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Rules can vary by state, so the below tips are for Florida.

1. Understand that a Medicare Supplement insurance plan, is just that. It only “supplements" original Medicare (Part A & Part B). Also keep in mind that original Medicare doesn’t cover everything.
   
   
2. Most prescription drugs are not included with a Medicare Supplement. (Only a very limited drugs are covered under Part A or Part B.) So if you also want prescription drug coverage, you will need to purchase a stand-alone prescription drug plan (also known as Part D) in addition to a Medicare Supplement Plan. 
   
   
3. Medicare’s Annual Enrollment Period is from October 15 through December 7. Although you can add a Medicare Supplement anytime during the year, if you are currently on original Medicare and can qualify. However if you have a Medicare Advantage Plan and want to switch to a Medicare Supplement, then you will need to do that during Annual Enrollment Period October 15 through December 7 or possibly during Medicare Open Enrollment Period January 1 to March 31 when some different rules may apply.)
   
   
4. Medicare Supplement Insurance plans (also know as Medigap plans) can help pay for some of your out of pocket costs not covered by original Medicare (Part A & Part B).
   
   
5. Choosing the right Medicare insurance plan for yourself depends on what you feel suits you the best and at the same time you can afford along with being with a financially stable insurance company.
   
   
6. Applicants qualify for Medicare Supplement Open Enrollment during the first six months they are enrolled in Medicare Part B. During Medicare Supplement open enrollment, you cannot be denied coverage, regardless of your medical history. So it is important you don’t miss that deadline. Unless you qualify for guaranteed issue later on, if you don’t enroll during this Medicare Supplement open enrollment period you will need to go through underwriting for approval and some people may not qualify due to the insurance company’s underwriting guidelines.
   
   
7. Medicare Supplement Insurance plans only cover one person per policy. So if your spouse wants coverage, he/she will also need to purchase a separate policy.
   
   
8. Medicare Supplement Insurance plans (A through N) are standardized, which means each plan with the same letter will offer the same coverage. (Exceptions are Minnesota, Wisconsin and Massachusetts.)
   
   
9. Since Medicare Supplement Insurance plans with the same letter offer the same coverage, it is important to know that premiums can vary widely from one insurance company to another, even though they offer the same exact coverage. So you basically want to find the lowest premium through a reliable insurance company.
   
   
10. Another thing to keep in mind is try to find out the annual increase history of the insurance company you pick for your Medicare Supplement plan insurance. You don’t want to purchase a plan that has historically had large annual increases, since if that happens in the future years you may not qualify (due underwriting guidelines) to switch to another insurance company’s Medicare Supplement later on down the road.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

In this Herald-Tribune article by Barbara Peters Smith, she mentions that when people say Medicare is going bankrupt, the fact is Medicare can't go bankrupt in the classic sense. To find out more details, click below to read her short article.

http://health.heraldtribune.com/2013/05/10/a-bit-of-clarity-in-the-murk-of-medicare-politics/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

A short Wall Street Journal article by Matthew Heimer mentioned the so called discount that Medicare obtains on hospital bills. It stated that the price comparison website NerdWallet released a study and found a catchy way to summarize: "Medicare obtains a discount of 73% on the average hospital bill," the site says, paying 27 cents for every dollar it's charged. It goes on to say that the hospital list prices are almost always higher than what Medicare or any private insurer will pay. Also another way to flip the same data might be to say that the average hospital charges Medicare 3.7 times as much as Medicare is likely to pay it. Along with many others, I personally feel this has the effect of over inflating overall health care costs and many without health insurance get hit the hardest!

Although the original web link is no longer working, I listed the original source below anyway.

Source: http://blogs.marketwatch.com/encore/2013/06/04/behind-medicares-hospital-bill-discount/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

This web page has been deleted.

Common Medicare Advantage terms and their definitions 

Deductible: The amount you pay for medical services or prescription drugs before your plan starts to pay.

Coinsurance: The percentage you pay for medical services or prescription drugs after your deductible.

Copayment (Copay): The flat dollar amount you pay for medical services or prescription drugs.

Cost sharing: The amount you pay for medical services or prescription drugs. It can include your copayment, coinsurance and deductible.

Extra Help: A federal program that helps pay for some of the out-of-pocket costs of Medicare prescription drug coverage. It’s also known as the Part D Low-Income Subsidy (LIS).

Maximum Out Of Pocket (MOOP): The most you pay during your plan’s policy period (usually a year) for covered medical services. Once you reach your MOOP, your plan pays 100% of covered medical services. Your premium doesn’t count toward your MOOP.

Network pharmacy: A pharmacy that has a contract with your plan. Your plan may only cover your prescription drug if you fill it at a network pharmacy. (See Preferred Pharmacy below)

Network provider: A health care provider (for example, a doctor, hospital or facility) that has a contract with your plan.

Preferred Pharmacy: Preferred pharmacies (that may be in many Medicare Advantage plans or Stand Alone Prescription Drug Plans), have contracts with your plan for specific Preferred Pharmacies, whereas, if you get your drugs from a preferred pharmacy in your plan, you will generally pay less, versus getting them at just a standard pharmacy in the plan network, where you will generally pay more for the same drugs.

Premium: What you pay each month to your plan for medical and prescription drug coverage (if included).

Primary care physician (PCP): This is your main doctor. You can visit your PCP for routine medical care and annual exams. They can also diagnose and treat common medical conditions.

Prior authorization: Requires you or your doctor to get approval from your plan before it covers a medical service or prescription drug.

Total drug cost: What both you and your plan pay for a covered prescription drug.

It all depends on your individual circumstances. Be sure to determine correct information on when to enroll regarding your individual circumstances or you may end up paying some hefty penalties for the rest of your life for enrolling late!

Some general tips:

If you want to get either a Medicare Supplement and Prescription Drug Plan OR instead a Medicare Advantage plan, you will first need to be enrolled in both Part A and Part B.

Although if you are still working at age 65, have credible health insurance through your employer, and want to keep to your employer health insurance, generally you do not need to enroll in Part A or Part B immediately. (Rules can differ depending on the number of employees at your company. Less than 20 employees has different rules.) 
It is always best to check with your benefits administrator to determine if you should enroll in Part A or Part B to be sure. 

However Part A is usually free for most people (if you worked 40 quarters, paid Medicare taxes during that time, and also are a US citizen or permanent legal resident for at least 5 years).
So you may want to enroll in Part A, even while you are still working since it free for most people. Then later enroll in Part B right away when you first retire or leave your work to avoid any hefty penalties. Note: There is a monthly premium for Part B.

Note: If you choose COBRA after you stop working, do not wait until your COBRA coverage ends to sign up for Medicare! (Check with the Social Security office for details on when you need to enroll to avoid penalties, etc.) If you delay enrolling in Medicare Part A or Part B after your Special Enrollment Period ends, you’ll have to wait until the next General Enrollment Period (January 1 to March 31 every year) to enroll, and you may have to pay hefty late enrollment penalties added to your premiums for the rest of your life if you choose to keep Medicare.

