What’s the difference between the part of Medicare and the plans …what is Part A, Part B, Part C, and Part D?

• Part A: Covers Hospitalization subject to deductibles and 20% co-insurance. A is provided to you for having worked 40 quarters or 10 years of employment while paying into Medicare. No cost to you if you qualify. You may also set up to be deducted from your bank account. 
• Part B: Covers medical care, physician care, and associated coverage subject to an annual deductible and 20% coinsurance. Part B is available to you for a small monthly premium that is taken from your Social Security payment or it can be billed quarterly (if you are not receiving your SS benefits).
• Part C: This is Medicare Advantage which is used as a combination of part A and part B. It is used in place of your original red white and blue Medicare card while continuing to pay your monthly part B premium. Some Advantage plans cover prescription drugs as well. Most all Medicare Advantage plans are network provider plans with some offering limited out of network coverage. Not all plans are available everywhere in your county and state. Some Medicare Advantage plans offer additional coverages normally not covered by Medicare such as dental, vision, hearing aid benefits, over-the-counter reimbursements, and gym memberships.
• Part D: Medicare Prescription Drug coverage. This coverage works with original Medicare A & B along with Medigap plans or Medicare Supplement coverages; plans A thru N.

Which enrollment period fits you best — OEP (Open Enrollment), AEP (Annual Enrollment), SEP (Special Enrollment)?

• OEP: Open Enrollment (for Medicare), occurs once in your lifetime. Open Enrollment can mean many things. Relating to Medicare it is as follows: It begins 3 months prior to the month your turn 65, through your birthday month, and continuing 3 months beyond your birthday month.
• AEP: Annual Enrollment (for Medicare), occurs every year from October 15 through December 7th.  The definition of Annual Enrollment can mean other things as well. Depending on whether your are talking about group insurance or Medicare, they have different definitions.  A group’s annual enrollment period is the pre-determined time set by you (the group) and your insurer to allow members to make changes to their plans or add other individuals that do not qualify for coverage as a result of a “SEP” or special election period.  Sometimes OEP and AEP are used interchangeably in a group situation.   The Annual Enrollment Period for Medicare refers to the time when members are able to change prescription drug plans and/or choose another available Medicare plan in your area with options more suitable to you.
• SEP: Special Enrollment (for Medicare) occurs when a QUALIFYING EVENT triggers a certain point in time with definitive beginning and ending dates to enroll in Medicare A, B, C, and D. We will need to evaluate if you have a special election/special enrollment period.

What works best for you, Medigap/Medicare Supplements or a Medicare Plan?

• Give me a call and we can explore this option together!

Does any Medicare Plan cover vision, hearing or dental?

• Generally speaking, Medicare does not cover dental or vision with the exception of a disease or injury to the eyes and teeth. Some Medicare Advantage plans offer limited dental and vision coverage.

What do I do when or if I move out of a particular area?

• This depends on if you are in a Medicare Advantage Plan or a Medigap plan associated with Original Medicare. With a Medigap plan, coverage is nationwide and generally speaking, nothing needs to be done other than notify the company of your billing changes. If you are in a part C, Medicare Advantage Plan… you must notify your respective company within a certain time period or risk losing your health, prescription coverage, and possibly losing a special election period to change both.

How do I know if my doctor is out of network or if there is any difference in cost?

• Your broker/Agent should go over network coverage available to you. They can identify and explain the in-network and out-of-network benefits and the costs associated with utilizing either or both. 

Medicare supplement plans A thru N are the same from company to company, so why pay more for the same thing?

• Medicare supplement plans (Medigap) A thru N are used with original Medicare and were standardized in 1992 with plan modernization in 2010. All plans, regarding your health care should pay the same and cover the same. In the state of Missouri, you are also able to change companies, staying on the same letter plan, as often as each year 30 days either side of your policy anniversary date (usually done to save money on premiums to combat rate increases). This guarantee issue period gives you the freedom to choose your company and assist with costs savings regarding your Medicare Supplement health insurance.

What’s the difference between Standardized Medigap Plans: A, B, C, D, F, G, K, L, M or N?

• Each plan covers the various deductibles, co-pays, and coinsurance associated with using original Medicare A & B. Call me and find out which one is right for you. January 1, 2020, the initial coverage level payment plans, F & C, are no longer available to those newly eligible for Medicare. Talk to your broker about alternatives available and to see if you qualify.

Can I change my Medicare Supplement Plan? Can I change my company?

• Each state has different guarantee issue rights concerning changing your plan and your company that provides your insurance. In the state of Missouri, you can change your company annually with no questions asked during your guarantee issue period. This guaranteed time to change associated with your policy anniversary date insists you remain on the same letter plan. You are able to change plans by completing the application in its entirety and subjecting yourself to examination for underwriting. Subjecting yourself to uderwriting allows the company to determine if they are willing to offer you coverage, should you not qualify for a guaranty issue period. You are generally able to change at any time during the year following any other companies underwriting rules and regulations.

What are your Guaranteed Issue Rights?

• Call to find out, it all depends on you and your individual specific situation. What is the Missouri Annual Option and how does it affect you? It is never too early or too late to check; it all depends on you and your individual specific situation.

What are the penalties that correspond with a late enrollment into the Part D, Prescription Drug Plan?

• Should you not get enrolled in a part D, prescription drug plan when you are first eligible, you may have to pay more. This corresponds to everyone from those turning 65 and missing their enrollment window to those who work past 65 and have a shorter window coming off of a credible coverage qualifying event. Generally speaking, you will pay 1% of the national average drug plan under Medicare for every month you are not enrolled in a drug plan but were eligible to be in a drug plan.

Who is exempt from late enrollment penalties concerning Part D?

• Generally military veterans enrolled through the Veterans Administration are exempt as well as some income and qualifications for those receiving subsidized assistance from the state or government.

Are you missing any of the state and federal assistance programs?

• Do any of these sound familiar? Social Security Extra Help, Medicare Savings plan, MO RX, Medicaid, VA – Veterans Administration… call me for assistance in determining if you qualify!

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Medicare Supplements at the most competitive rates available from top-rated companies. Ask me about Health Insurance or Life Insurance that potentially could provide savings in costs to you.