down the most common plan types with a quick list of pros and cons.

HMO (Health Maintenance Organization)

Pros:

• Lower out-of-pocket costs when you stay in-network
• Simplified care coordination through your primary care physician (PCP)

Cons:

• You’ll need a referral from your PCP to see most specialists
• Coverage is limited to in-network providers

PPO (Preferred Provider Organization)

Pros:

• Flexibility to see specialists without a referral
• Out-of-network coverage available (though at a higher cost)

Cons:

• Generally higher premiums and out-of-pocket costs

POS (Point of Service)

Pros:

• Option to see out-of-network providers
• Lower costs when you stay in-network

Cons:

• Often requires a referral from your primary care physician to see a specialist

EPO (Exclusive Provider Organization)

Pros:

• No referrals needed to see specialists
• Lower premiums compared to PPO plans

Cons:

• No coverage outside your plan’s network (except in emergencies)

Finding the right health insurance plan can feel like a challenge, but you don’t have to navigate it alone. Health Plans of America connects you with licensed insurance professionals who can help you compare options, find savings, and get answers to all your health coverage questions.

Whether you’re exploring new plans, renewing your coverage, or just looking for expert advice, Health Plans of America is here to help you make the right choice.