For a relate blog post, click the web link below:

How Do I Get Medicare Part A & Part B?

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

I came across very interesting two minute 15 sec video and also on the same web page an article on a different subject regarding the gag rule for prescription drugs. I felt both the article and video were very informative and worth reading and/or viewing.

Disclaimer: There possibly may be be a random commercial, (possibly even political?) preceding the video. I have no affiliation with any of these commercials and I just ignore them altogether myself and recommend you do the same.

When gag clauses are in effect, pharmacists are barred from telling consumers about less expensive price options because of the clauses in their contracts with PBMs. The clauses specifically prevent pharmacists from discussing less costly alternatives, including therapeutically similar drugs.

Some specific states already have their own state laws banning the gag rules. Many states have bills introduced into legislation in 2018 or passed already. 

"In the past two years, at least 21 states have enacted laws prohibiting "gag rules" on pharmacists, according to the Prescription Drug Resource Center of the National Conference of State Legislators. The most recent legislation was passed in Arizona, Colorado, Florida, Indiana, Kansas, Kentucky, Mississippi, Utah, Virginia and West Virginia between March and May.”¹

Click the web link below to read view short video or read article.

https://www.cnn.com/2018/05/11/health/pharmacy-gag-rule-trump-lower-drug-prices/index.html

1. Source: Article By Sandee LaMotte, CNN - Updated 7:53 PM ET, May 11, 2018
https://www.cnn.com/2018/05/11/health/pharmacy-gag-rule-trump-lower-drug-prices/index.html

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

I found this informative MarketWatch article about Medicare by Alessandra Malito and thought I’d share it. 

Gist is:

• Medicare can be very confusing to seniors!
  
• No one told me! (It is assumed that since Medicare is a government program that there should be people out there to tell you how to use it.) Hint: Find an experienced independent insurance agent that specializes in Medicare, such as myself!
• Sign up for Medicare at the correct time or you may get steep penalties.
• Understand that as long as you have continuous credible group coverage through your employer, generally you don’t need to sign up for Medicare right at age 65 to avoid penalties. However for employers with fewer than 20 employees, generally you have to get Medicare because small employer plans become secondary and Medicare becomes the primary player.
• Understand and use the Medicare coverage you have. Also understand what is not covered, such as Long Term Care, for example.

For more information, click on web link below read entire article.

http://www.marketwatch.com/story/this-man-wants-you-to-get-whats-yours-from-government-benefits-2016-09-29

Confused and/or want more information about how to enroll in a new (or different) Medicare Insurance Plan or which Medicare Insurance plan to enroll in, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

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Related Topic:

Click on web link below to find out answer.

Medicare Insurance Plans - Do Agents Charge Clients Fees?

In this USA Today article by Susan Jaffe from Kaiser Health News it reminds Medicare beneficiaries that they are already covered and that their benefits are not changing for this upcoming 2014 year. They don't need to do anything with the new Marketplace because they don't apply to seniors.

So, if you are already 65 years old and on Medicare you don't need to be involved in the marketplaces. However during the Annual Election Period of Oct 15 through Dec 7, which is totally separate and different from the Marketplaces, seniors can shop for private health plans known as Medicare Advantage plans and if they don't like their current plan they can switch to a different Medicare Advantage plan or to a Medicare Supplement and/or Part D for their prescription drugs.

To read more click on the link below.

http://www.usatoday.com/story/money/business/2013/08/24/medicare-health-insurance-marketplace/2692977/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Do I need Part A and Part B?

If you want to get either a Medicare Supplement and Prescription Drug Plan OR instead a Medicare Advantage plan, you will first need to be enrolled in both Part A and Part B.

How do I get Part A and Part B?

Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically and other people have to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.¹ 

Below are some situations that may apply to you:

• I’ll be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before I turn 65. 
  In most cases, you'll automatically get Part A and Part B starting the first day of the month you turn 65. Note: If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month!
  If you will be getting Social Security benefits, you don’t need to enroll manually since you should automatically be enrolled Part A and Part B. You should receive your red, white, and blue Medicare card in the US Mail approximately 3 months before your 65th birthday.

• I won’t be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before I turn 65.
  If you aren’t getting benefits from Social Security (or the RRB) at least 4 months before you turn 65, you'll need to sign up with Social Security to get Part A and Part B.
  (Note: You should generally sign up three months in advance of your 65th Birth Month, since it can take a while to process your enrollment.)
  So how do I sign up?
  
  • Apply online at Social Security. (Note: If you started your online application and have your re-entry number, you can go back to Social Security to finish your application.)
    These web links should be very helpful:
    • https://www.ssa.gov/benefits/medicare/
    • How To Apply Online For Medicare Part A and Part B

• Apply Online for Medicare Part B During a Special Enrollment Period
  
  • https://secure.ssa.gov/mpboa/medicare-part-b-online-application/
  • Visit your local Social Security office.
  • Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
  • If you worked for a railroad, call the RRB at 1-877-772-5772.
  • If you already have Part A and want to sign up for Part B, complete an Application for Enrollment in Part B (CMS-40B). 

• I'm under 65 and have a disability.

       You automatically get Part A and Part B after you get one of these:

            1. Disability benefits from Social Security for 24 months

            2. Certain disability benefits from the RRB for 24 months

• I have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease).
  You automatically get Part A and Part B the month your disability benefits begin. 
  You don't need to sign up if you automatically get Part A and Part B. You'll get your red, white, and blue Medicare card in the mail the month your disability benefits begin.
  
  
• I have End-Stage Renal Disease (ESRD).
  

If you’re eligible for Medicare because of ESRD, you can enroll in Part A and Part B.

If you qualify for Part A, you can also get Part B. Enrolling in Medicare is your choice. But, you’ll need both Part A and Part B to get the full benefits available under Medicare to cover certain dialysis and kidney transplant services.

When you enroll in Medicare based on ESRD and you’re on dialysis, Medicare coverage usually starts on the first day of the fourth month of your dialysis treatments. This waiting period will start even if you haven’t signed up for Medicare. For example, if you don’t sign up until after you’ve met all the requirements, your coverage could begin up to 12 months before the month you apply.

If you're covered by an employer group health plan, your Medicare coverage will still start the fourth month of dialysis treatments. Your employer group may pay the first 3 months of dialysis.

Medicare coverage can start as early as the first month of dialysis if you meet all of these conditions:

• You take part in a home dialysis training program offered by a Medicare-certified training facility to teach you how to give yourself dialysis treatments at home.
• Your doctor expects you to finish training and be able to do your own dialysis treatments.
• The regular course of dialysis is maintained throughout the waiting period that would otherwise apply.

If you have Medicare only because of permanent kidney failure, Medicare coverage will end:

• 12 months after the month you stop dialysis treatments.
• 36 months after the month you have a kidney transplant.

