FAQ

Unfortunately, you do not have a local agent.   If I help you sign up for your plan, then I will be your local professional agent.  When your questions arise and they will, having me as your local resource comes in handy.

Original Medicare consists of two parts and is offered by the federal government.  Part A is your Hospital Coverage.  Part B is your Medical Coverage.  Neither Part A nor Part B cover everything, nor do they include prescription drug coverage.  Probably most important, there is no maximum out of pocket for medical expenses.

If you worked all your life, the government provides you with hospitalization, Part A, with no premium.  However, there are deductible and copayments, so it’s not 100% of the cost.  In order to get routine medical coverage, you’ll need to buy Part B.  If you are receiving Social Security Benefits, they take the Part B premium out of your Social Security check.  If not collecting Social Security, you’ll send in your Part B premium payment.

There are 2 ways to get additional coverage.  One way is to purchase one or both of the following: a Medicare Supplement Plan and/or a Prescription Drug plan, both offered by private insurance companies.  A Medicare Supplement plan will help pay for some of the out-of-pocket cost that Original Medicare does not pay.  A Prescription Drug plan, also known as Part D, will help pay for your prescription drugs.   Both of these plans will have their own monthly premium.

The other way is to choose a Medicare Advantage Plan, also known as Part C.  Medicare Advantage plans are also offered by private insurance companies.    A Medicare Advantage plan combines Part A and Part B into one plan, usually includes Part D, and may also include some additional benefits beyond Original Medicare.  A Medicare Advantage plan may have a monthly premium or it may be a low as $0 premium per month.

There are certain times of the year you can enroll and disenroll into a Medicare plan.  Knowing these enrollment periods and how they affect you is important.

Your Initial Enrollment period which last 7 months: 3 months before your 65th birthday month, your birthday month and 3 months after.

The Annual Election Period runs Oct 15th to Dec 7th each year. 

The Medicare Advantage Open Enrollment Period runs Jan 1st to Mar 31st.

Special Enrollment Periods occur throughout the year for major life changes, such as moving from one state to another.  Contact me to see how you may qualify for a Special Enrollment Period. 

The General Election Period is available for people who don’t sign up for Medicare during an eligible enrollment period.  The General Election Period runs from January 1st to March 31st and becomes effective July 1st of that year.

Late Enrollment Penalty -Please note that if you enroll after your Initial Enrollment
Period or Special Enrollment Period, you may be subject to late enrollment penalties for
Part A, Part B and Part D.

Medicare is a federal government program and it is administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).

Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.  Call Social Security toll-free at 1-800-772-1213 to see if you qualify.

If you have Original Medicare and a Supplement Plan, you can see any doctor that accepts Medicare.

If you have a Medicare Advantage Plan, you’ll want to make sure your agent looks up your doctor in the insurance directory of the plan you are interested in.