benistar medicare guide

Benistar’s Comprehensive Guide to Medicare

Understanding the Medicare program is key in effectively capitalizing on all your potential benefits!

Understanding the Medicare program is key in effectively capitalizing on all the benefits brought to you by Benistar. Benistar works closely with Medicare and comprehension of the program is incredibly integral. Benistar’s medical plans coordinate with Medicare to provide seamless coverage for retirees. Our retiree prescription drug plans are Employer Group Waiver Plans (EGWP), established for groups under Medicare Part D. Our partners contract with the Centers for Medicaid and Medicare Services (CMS) to serve as a Medicare Part D Plan Sponsor. The plan adheres to CMS regulations regarding Part D plans.

Specifically, Benistar works as an administrator for a Part D EGWP Plan Sponsor. Medicare Part D is a federal government program to finance, manage and administer the costs of prescription drugs and prescription drug insurance premiums for Medicare recipients.

There are many components of Medicare, far beyond Part D and its stipulations. Originating on July 30, 1965 President Lyndon B. Johnson made Medicare law by signing H.R. 6675 in Independence, Missouri. The program has burgeoned into a healthcare behemoth in the last 50 years. In fact, there is a whole alphabet to explain the plans, ranging from A to D.

Part A pertains to the cost of care at healthcare facilities, primarily inpatient settings. However, Part A sometimes includes coverage for home health services, hospice care and skilled nursing facilities.

Part B covers outpatient healthcare services, including: doctors’ visits, outpatient procedures and lab tests. It also covers extraneous services such as: durable medical equipment, wheelchairs and scooters, oxygen tanks and ambulance services. Lastly, Part B also covers some preventative measures, including: screening for heart conditions, diabetes and certain types of cancer.

Parts A and B are the only governmentally-funded portions of Medicare, but there are two more private types, Part C and D, respectively.

Also known as Medicare Advantage Plans, Part C Plans involve paying premiums to private insurers, who then provide coverage for charges that Parts A and B don’t subsidize in addition to providing the Part A and Part B benefits. There are a wealth of Part C plans, therefore, it’s of the utmost importance that you screen them carefully, to ensure you get all the products and services you want.

Part D Plans, the ones associated with Benistar’s offerings, are offered through private insurance companies and the coverage that different policies offer vary widely from insurer to insurer and from plan to plan. Similar to Plan C, it’s incredibly pertinent that you are discerning when it comes to the private insurer that provides you with Part D options, like Benistar does.

Benistar is relatively unique in our approach to Medicare and customer service in general. We offer flexible plan designs that often adjust or eliminate Medicare deductibles or co-pays, are available nationally without exclusive networks, and include broad formularies. We also offer a renowned Customer Service Center that can answer questions and solve issues related to the Medicare environment.