Medicare Made Easy

Reaching Medicare age comes with a lot of questions, but getting answers shouldn’t be complicated. Whether you’re still working, retiring soon, or figuring out how your current coverage fits in, we’ll help you understand your options and avoid missing important deadlines. We can help compare plans, stay with your doctor, and get the benefits you deserve.

Who is Medicare for?

  • Persons 65 years of age or older

  • Persons with a State recognized disability

  • Persons with End Stage Renal Disease (ESRD)

2 categories make up Original Medicare:

  • Part A: Covering costs of hospital stays and in-patient care

  • Part B: Covering costs for doctors visits and out-patient care.

Medicare Supplements

Normally the costs of Original Medicare would cover 80% of all hospital and doctor visit care. This leaves 20% of costs as an out-of-pocket deductible with no maximum limit.

Medicare supplements, aka “Medigap Policy”, helps cover this 20% of costs that would otherwise be your responsibility to pay.

Medicare Supplements will not cover any Long Term Care, Private Nursing, Vision, Dental, Hearing, or Prescription Drugs.

Costs of doctor/hospital visit

What about Part C?

You qualify for Medicare Part C if you have worked in the US with a valid Social Security number for at least 10 years.

Part C will help with prescription drug coverage, hospital coverage, and add value benefits.

Depending on your plan you could receive benefits for vision, dental, gym memberships, etc,.

Part C vs Medicare Supplements

Between you and your agent it is vital to discuss the needs and requirements for your health and financial goals . The differences between both come down to need for prescription drug help, how often you visit the doctor, likelihood of hospitalization, and more.

When do you qualify and enroll for Medicare?

IEP - Initial Enrollment Period

The period 3 months before and 3 months after your 65th birthday.

AEP - Annual Enrollment Period

October 15 to December 7th, during this period if you are new to Medicare or have an existing plan you can “shop” plans for a policy that will best fit your needs.

In addition to the most standard enrollment periods there are Special Enrollment Periods (SEP) which allow coverage change that are year round periods that are triggered by:

  • Medicaid & Medicare Savings Plan Recipients

  • Loss of Medicaid

  • Chronic Conditions

  • Recent Move to Service Delivery Area

  • and more…

FAQ about Medicare

I am turning 65 this year. What should I do to prepare for Medicare?

For your appointment, make sure to have ready your Social Security number, basic personal info, and a list of any medications and physicians you see. Remember you can initially enroll 3 months before and 3 months after your 65th birthday. Outside of this window, you will need a special enrollment period.

Can I change my plan in the middle of the year?

Outisde of the Initial Enrollment Period and Open Enrollment Period you will need to qualify for a Special Enrollment Period like change of address, loss of credible coverage, or another election period.

Why do my friends/family get different benefits than me?

Each individuals policy can be affected by their income, age, and zip code amongst other considerations. Each plan has positives and negatives and these trade-offs are made for each person and will differ from needs to needs.

What medications are covered?

There are a wide variety of subscriptions and organizations that can help cover your gaps in coverage. When looking at your policy we can go into detail over anything that is going to be left out and find the resources that will help fill these gaps.

How do I know if my doctor is in-network? What if they are not?

Depending on your needs your agent might advise for a plan that isn’t taken by your doctor. Ultimately, the choice is yours. If you feel strongly about keeping your doctor we can find a plan taken by them. If you don’t have strong feelings sometimes switching plans is more beneficial cost-wise.

What about my OTC drug card?

Some Medicare Advantage and other health plans include an OTC (over-the-counter) drug card that can be used at retail phramacies. Not all plans have an OTC card so it’s important to fully understand your coverage with your agent.

Need a personal look at your health options?

We have agents ready to make sure you are getting the most out of your plan.

Or give us a call at 214-324-6969