Medicare

We represent all the Medicare prescription plans, most Medicare Advantage plans, and the best Medicare supplement plans available. We enroll our clients in the plans that are the most suitable for their health care needs and we will continue to do so, year after year. There is never a charge for our services.

Medicare Supplement companies we currently represent include

Medicare Advantage companies we currently represent include:

Medicare Prescription Drug plans we currently represent include:

What is Medicare?

Medicare is a federally funded insurance program for:

• Individuals 65 or older
• Certain younger people with disabilities
• Those with end-stage renal disease (ESRD) or ASL (also known as Lou Gehrig’s disease)

If you already are receiving Social Security benefits or railroad retirement checks when you become eligible for Medicare, you do not need to sign up separately. However, you can sign up even if you do not plan on retiring at 65. To sign up, contact Social Security around 3 months before you turn 65.

When Can I Enroll?

There are several different enrollment periods:

• Initial Enrollment Period: The 7-month window around your 65th birthday (3 months prior to, the month of, and the 3 months following your 65th birthday).
• Annual Enrollment Period: From October 15th- December 7th people with Medicare can make changes to their Medicare Coverage.
• Open Enrollment Period The time each year when those enrolled in a Medicare Advantage plan can make changes to their plan. This takes place from January 1st- March 31st.
• Special Enrollment Period For certain life changes, such as losing employer coverage or moving to a new service area which then allows you to enroll or make changes outside of the standard enrollment periods.

What Are the Parts of Medicare?

• Part A: Hospital Insurance - Covers impatient hospital stays, skilled nursing care, hospice, and some heath service costs.
• Part B: Medical Insurance - Covers medically necessary doctor visits, outpatient surgery, physical therapy, home care, and medical equipment.
• Part C: Medicare Advantage Plan - Combines Part A, Part B, and often Part D into one comprehensive plan offered by private insurers.
• Part D: Prescription Drug Plan - Adds prescription drug coverage to Original Medicare (Part A and Part B). Plans vary in price and drug coverage.
• Medigap: Medicare Supplement Plan - Helps to cover the “gaps” in Part A and Part B to help reduce out-of-pocket costs.

Original Medicare

Funded by the federal government and made up of Parts A and B. It provides the essential coverage for hospital and medical expenses. With Original Medicare, you can go to any hospital or provider that accepts Medicare. Most people will not pay a premium for Part A, but you may pay one for Part B. The premium for Part B is usually deducted from your Social Security check.

Part D (Prescription Drug Coverage)

This coverage is an optional plan that can be added on to Original Medicare to add prescription drug coverage. Plans vary in price, copays, and the drugs included on their prescription drug list.

Medicare Supplement Insurance (Medigap)

This coverage covers the “gaps” in Part A and Part B to help reduce out-of-pocket costs. These gaps can include things like copayments, coinsurance, and deductibles.

Medicare Advantage (Part C)

Medicare Advantage plans are an alternative to Original Medicare. They combine Part A, Part B, and usually Part D into one plan offered through private insurers. It has low or no premiums and a total out-of-pocket cap. These plans can include other benefits such as eyewear, hearing aids, wellness services, and online tools and resources that Original Medicare does not cover. With these plans you may be required to see in-network providers and you will likely be responsible for copayments and potentially other costs.

What If I Am Still Working?

If you are:

Covered on an employer plan with a company that has MORE than 20 employees

You have the option to remain on the Group Health Plan as Primary coverage

You do not have to sign up for Medicare

If you are:

Covered on an employer plan with a company that has FEWER than 20 employees

You may need to sign up for Medicare Part A and Part B

Medicare is Primary coverage for groups with less than 20 employees

If you are:

65 or older and enrolled in Cobra Coverage

It is recommended that you enroll in Medicare Part A and Part B

Medicare is Primary coverage

There are regulations around enrolling in Medicare that can result in a financial penalty. If you are working, you may or may not need to enroll in Part A and/or Part B. One of our agents can help you understand whether you need to enroll in Medicare. If you are working, we can compare your current plan to Medicare to determine which plan best fits your needs.