Your Medicare coverage will be extended if:

• You start dialysis again, or you get a kidney transplant within 12 months after the month you stopped getting dialysis.
• You start dialysis or get another kidney transplant within 36 months after the month you get a kidney transplant.

For more details click on web link below:

https://www.medicare.gov/basics/get-started-with-medicare/sign-up/ready-to-sign-up-for-part-a-part-b

For a relate blog post, click the web link below:

Do I Need Part A & Part B at Age 65?

1. Source: https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

This Sarasota Herald-Tribune article by Maggie Clark & Barbara Peters Smith explains that changes to Medicare insurance plans can effect your health coverage.

Sometimes due to negotiations between insurance companies and providers such as hospitals, medical groups, or even individual doctors, patients can get caught in between while the insurance companies and providers either work out their differences or worse. (The insurance companies decide to drop those providers and not to accept patients in-network from them going forward.)

There aren’t any rules that stop insurance companies from dropping providers (doctors, medical groups, and hospitals) at any time during the year. So even though you may sign up during the annual enrollment period, your doctors, medical groups, or hospitals can be dropped at any time afterwards! The insured customers need to realize that their providers are not guaranteed to be in-network all year long in a Medicare Advantage Plan.

A Medicare Advantage plan receives a lump sum amount from the government for each enrollee, and reimburses providers in its network at pre-negotiated rates. Insurance companies make profit on any remaining balance after enrollee’s bill are paid.

As a more expensive, but yet a lot more flexible, alternative to an Medicare Advantage plan is to instead purchase both a Medicare Supplement and a Part D (Prescription Drug Plan). Generally most Medicare Supplement plans do not require you to stay in-network and as long as your provider accepts original Medicare then you are also covered with your Medicare Supplement plan. As with anything else, generally to get more flexibility you will pay a higher price. Many Medicare Supplement plans (such as Plan F), don’t have virtually any copays or deductibles. (That is unless you go out of the United States.) You are basically paying a predetermined upfront premium each month. However with Medicare advantage you are basically taking a chance. Even though there are either no premium at all or possibly a very low premium, you may still have copays, coinsurance, deductibles, etc. all which can add up more than a Medicare Supplement total yearly premiums if you become very ill. I kind of relate a Medicare Advantage plan, to a "pay as you go" type plan.

Source: Sarasota Herald-Tribune article by Maggie Clark & Barbara Peters Smith
The original web link below is no longer valid.
http://www.heraldtribune.com/article/20141126/ARTICLE/141129787?Title=How-Medicare-insurance-plan-is-changing-health-coverage

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

For instructions directly from Social Security, which is where you start the process, click on web link below. 

https://www.ssa.gov/medicare/sign-up

Also an additional web link from Medicare.gov as well. (But it will eventually send you back to Social Security web site.

https://www.medicare.gov/basics/get-started-with-medicare/sign-up/ready-to-sign-up-for-part-a-part-b

See previous blog post for more info:

How Do I Get Medicare Part A & Part B?

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Before I get started with the information below, I just wanted to first mention that: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Step 1: Decide if you prefer Original Medicare OR a Medicare Advantage Plan
(Like an HMO or PPO)

Step 2: Decide if you want Prescription Drug Coverage (Part D)

Step 3: Decide if you want supplemental coverage. (This type of supplemental coverage to Original Medicare is also known both as a Medicare Supplement Plan or as a Medigap plan. Two different names for the same thing.)

Some important things to know and other tips to keep in mind: 

• You first need to be enrolled in both Part A and Part B (Through the Social Security Office) in order to get enrolled in either a Medicare Supplement Plan or a Medicare Advantage Plan. Make sure to enroll in Part B when you are first eligible, or you may face penalties later on if you don’t have creditable coverage.
• You are not allowed to be enrolled in both a Medicare Advantage plan and a Medicare Supplement at the same time.
• Many, but not all, Medicare Advantage plans may have drug coverage included in their plan.
• Many, but not all, Medicare Advantage plans may have zero (or very low) premiums.
• Many, but not all, Medicare Advantage plans may have dental care, vision, fitness benefits, and even "Over The Counter” (OTC) credits, etc. included in your plan at no extra charge.
• If you choose a Medicare Supplement (Medigap) plan, you will need to purchase a separate additional Part D Prescription Drug Plan (PDP), if you want drug coverage.
• If you don’t enroll in a Medicare plan that has Prescription Drug Coverage when you are first eligible and don’t have credible coverage, then later in life if you enroll in a plan with Prescription Drug Coverage, you will incur a 1% per month government penalty for each month you missed from when you were first eligible and that penalty will continue for the rest of your life as long as you keep Prescription Drug Coverage!
• If you pick a Medicare Advantage plan, be sure to verify that your existing doctors are in the network of specific Medicare Advantage plan that you choose. Also verify that all your prescriptions are covered by the plan and find out your out of pocket costs of each drug.
• It is important to know what coverage you will have if travel out of your area. All Medicare plans cover you if you have a true emergency. However some HMO plans do not have coverage out of your service area for other things that are not considered true emergencies.
• Medicare.gov Plan Finder can help you compare Medicare Advantage and PDP plans.
• If you are still confused or just want some guidance, please contact me to help explain things in simple terms and then enroll you in a Medicare Supplement plan OR Medicare Advantage plan of your choosing after I give you the information you need to make an intelligent decision. If you would like my assistance, please call me at 941-404-5334. By calling this number, I understand I will be directed to a licensed insurance sales agent.

I just read several articles with good tips on how to save money on your prescription drugs.

Read the actual articles in web links below to get all their tips.

However below are just some of the tips: (Some tips I feel are common sense. Others are good tips you may not know about!)

1. Use generics when possible.
2. Shop around.(Drugs costs can vary by hundreds of dollars at different pharmacies, even within the same town!)
3. Some warehouse clubs such as CostCo and Sam’s Club tend to have low overall prices and you do NOT need to be a member to get those low prices!
4. Try smartphone apps (or simply go online if you don’t have a smartphone.)
   Some of the apps or websites you may want to check out are: GoodRx, Blink Health, WeRx.org, and HealthWarehouse.com.
5. Use Discount cards when not using health insurance. Also instead of just using your insurance, still check to see if the discount card prices are less then your insurance copay or coinsurance amount, and/or deductible.
6. Ask for free samples from your doctor to help reduce your costs.
7. Some pharmacies or grocery store chains even offer free generic drugs. (Or at a very reduced cost, anyway!) Generally those types offered for free or reduced cost are some antibiotics and some diabetes medications.
8. Make sure to “Ask” the pharmacist directly for the cheapest price, including if you didn’t use your insurance, but instead used coupons or discounts. (Note: Many drugstores/pharmacists have a "gag clause” which doesn’t allow them to offer you the cheapest price, unless you ask for it!)
9. Know your insurance coverage. Find out in advance whether your prescription drug is in your plan’s formulary. Also what tier level your drugs are. Ask your doctor if there is a less expensive drug that does the same thing and is suitable to your needs.
10. Sometimes, but not always, ordering by mail can be less expensive. Be sure to check, some plans actually charge more for mail ordering though.
11. Use a pharmacy in your plan’s network. Otherwise, your prescription may not be covered.
12. If your plan has preferred pharmacies, try to use the preferred pharmacies to save even more money.
13. Ask your pharmacist and doctor if ordering a larger dosage and then splitting your pills is safe. (Note: Some pills are time released or have other reasons not to split them, so be sure to ask first!)
14. Patient assistance programs offer free or reduced cost medications to low income, and sometime to the uninsured. Can’t hurt to ask them!

