Are you prepared for this important milestone?
When people become eligible for Medicare, they may be bombarded with information about enrollment and/or the types of coverage that is available to them. Medicare recipients have a certain time-frame in which they must enroll in Medicare and select the right coverage to avoid excessive medical costs down the road, and sometimes severe fines and penalties. Missing a step in the process, or selecting the wrong coverage, can quickly drain your life’s savings. Use the info buttons to the right to learn more about Medicare coverage and the Medicare system, and to request a quote.
Medicare Open Enrollment
October 15th through December 7th
If you are already enrolled in a plan, you can change your Medicare Advantage or Part D Plan during this time.
Your Medicare Plan Options
We offer the following types of Medicare Coverage to replace or offset costs of Original Medicare Parts A & B (learn more below on the basics of Medicare).
Medicare Advantage Plans are offered by private carriers and replace your original Medicare Parts A and B, as they are rolled into one plan. You can select between an HMO or PPO, and most plans may cover more of your healthcare costs and have additional benefits, such as prescription drug coverage. Some may have dental or vision benefits. Premiums vary based on coverage, carrier and geographical location.
According Kaiser, note the average Medicare recipient has over 20 Medicare Advantage plans to choose from. Ultimately, The Best Plan is one from a Quality Carrier, Has No Or A Low Premium And Leaves You With The Least Or No Out Of Pocket Expenses.
Medicare Supplement Insurance policies complement your Original Medicare Parts A and B. They cover some, if not all, of the expenses that Part A and B do not cover, like co-pays, deductibles and other charges.
There are many different types of Medicare Supplement policies available, however they are regulated so the benefits for these various policies (known as Plan A through N), are all the same regardless of the carrier. However, premiums can vary greatly among carriers.
Ultimately, The Best Supplement Plan Is One That Is Purchased From A Quality Carrier, Has A Low Premium And Leaves You With The Least Or No Out Of Pocket Expenses.
Prescription drug coverage offered by private carriers contract with Medicare. Because premiums vary greatly, you should carefully weigh your prescription costs against all variables of these plans. Selecting the wrong plan can wind up costing you thousands. Some Medicare Advantage plans may offer prescription coverage as well.
Please note that you should sign up for Part D (even if you do not have prescriptions) when you first turn 65, as waiting may result in a costly monthly penalty added to your premium.
Medicare Basics, the Different Parts of Medicare
Medicare is the federal health insurance program for people who are 65 or older. Medicare has 4 parts (not to be confused with plans). Each part of Medicare helps pay for different health care costs. Some parts of Medicare are FREE, some require an additional premium.
Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Most people get Part A for free.
Medicare Part B resembles what you may think of as traditional health insurance and covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Most people will pay a standard Part B premium which varies depending on income.
C is Medicare Advantage, as mentioned above, and replaces Original Medicare Part A & B as an alternative option for Medicare coverage. Some people may pay an additional premium (in addition to their Part B premium) for Part C.
Medicare Part D, as mentioned above, is Prescription Drug coverage. Note that Part D is not offered under original Medicare A & B, you must enroll in a separate Part D plan to get these benefits. An additional premium is required for Part D.
Frequently Asked Questions
No, Medicare is not automatic unless you are receiving Social Security benefits.
Your initial enrollment period starts 3 months before your 65th birthday, and includes your birthday month, and ends 3 months after your 65th birthday.
You can apply online or call your local Social Security office. You’ll enroll, create your Medicare account, track your Medicare information such as bills, claims, health information and more, as well as print your Medicare card.
To enroll, you will be required to provide proof of your eligibility. Some acceptable documents are birth certificate, proof citizenship if not born in the US, W-2 or tax forms, and or military records.
Know your needs. Make a list of your healthcare costs and needs, including regular health maintenance visits, specialists you see, prescription drug costs and any procedures you know you will need.
Check your providers. Do your current healthcare providers accept Medicare? While most do, some doctors opt out of Medicare and are not required to follow Medicare rules, which could cost you.
Ask for help. We’ll do the hard work for you, helping you to add up all your costs (copays, premiums, etc.) so you can pick the best option. Our guidance is provided at no cost and no obligation!
When you are eligible for Medicare, signing up right away helps you to avoid premium surcharges, however, if you have “credible” coverage through an employer you may not have to.
Does your employer have less than 20 employees? If so, you still will need to enroll in Medicare Parts A & B which will serve as your primary insurance, with your employer coverage as secondary. If you fail to enroll, your employer plan may not pay your medical claims.
Are you on COBRA? If so, you will need to enroll in Medicare to avoid premium surcharges.
If you are not on COBRA, and your employer has more than 20 employees, in this instance, you can stay on your employer coverage. In order to avoid premium surcharges, you have an eight-month special enrollment period to sign up for Medicare when you leave your job, or if your employer stops offering coverage. It will start the month after you separate from your employer, or the month after your group health coverage ends – whichever happens sooner.
Both of these Medicare options are sold by private carriers. You do, however, have to be already enrolled in Original Medicare before you can buy or switch to these options.
Once enrolled, you must act during annual open enrollment if you need to switch to Medicare Advantage or change your existing Advantage plan.
For Medicare Supplements – note you have a once in a lifetime window that begins the month you become eligible for Medicare and allows you to enroll in any Medigap plan without answering health questions, meaning you won’t be denied coverage or pay higher premiums for health problems. After this window closes, if you wish to buy a Supplement plan, you can do so at any time of the year, but you’ll most likely have to go through medical underwriting.
Prescription drug coverage is Part D of Medicare and is offered by private carriers who contract with Medicare. Even if you do not take medications routinely, you should enroll in a plan as soon as you are eligible to avoid penalty surcharges. Because premiums vary greatly, you should carefully weigh your prescription costs against all variables of these plans. Selecting the wrong plan can wind up costing you thousands. Some Medicare Advantage plans may offer prescription coverage as well.
Typically, Medicare does not cover these costs unless they are related to services received in a hospital. Medicare does however cover some eye care services for diabetics, such as testing and treatment for diabetic retinopathy, or glaucoma. It also covers other eye disease, such as age-related macular degeneration (AMD).
They only way to have most of these types of services paid for by Medicare is through a Medicare Advantage plan.