DISCLOSURE:

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.

Why should I have a Medicare Insurance Broker?

Change is always easier when you are doing it with someone that has knowledge of the task at hand. As your broker gives I can be the place you go with questions, make any needed changes quickly, and have an advocate to assist with all your health care needs. I would be happy to make calls on your behalf when possible, answer all your questions, and help make the switch to Medicare simple.

How do I enrolled in Original Medicare (Parts A & B)?

There are two ways to be enrolled in Original Medicare (Parts A & B). The first is automatic enrollment and the other is enrolling on your own.

You will be automatically enrolled in Original Medicare (Parts A & B):

• if you're receiving Social Security or Railroad Retirement Benefits when you turn 65.

OR

• if you qualify for Medicare because of a disability or mental condition.

You must enroll yourself in Original Medicare (Parts A & B) if you are not receiving Social Security benefits when you become eligible. Here are the ways to enroll in Medicare:

1. Online application, Click HERE **See the "Enroll in Original Medicare (Parts A & B)" section above for quick instruction information.

2. Phone: (800) 772-1213 (TTY (800) 325-0778), Monday-Friday 7:00am-7:00pm.

3. In person at your local Social Security office.

What is Covered when I enroll in Original Medicare (Parts A & B)?

This is the coverage that is provided by the Federal Government to help with health care costs. Part A helps pay for hospital and inpatient expenses. Part B helps pay for regular doctors visits and outpatient care. The coverage is 80/20 with no out of pocket maximum. This means Medicare covers 80% and you would be responsible for the other 20% of the medical costs. Example: Hospital stay for a heart attack can cost approximately $200,000. Medicare would cover $160,000. With the no out of pocket maximum, you would be responsible for the other $40,000 unless you have additional Medicare coverage. I can help you find the right plan to give you the additional coverage you need.

What are my Medicare options for additional coverage?

After you enroll in Original Medicare (Parts A & B) you will want additional coverage to help with expenses that are not covered in your Original Medicare. Original Medicare typically does not cover: routine eye exams, dental, or hearing aids. It also does not cover Prescription Drugs. In addition, you are REQUIRED to have prescription drug coverage within 63 days of becoming eligible for part D (prescription drug coverage). The penalty time is 1% for every month you did not have coverage and this penalty must be paid as long as you have Part D coverage. For example, if you became eligible for Part D on 01/01/2021, but you did not enroll in Part D until 03/01/2022 that is 14 months that you did not have creditable drug coverage which would result in a penalty of 14% of the average Part D premium to be paid as long as you have Medicare prescription drug coverage.

What is a Medicare Supplement Plan (MediGap)?

This is a plan that is covered by private companies that helps pay for some of the out of pocket expenses that are not covered by Original Medicare (Parts A & B). These plans have more predictable costs, no network restrictions which means you can see any doctor who accepts Medicare patients. You don't need a referral to see a specialist (think PPO). This choice is great for those who travel within the US and may live in different states for extended periods of time because you can take this coverage with you anywhere in the United States. Medicare Supplement plans have guaranteed coverage for life (as long as you pay your premiums when due) which means your coverage cannot be cancelled.

Premiums are typically higher on these plans and the rates are subject to change. Premium amounts can change annually.

NOTE: All Medicare Supplement plans will require a separate Prescription Drug Plan to avoid penalty and received prescription drug coverage.

What is a Medicare Advantage Plan?

These are the "all- in one" plans offered by private companies that combine Original Medicare (Parts A & B) with additional benefits that you can't get from Medicare by itself. Most Medicare Advantage plans include prescription drug coverage (Part D) as well. Medicare Advantage plans may also include other benefits such as: dental, vision, hearing, and fitness.

Plan premiums can vary, but you can choose the plan that best suits your needs and budget. Some of these plans have a $0.00 monthly premium.

Many Medicare advantage plans offer perks such as transportation to medical appointments, wellness and fitness programs, eye glasses, hearing aids, and dental exams.

What is a Medicare Prescription Drug Plan?

These are stand alone prescription drug plans (Part D), provided by private companies to help pay for prescription medication. These plans cover most commonly prescribed medications, specific brand name drugs (each plan has a list of covered drugs), and commercially available vaccine that are not covered by Part B.

**You are REQUIRED to have prescription drug coverage within 63 days of becoming eligible for part D (prescription drug coverage). The penalty time is 1% for every month you did not have coverage and this penalty must be paid as long as you have Part D coverage. For example, if you became eligible for Part D on 01/01/2021, but you did not enroll in Part D until 03/01/2022 that is 14 months that you did not have creditable drug coverage which would result in a penalty of 14% of the average Part D premium to be paid as long as you have Medicare prescription drug coverage.

When should I enroll in Original Medicare (Parts A & B)?

In most cases first time enrollment occurs around the age of 65. In some cases, people qualify for Medicare prior to the age of 65 based on disability or medical condition. The Initial Enrollment Period (IEP) for Medicare due to age or disability is 7 months. Medicare enrollment due to medical condition can occur after the 25th month of receiving disability benefits. You might also enroll if you are still working, but you employer or spouse's employer require you to switch to Medicare.

I'm not planning on retiring at age 65, what should I do?

This depends on a few factors. If your employer has 20 or more employees, most of the time you can delay Medicare enrollment. You can also choose to drop your employer coverage and go with Medicare. Make sure you reach out to your employer to ensure you have creditable drug coverage to avoid any penalties. In addition, make sure you enroll in Medicare within 8 months of either losing your coverage or retiring.

If your employer has fewer than 20 employees you will most likely need to enroll in Medicare during your initial enrollment period. Please reach out to your HR department to confirm coverage details.

Can I delay enrollment in Medicare if I am covered by my spouse's health care plan?

Yes, but it will depend on your spouse's employer's rules. Please have your spouse check with HR on their coverage rules. They may require that you enroll in Medicare to remain covered by the company insurance plan.

What do I need to sign up for a Medicare Advantage or Medicare Supplement Plan today?

We need very little!

1. You will need to be enrolled in Original Medicare (Parts A & B). Click HERE to enroll right now. ** See the Enroll in Original Medicare (Parts A & B) above for quick instructions information.

2. Call me to talk through the plan that is best for you! (951) 394-3301

3. We will need some simple personal information and the name of your primary care doctor (if you want to remain with the same provider).

What are the different enrollment periods?

Annual Enrollment Period - October 15 – December 7

During annual enrollment you can change your Medicare Advantage or Prescription Drug Plan. You can also drop your plan and return to Original Medicare (Parts A & B).

Medicare Advantage Open Enrollment - January 1– March 31

If you’re already a Medicare Advantage plan member, you may dis-enroll from your current plan and either switch to a different Medicare Advantage plan one time only, or go back to Original Medicare during this period.

Special Enrollment Period - Anytime

Depending on certain circumstances, you may be eligible to enroll in a Medicare plan outside of the initial enrollment or annual enrollment time frames. Some ways you may qualify for a Special Enrollment period are if you:

• Retire and lose your employer coverage

• Move out if the plan’s service area

• Qualify for Extra Help

• Have been diagnosed with certain qualifying chronic health conditions

• Several weather in your area

Do I have to change my doctor?

Under most circumstances you do not have to change your primary care physician. I can help you find a plan that best suits your needs and make every effort to keep your doctor in place. There are instance where a change of doctor my be necessary, but there are many highly rated providers available to choose from.