Click on the 4 web links below to read the articles:

How to Pay Less for Your Meds (Consumer Reports)

How to Pay Less for Drugs (AARP)

How to pay less for your prescription drugs, legally (CNN)

10 Expert Tips for Slashing Prescription Drug Costs (MoneyTalkNews)

Sources: Consumer Reports, AARP, CNN, and MoneyTalkNew

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

"You generally will receive Medicare benefits after you receive disability benefits for 24 months. When you become eligible for disability benefits, Social Security will automatically enroll you in Medicare.  

Special rules apply to:

End-stage renal disease (permanent kidney failure). People with permanent kidney failure get Medicare beginning:

• The third month after the month a regular course of renal dialysis begins
• The month of kidney transplantation
• Lou Gehrig's Disease (amyotrophic lateral sclerosis). People with amyotrophic lateral sclerosis get Medicare beginning with the month they become entitled to disability benefits.
  

Note: Residents of Puerto Rico or foreign countries will not receive Part B automatically. You must elect this benefit.” ¹

1. Source: AARP

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

I felt this New York Times article by Austin Frakt was very interesting. The article infers from research that Medicare Advantage plans cost about 6% more to the taxpayers, but that Medicare Advantage plans outperform traditional Medicare by offering higher quality.

My personal feelings are that there isn’t one type plan that fits everybody. It really depends on your individual circumstances, budget, current health, and feelings about using in-network doctors, etc. Medicare Advantage may be great for one person, and a Medicare Supplement with a Prescription Drug Plan may be the best option for another person. I never steer my clients towards one type plan or the other. I present their options and let them choose what they feel is best for their particular situation.

To read more, click on the link below.

http://www.nytimes.com/2014/08/19/upshot/medicare-advantage-is-more-expensive-but-it-may-be-worth-it.html?_r=1&abt=0002&abg=0

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

These free Medicare "wellness" checkups could end up cutting costs, but it seems they haven't caught on just yet according to this WSJ article by Elizabeth O'Brien. 

If you don't have time to read the whole article, below is an excerpt pulled directly from the article that I thought was important, so Medicare patients know what to expect:

"The new benefit can be confusing to patients, doctors say, because it’s specifically focused on prevention and screenings. It’s also not the same a complete, head-to-toe physical exam. Traditional Medicare still doesn’t fully cover a complete physical; patients are responsible for 20% coinsurance for these exams, an amount that can exceed $100, experts say. (Individual Medicare Advantage programs may fully cover a physical.)

Patients leave their clothes on for the wellness visit, Langston said. While doctors are given leeway to do as much of a “focused” physical exam as they think necessary, it’s likely that a doctor won’t listen to your heart during the wellness visit, nor do many other hands-on procedures. Instead, the doctor or other medical professional will take your blood pressure and record your body mass index. Patients get screened briefly for depression and cognitive impairment, and get a vision test; they also get some vaccines, if needed.

In addition to these screenings, there’s plenty of talk: the patient and doctor will discuss the patient’s medications and medical history and create a customized prevention plan based on a personalized health risk assessment. The two might schedule preventative screenings for the next few years. (Under the Affordable Care Act, screening mammography and colorectal cancer screenings are among the tests now free for beneficiaries, who had to pay coinsurance for these services before.)"¹                                          

To read the full article, click on link below.

http://www.marketwatch.com/story/medicare-wellness-visits-worth-a-second-look-2013-02-26?siteid=nwhpf

  ¹ Source: WSJ article by Elizabeth O’Brien

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Are Medicare & Social Security eligibility ages both the same age? Generally not, since your “Full" Social Security retirement benefit age is normally not the same age as when you are eligible for Medicare!

Social Security’s full retirement age is 66 for most baby boomers!* However you will receive a smaller monthly payout if you decide to sign up at a younger age. You can also opt to further delay signing up for Social Security until you are older, in order to qualify for larger monthly payments later in retirement.

In contrast, the Medicare eligibility age remains 65! So, if you want to wait until 66 or later to claim Social Security, you will need to make sure to sign up for Medicare separately at age 65 to avoid penalties later on.

Below is what you need to know about signing up for Medicare before claiming Social Security:

1. Social Security and Medicare are separate decisions.
2. Some people are automatically enrolled in Medicare.
3. Remember to sign up for Medicare on time.
4. Signing up for Medicare after you missed the Initial Enrollment Period can trigger penalties.
5. Beneficiaries who work can avoid the Medicare late enrollment penalty.
6. Be prepared to get a bill.
7. Don't wait until age 65 to start researching your Medicare options.

*Click on this Social Security Web link to help figure out your exact full retirement age.

https://www.ssa.gov/planners/retire/retirechart.html

Source: Chart below was cut and pasted from the above Social Security web link.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Annual Enrollment Period is also sometimes called Annual Election Period and abbreviated as AEP. This year it starts on Oct. 15 and ends on Dec. 7. During this time, Medicare beneficiaries can add, change, or drop Medicare health plans and/or prescription drug coverage for the following year (effective January 1).

If you're satisfied with your current Medicare plan, you don't need to take any action. However, plan details can change annually, so you should compare your plan options to confirm that your health and prescription drug needs are covered by your plan for the next year. This is an important time for beneficiaries to reevaluate their current Medicare Advantage and Medicare Part D Prescription Drug Plan coverage and compare it with the options available in the upcoming year, because effective coverage will be locked in for a calendar year.

Agents can start to talk to clients or prospects about the upcoming year’s plan starting Oct. 1. However agents are not permitted to enroll clients until on or after Oct. 15.

In addition, agents are required to get client’s (or prospect’s) written permission in advance of discussing Medicare Insurance plans per CMS (Centers for Medicare and Medicaid Services) and keep their conversation during that original appointment narrowed down to only Medicare related topics listed on the SOA (Scope Of Appointment) form. The Scope Of Appointment form is designed to protect seniors from unscrupulous agents making Medicare appointments and then on the same appointment trying to sell prospects annuities, life insurance, or other non-Medicare related products instead. If other non-Medicare related products are to be discussed, another appointment needs to be made and discussed during that additional appointment and not on the same Medicare appointment as to comply with CMS rules.

