Medicare and General – Simplete Local


Champaign, Ill. (WCIA)

Medicare and General – Simplete Local

When it comes to Medicare choices, failing to plan may be planning to fail. The choices can seem dizzying and the terminology confusing, but taking the “I’ll think about it tomorrow” approach can spell trouble.
Here to help us avoid costly mistakes and side-step pitfalls is Jonathan Davis, community liaison with Simplete.

Q: The first and arguably most important decision to be made is whether to obtain coverage from Original Medicare or through a Medicare Advantage Plan. What are some of the key differences?
Original Medicare:
• Includes Part A (hospital coverage) and Part B (physician and outpatient services). Coverage for Part D (prescription drugs) is purchased separately
• Most participants receive Part A coverage for free and pay the standard Part B premium amount determined by Social Security for Part B coverage
• Participants do not get coverage for things like routine dental, vision or hearing services
• No yearly cap on out-of-pocket expenses
Medicare Advantage:
• A comprehensive plan that bundles Part A, Part B and often Part D coverage
• Monthly premiums with some plans starting at $0/month and participants pay the standard Part B premium amount as determined by Social Security
• Often includes additional coverage for routine vision, dental and hearing services plus extra wellness and care coordination benefits and may also include coverage for some fitness activities and over-the-counter drugs
• Yearly limit on out-of-pocket costs for medical services

Q: Why choose a Simplete plan?
• Simpler, more complete healthcare experience
• Providers you know and trust
• Less expensive each month and when you use services
• Streamlined relationship with leading providers
• Partners even more invested in good outcomes

Q: What is coming for 2022?
• Expanded coverage for dental care
• Expanded vision coverage benefit, increasing the yearly allowance for optical frames, lenses, or contacts
• Expanded prescription coverage for Tier 1 prescriptions
• Expanded BeFit benefit, which includes a wider variety of fitness activities for those with active lifestyles
• Over-the-counter drug discount program
• New 24-hour a day/7 days per week pet health hotline
• Continued focus on keeping members healthy, not just supporting them when they are sick

Q: How do people get more information or sign-up during Medicare Open Enrollment: October 15 — December 7?
• Call a Simplete representative at 1-877-634-3390
• Go to

Q: What if someone is overwhelmed about even getting started? What additional support does Simplete provide?
• Whether people are personally shopping for a plan or assisting a family member with the Medicare decisions, we are a phone call away and will help answer questions

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