Note: Signing the Scope Of Appointment form does NOT obligate you to enroll in a plan, affect your current enrollment, or enroll in you in Medicare plan.

To read more info from Medicare.gov click on these links:

Medicare Open Enrollment

https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html

Understanding Medicare Part C & Part D Enrollment Periods

https://www.medicare.gov/Pubs/pdf/11219-Understanding-Medicare-Part-C-D.pdf

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

A very short gist for this issue brief, basically states that Medicare coverage for skilled nursing or therapy is not dependent on a beneficiary’s potential for improving under such care. Instead the coverage depends solely on whether the beneficiary needs the care.

Center for Medicare Advocacy released a new resource on the Medicare Improvement Standard. The issue brief, “Implementing Jimmo v. Sebelius: An Overview,” is intended to provide Medicare stakeholders with an overview of the Jimmo Settlement, what it means in different care settings, and links and references to helpful resource materials.¹

In 2013, a federal district court approved a settlement agreement in Jimmo v. Sebelius, No. 5:11-CV-17 (D. VT) agreeing that Medicare coverage for skilled nursing or therapy care is not dependent on a beneficiary’s potential for improving under such care. Instead, the coverage depends solely on whether the beneficiary needs the care. The Jimmo Settlement and later court decisions apply to everyone with Medicare throughout the country, regardless of whether an individual is in traditional Medicare or a Medicare Advantage plan.¹

To download read the entire issue brief, click on the web link below:

https://www.medicareadvocacy.org/wp-content/uploads/2019/06/Jimmo-Improvement-Standard-Issue-brief-June-2019.pdf

To read an overview of the Jimmo Settlement, click on the web link below:

https://www.medicareadvocacy.org/new-issue-brief-implementing-jimmo-v-sebelius-an-overview/

1. Source: Medicare Rights Center blog post by Lindsey Copeland

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

In my opinion, this MedicareRights.org’s "Dear Marci” internet post had a very good explanation regarding what Original Medicare covers for skilled therapy. So I thought I’d share their web link below.

Note: If you have a "Medicare Advantage" plan, your coverage and costs are specific to your own plan and can vary from one Medicare Advantage plan to another. Medicare Advantage plan coverages and costs are generally not the same as Original Medicare alone. 

Previously there was a maximum limit on how much was covered for skilled therapy under Original Medicare. However, did you know that starting in 2018 the therapy cap (maximum allowed to be paid) was removed? Starting in 2018, although once your therapy costs reach a certain amount, Medicare will require your provider to confirm that your therapy is medically necessary.

Click on web link below to read the entire MedicareRights.org internet post.

https://mailchi.mp/medicarerights.org/should-i-change-my-medicare-health-or-drug-plan-this-fall-288137?e=440756ac79

1. Source: Dear Marci - Medicare Rights Center

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Contact me as an independent agent and I can help you understand your choices and assist you choosing a plan.

Note: It doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have the benefit of personalized service by a local agent to help answer your questions. 
If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

PS: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you understand your options, let you choose a plan that you feel fits your needs the best, and then enroll you in the plan you choose.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

With that said above, if you still would like to research on your own first and also read a couple of informative AARP articles, click on the web links below. These articles are regarding "how to choose a Medicare plan" and if you plan on enrolling in a Medicare Supplement, "how to choose the right Medicare Supplement plan," (Also known as Medigap plans).

How To Choose A Medicare Plan

How To Choose The Right Medicare Supplement Plan

This web page has been intentionally deleted!

A recent blog post dated Dec. 5, 2016 on the Center on Budget Policy Priorities by Paul N. Van de Water (Senior Fellow Director, Policy Futures) addressed a common false myth about the financial footing of Medicare and that it was going bankrupt. However he wrote that Medicare is not running out of money.

The Center on Budget Policy Priorities writes: 
"Medicare’s Hospital Insurance (HI) trust fund will remain solvent - that is, able to pay 100 percent of the costs of the hospital insurance coverage it provides - through 2028, the program’s trustees wrote in their latest report. Even after 2028, when the HI trust fund is projected for depletion, incoming payroll taxes and other revenue will still cover 87 percent of Medicare hospital insurance costs. 

Policymakers will need to close this shortfall by raising revenues, slowing the growth in costs, or most likely both, as they’ve done many times before.  But Medicare’s hospital insurance program will not run out of all financial resources and cease to operate after 2028, as 'bankruptcy' suggests.

The 2028 date doesn’t apply to Medicare coverage for physician and outpatient costs or to the Medicare prescription drug benefit, neither of which faces insolvency. They’re financed through the program’s Supplementary Medical Insurance (SMI) trust fund, which consists of two separate accounts - one for Medicare Part B, which pays for physician and other outpatient health services, and one for Part D, which pays for outpatient prescription drugs. Premiums for Part B and Part D are set each year at levels that cover about 25 percent of costs; general revenues pay the remaining 75 percent. Therefore, SMI can’t run short of funds.”¹

To read the entire blog post from Center on Budget Policy Priorities (CBPP) click on the web link below:

http://www.cbpp.org/blog/to-repeat-medicare-isnt-going-bankrupt

1. Source: http://www.cbpp.org/blog/to-repeat-medicare-isnt-going-bankrupt
Paul N. Van de Water (Senior Fellow Director, Policy Futures) Dec. 5, 2016

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

I read an informative AARP Bulletin article by Patricia Barry and I thought I’d share the top 10 Medicare mistakes they mentioned to be aware of:

1. Assuming you don't qualify if you haven't worked long enough
2. Failing to enroll in Part B when you should
3. Believing you don't need Medicare Part B if you have retiree or COBRA health coverage
4. Thinking you must reach full retirement age before signing up
5. Not signing up for Part D because you don't take any prescription drugs
6. Misunderstanding enrollment periods
7. Picking a Part D drug plan on the basis of its premium or its name or because your best friend chose it
8. Being too late to buy medigap with full protections
9. Failing to read your Annual Notice of Change
10. Not realizing that you may qualify for help to lower your costs

However for more information on each of the bullet points above, read the entire article by clicking the web link below:

http://www.aarp.org/health/health-insurance/info-2014/medicare-mistakes-to-avoid.html

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Click on link below for another related blog post:

Medicare Enrollment Mistakes Can Be Costly

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

"Observation Status" is a designation used by hospitals to bill Medicare.¹

People who receive care in hospitals, even overnight and for several days, may learn they have not actually been admitted as inpatients. Instead, the hospital has classified them as Observation Status, which is an “outpatient" category.¹

Since March 8, 2017, hospitals have been required to give patients the Medicare Outpatient Observation Notice (MOON) within 36 hours if the patients are receiving "observation services as an outpatient" for 24 hours. Hospitals must also orally explain observation status and its financial consequences for patients. The MOON cannot be appealed to Medicare.¹

Outpatient Observation Status is paid by Medicare Part B. When hospital patients are classified as outpatients on Observation Status, they may be charged for services that Medicare would have paid if they were properly admitted as inpatients.¹

Most significantly, patients enrolled in Original Medicare will not be able to obtain any Medicare coverage if they need nursing home care after their hospital stay. Medicare only covers nursing home care for patients who have a 3-day inpatient hospital stay - Observation Status doesn’t count towards the 3-day stay.¹ (A Medicare Supplement would also not cover the cost.)

Most Medicare Advantage Plans now include a specific Observation Status benefit co-payment. However, be sure to check your specific Medicare Advantage plan for details. Also, a three day prior inpatient hospitalization does not apply to Medicare Advantage plan members, however, referrals and plan authorizations would be required for admittance to a Skilled Nursing facility.

To read more click on the web link below:

https://medicareadvocacy.org/medicare-info/observation-status/

1. Source: Center for Medicare Advocacy https://medicareadvocacy.org/medicare-info/observation-status/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

When to enroll in Part D:

When you become eligible for Medicare, you may sign up for Part D (Prescription drug coverage part of Medicare), as soon as you are enrolled in either Medicare Part A or Part B. Although you do not necessarily have to sign up for Part D if you choose not to, but you may face a late enrollment penalty if you do not sign up when you are first eligible. However, if you have creditable coverage, you can delay signing up for Part D and will not have to pay a late enrollment penalty.

Keep in mind some, but not all, Medicare Advantage plans include Part D combined in with their benefits. With most Medicare Advantage plans you cannot have both a Medicare Advantage plan and a separate stand alone Part D plan. 

You would only choose to enroll in a stand alone Part D plan if you decided to go with original Medicare and a Medicare Supplement plan OR just original Medicare alone.

What is creditable coverage?

It is coverage that on average is as good as or better than the Medicare drug benefit offered through Part D. You should receive notice from your plan or employer every year informing you whether your drug coverage is creditable for Part D. If you do not receive this notice, you should contact your plan or employer’s benefits administrator. 

Creditable coverage can be from:

• Current employer coverage from you or your spouse
• Former employer coverage from you or your spouse, such as retiree insurance
• Federal Employee Health Benefits
• Military coverage, such as TRICARE for Life (TFL) or Veterans’ Affairs (VA) benefits

Note: If you currently have creditable coverage that you like, you may want to keep it. since if you join a Medicare prescription drug plan, you may lose your creditable drug coverage and be unable to get it back later. Ask your employer or benefits administrator what will happen to your other drug coverage if you join a Part D plan.

For more information on Part D click on the web link below.

https://www.medicare.gov/part-d/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Where do I call or visit to enroll in Medicare or just ask questions:

You can visit your local Social Security Office or you can call the National Social Security Hotline at 800-772-1213. The locations of Social Security Offices can be found by clicking this web link www.ssa.gov. 

Questions to ask when enrolling into Medicare:

Keep in mind Medicare coverage is divided into parts. (See related web links below.)

1. When will my Medicare coverage begin?
2. What will I be paying for Medicare coverage?
3. How will I pay for my Part B premium?
4. How will Medicare work with any other health coverage I have?

Questions to ask when you have another type of insurance coverage:

Note: Only people covered by large group health plans from current employers can delay Medicare Part B enrollment without paying a late enrollment penalty.
Examples: 
a) If you are 65 or over and have a large group health plan that your (or your spouse’s) employer employs 20 or more employees. 
b) If you have Medicare due to a disability and have a large group health plan that your (or your spouse’s) employer employs 100 or more employees.

1. Will my current insurance coverage allow me to delay Medicare enrollment?
2. When should I enroll into Medicare if I am delaying now?
3. How will delaying enrollment now affect when I can enroll into Medicare in the future?
4. How will delaying enrollment now affect my Medicare premium later?
5. What information and documents will I need to provide to Social Security when I do enroll into Medicare?

Note: if you visit a Social Security Office, ask for a receipt that reflects the your visit. If you call Social Security, ask the representative to send you a record of your call. Always, write down the representative’s name, the date, the time of day and what the representative said.

Click On Related Web Links:

• Explanation of Part A, Part B, Part C, and Part D
• Medicare Part A & Part B - Do I have to sign up or does that happen automatically?
• Medicare Part B Initial Enrollment Information.
• When Do I Need To Do To Enroll?

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

It all comes down to a personal decision on what you feel fits your needs the best. There isn’t one magical plan that fits everybody’s needs the best!

Some important questions and items you should ask or review with an *independent" agent before switching plans are listed below. 

*I added the word “independent” since independent agents can offer multiple insurance companies giving you more flexibility and choices than just a captive agent that only works for one insurance company.

• Star Ratings for Medicare Advantage Plans and Prescription Drug Plans.
  (Provided each year by Medicare. Keep in mind that they can change from year to year. The star ratings can be found at Medicare.gov. If you cannot go online, each Medicare insurance plan enrollment guide booklet should also include the updated upcoming year’s Medicare star ratings for that specific plan.)
• Carefully review the "Benefits at a Glance” and/or the more comprehensive “Summary Of Benefits.” 
  In my opinion, some of the important (but not limited to) items to focus on and that should be considered before making a decision on which plan you choose are:
  
  • What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
    
  • Annual Out-Of-Pocket Maximum (That is the most you will pay in a year for Medical care provided by the plan. Note: This Annual Out-Of-Pocket Maximum amount does NOT include a maximum amount for prescription drugs, even if prescription drugs happen to be included in your plan.)
  • Copays for primary care physicians and also copay amounts for specialists.
  • Inpatient hospital care per day cost and how many days you have to pay.
  • Outpatient surgery cost (Find out if that outpatient surgery amount you are responsible for is just a plan flat copay amount or a percentage of the total amount?)
  • Emergency Care costs
  • Diagnostic radiology services and diagnostic tests/procedures costs
  • Ambulance
  • Prescription Drugs - Find out if your specific drugs are included in the formulary (complete drug list) of the plan you choose. (Note: Each specific plan can have a different formulary, even if they are with the same insurance carrier.) Then find out the Tier level and/or cost of each of your drugs, plus what the annual drug deductible will be (if any). Also find out which Pharmacies are in the network and also which are considered preferred Pharmacies for that plan - allowing you to get the least expensive prices.
  • If the Medicare insurance plan you choose has a network. Find out in advance if each of your specific doctors, hospitals, and other providers are in network for that specific Medicare insurance plan.
  • If a fitness program is important to you, find out if a basic gym membership is included in your Medicare insurance plan at no additional cost.
  • Find out what additional benefits, such as dental, vision, hearing, or even if there may be an allowance for "Over The Counter Drugs” is included with the plan you are considering.
    
  • Find out in advance if you can travel and still be covered for non-emergency visits to the doctor, etc. with that specific plan. (Note: Almost all the Medicare insurance plans do cover you if it is a true emergency!)
  • Plus there are many other items to compare, so determine what is important to your specific needs before making a decision!

Click on web link below for related blog post:

Medicare Insurance Plan Choices for this Upcoming Annual Enrollment Period

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

• If you want to enroll in a Medicare insurance plan (such as a Medicare Supplement or a Medicare Advantage Plan), then the first step is to be enrolled in both Part A and Part B through the Social Security office. 
  
  
• If you do not already receive Social Security benefits when you turn 65, you must to apply for Medicare yourself. You can make an appointment at your local Social Security office to enroll or you can even enroll directly online at https://secure.ssa.gov/iClaim/rib . 
  However if you already receive Social Security benefits when you turn 65, the federal government will automatically enroll you in Medicare. You should not need to sign up for Medicare and your Medicare will start on the first of the month that you turn 65. Click this link to read related blog post. 
  
  To avoid penalties, you must enroll during your Initial Enrollment Period. Your Initial Enrollment Period includes the three months before your 65th birthday, the month of your 65th birthday, and the three months following your 65th birthday. If you enroll in Medicare during this seven month period, you can avoid late enrollment penalties and gaps in health insurance coverage.
  
  The Part B premium will be automatically deducted from your Social Security check. However, if for some reason you choose that you don’t want Part B you can contact the Social Security office and opt out of it. (Keep in mind there will be penalties later on if you decide you want to enroll in Part B later on in life and you didn’t enroll when you were first eligible.)
  
  
• Once you are eligible, you can then pick the Medicare insurance plan and insurance company that you personally feel will best accommodate your needs. There are a variety ways of choosing Medicare Insurance plans, but it can be quite confusing and overwhelming doing all the research yourself. That is the time where you may want to choose an independent agent that carries multiple carriers to assist you. (Please Note: Independent agents are paid directly by the insurance company if you enroll through the agent. Commissions and fees are NOT paid to the agents by the clients’ themselves. Also keep in mind that independent Medicare insurance agents do not work directly for the Federal government.)
  
  
• Gist: So if you enroll online or by phone directly with the insurance company, it will still cost you the same as enrolling with an independent agent, but without the benefit of a local independent agent explaining things in depth to you personally. Also by enrolling directly with an independent agent such as myself, you will get the benefit of a local person explaining Medicare to you in person on a one-on-one basis in your home, office, or other location, as well as explaining different Medicare insurance plans from different insurance companies, answering all your questions, and then also being here locally if you have questions, etc. after you are enrolled. With all the extra benefits of using a local independent agent to enroll you in a Medicare insurance plan at no additional cost to you, it is really a no-brainer to enroll through an independent agent. Call me at 941-404-5334, if I can assist you.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

You need to enroll in Medicare on time or you could face penalties. The appropriate steps you need to take to enroll in Medicare on time will differ depending upon whether or not you already collect Social Security retirement benefits when you turn 65 or not. 

If you already receive Social Security benefits when you turn 65, the federal government will automatically enroll you in Medicare. You should not need to sign up for Medicare and your Medicare will start on the first of the month that you turn 65. 

However on the other hand, if you do not already receive Social Security benefits when you turn 65, you must to apply for Medicare yourself. To avoid penalties, you must enroll during your Initial Enrollment Period. Your Initial Enrollment Period includes the three months before your 65th birthday, the month of your 65th birthday, and the three months following your 65th birthday. If you enroll in Medicare during this seven month period, you can avoid late enrollment penalties and gaps in health insurance coverage.

The date your Medicare coverage begins depends on when you enroll during your Initial Enrollment Period. For your coverage to begin as soon as possible, it is best to enroll in the first three months of your Initial Enrollment Period (that is the three months before the month you turn 65). Your Medicare coverage will then go into effect starting the first day of the month you turn 65. If you enroll during the month you turn 65, your Medicare coverage will go into effect the following month. If you enroll during the fifth month of your Initial Enrollment Period, your Medicare coverage begins two months after you enroll. If you enroll during the sixth or seventh month of your Initial Enrollment Period, your coverage begins three months after you enroll.

To enroll in Medicare, you can call the Social Security Administration at (800) 772-1213, or you can enroll online, or you can visit your local Social Security office.

When you enroll in Medicare (either actively during your Initial Enrollment Period or automatically), you receive Medicare Parts A and B. Most people do not pay a premium for Part A, but almost all people owe a premium for Part B. That Part B premium can be deducted directly from your Social Security benefits if you already receive them.

Click link below to read more about enrolling in another related blog post:

Medicare: When To Enroll

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Did you have employer insurance through a current job or your spouse’s job at the time you became eligible for Medicare?

If yes:

You may be eligible for a "Special Enrollment Period," which means you can enroll in Medicare without penalty at any time while you have group health coverage and also for 8 months after you lose your group health coverage or you (or your spouse) stop working, whichever comes first. 

If no:

You can apply for Medicare during the General Enrollment Period, between January 1 and March 31 of each year. Your coverage will start the following July and you will have to pay a Part B premium penalty. 

Note: It is best to contact the Social Security office find out information for your specific situation.

Social Security (800-772-1213)
www.ssa.gov/pgm/reach.htm

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Many American’s are totally confused when becoming eligible for Medicare on what their options are and then which plans to choose from. All the TV ads, newspaper ads, and even the abundance of US Mail you receive still doesn’t clarify the subject and sometimes even adds to the confusion. Additionally many folks already on Medicare still really don’t know what type plan they have or their options to change plans.

A “Medigap” policy is basically just another name for a "Medicare Supplement” policy.

A Medicare Supplement (Medigap) policy is a standardized supplemental health plan that pays for part or all of Medicare related health care costs that you would otherwise pay out of pocket if you just had Original Medicare. Medicare Supplement policies only work with Original Medicare Parts A and B, which is Medicare coverage through the federal government. So need to have Part A & Part B first if you want to enroll in a Medicare Supplement policy.
Note: If you plan to get your Medicare benefits through a private insurance company, called a Medicare Advantage Plan (also known as Medicare Part C), then you cannot additionally purchase a Medicare Supplement policy. To be very clear, you cannot legally have both type policies at the same time.

Medicare Supplement policies “supplement" Original Medicare costs. Those type of out of pocket costs can include deductibles, coinsurance charges, and copays). Medicare Supplement policies do not usually pay for items not covered directly by Medicare. However, some Medicare Supplement policies do cover some emergency care received in foreign countries, which is typically not covered by Medicare.  

Medicare Supplement policies are regulated by each state, usually under a department of insurance or a similar state agency. This means that some aspects of Medicare Supplement policies work differently in each state. Medicare Supplement policies are still subject to some federal regulations, but different states may have their own Medicare Supplement rules as well.

There are different types of Medicare Supplement policies that you can purchase. Private insurance companies can offer ten standardized Medicare Supplement policies in most states: Plans A, B, C, D, F, G, K, L, M, and N. Note that insurance companies do not have to offer all ten Medigap policies. 

Important Note: Plans with the same letter offer the same benefits, but each insurance company may charge a different monthly premium. Meaning that you can get the same exact coverage even if you choose the exact same letter plan with a lower monthly premium from a different insurance company. So it is best to shop around to get the lowest premium with an insurance company that is reputable and pays their claims on time. Also it is important to review the history of the past years increases for any company you are considering enrolling with. Some Medicare Supplement insurance companies have had very minimal increases while others may have had large annual increases. So although the past doesn’t always predict the future, it is a good guide to help you decide.

Related Topics:

Click web links below to read:

Medicare - Medicare Advantage Plans Are Not The Same As Medicare Supplement Plans

Medicare - What Is The Difference Between Medicare Supplement And Medicare Advantage Plans

I am an independent insurance agent, certified to handle multiple Medicare insurance companies, allowing me to help you find the Medicare insurance you feel fits your needs. I pride myself in providing excellent customer service to my clients. I will be attentive to your needs and strive to meet or even exceed your expectations for your Medicare insurance needs.

So if you are confused and/or want more information about which Medicare insurance plan to enroll in, either as a new plan or even if you are just switching to a different Medicare Insurance plan, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

ANOC is an abbreviation for Annual Notice Of Change.

The Annual Notice of Change (ANOC) may be considered the most important mailing you'll receive from your Medicare plan each year, and you should definitely read it.

If you are currently enrolled in a Medicare Advantage Plan or a stand-alone Part D prescription drug plan, then you should receive a plan "Annual Notice of Change" (ANOC) and/or *Evidence of Coverage (EOC) from your plan each fall no later than September 30. If you do not receive an ANOC from your plan by the first week of October you should call your plan’s member service phone number on the back of your member ID card.

The ANOC notices include a summary of any changes to your plan’s list of covered drugs (known as a formulary), copays, coinsurance, deductibles, other health benefits, and premium costs that will be effective January 1st of the next year. It is important for you to read your mail from your plan to see if there are any changes that may affect you. The fact is that almost every plan makes some changes for the new year, so the costs and benefits in place on December 31 may well be dramatically different on January 1. Review any changes to decide whether the plan will continue to meet your needs in the next year.

*Evidence of Coverage is a more comprehensive list of the plan’s cost and benefits for the upcoming year.

Note: If you feel your current plan will not meet your needs for the upcoming year, feel free to call me at 941-404-5334 to set up an appointment where we can review some different plans together that you feel may fit your needs better.

All this Medicare information can be overwhelming and confusing to many people. As an independent licensed agent I can explain all this to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a different plan that you feel may fit your needs better.

By the way, it doesn’t cost you any more if you enroll through me as an independent agent versus directly with an insurance company either over the phone or via the Internet since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Each Medicare Insurance Plan type covers different things, and even the same type plan in a different area may cover different things and/or at different out of pocket expenses. It is important to have your insurance agent that enrolls you in a plan explain what your Medicare Insurance Plan covers, and also make sure that all your doctors and prescriptions are covered under your Medicare Insurance plan you choose “before" signing up.

If you are confused after you already have enrolled in a Medicare Advantage plan you should call the member services toll free phone number on the back of your member ID card and ask the phone representative your questions. They should be able to tell you if your doctor is in network, if your prescriptions are covered, if a medical procedure is covered, as well as the amount your copays, coinsurances, or deductibles, if applicable for your procedures. Also they can look up what Pharmacy is in network and which Preferred Pharmacies will save you the most on your specific drugs.

For those with a Medicare Supplement, most plans will allow you to go to any doctor in the U.S. that takes Medicare. However there are some select Medicare Supplements plans that require you to use in network “hospitals." You can also call the member services toll free phone number on the back of your member ID card if you have any questions on your Medicare Supplement Plan. Keep in mind that you will need to have a separate Prescription Drug Plan if you want your prescription drugs covered, since none of the newer Medicare Supplement plans include prescription drug coverage.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

There are many factors that determine whether Medicare is primary (pays first) or secondary (pays second) and it will depend on your specific situation.

If you have Medicare and other health insurance or coverage, each type of coverage is called a "payer." When there's more than one payer, "coordination of benefits" rules decide which one pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" to pay. In some cases, there may also be a third payer.

Medicare can either be primary or secondary to your employer coverage. This coverage usually depends on the size of the employer and whether or not you or your spouse are currently working.

Primary insurance pays first for health care claims. Secondary insurance pays after the primary insurance for some or all of what the primary insurance did not cover. Knowing which is your primary insurance is important to understand because secondary insurance often refuses to pay anything if the primary insurance has not paid first.

You should consult with to your employer to find out how your employer insurance will work with Medicare.

Generally if you are 65 or over and still have insurance through your (or your spouse’s) current employer that has 20 or more employees, then your employer coverage is primary. However with that said, if you have insurance coverage through your (or your spouse’s) current employer that has fewer than 20 employees, then Medicare is primary.

For other situations, please click on the web link below

How Medicare coordinates with other coverage

https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/how-medicare-works-with-other-insurance.html

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Many, but not all, Medicare Advantage plans include prescription drugs at no additional premium. 

Medicare Advantage plans that do include Part D prescription drugs may have some caveats, with regards to member’s out of pocket costs, when it comes to getting certain types of injections at at doctor’s office. Depending on how the doctor’s office bills the shot, the member’s out of pocket expense could be a big shock to them. Some prescription drugs can be billed under different parts of Medicare (including any Medicare Advantage plan that includes prescription drug coverage.)

It is important to ask BEFORE having a shot at a physician’s office whether the shot will be billed under Part B or Part D. If billed under Part B, the member’s out of pocket expense could be 20%! Which could be a lot more expensive than the Part D Tier level out of pocket expense a member thought it was going to be for that same drug. Out of pocket costs to the member can be ambitious for different type shots/drugs. So it is important to do the research of how much your out of pocket expense will be before you have the injection at a provider’s office! I highly suggest you talk to your doctor’s office in advance of getting your Osteoporosis (or other type) shot and find out what your out of pocket costs will be.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Review

Something important to know, it can really pay to appeal a Medicare Advantage denial of coverage since chances are good the denial will be overturned if the claim is legitimate. 

When beneficiaries and providers appealed preauthorization and payment denials, Medicare Advantage Organizations (MAOs) overturned 75 percent of their own denials during 2014 to 2016 according to a report from the Office Of Inspector General (OIG).¹ 

During the same period, independent reviewers at higher levels of the appeals process overturned additional denials in favor of beneficiaries and providers.¹

Beneficiaries and providers rarely used the appeals process, which is designed to ensure access to care and payment. During 2014 to 2016, beneficiaries and providers appealed only 1 percent of denials to the first level of appeal.¹

When Medicare Advantage beneficiaries and providers appealed, they were usually successful in getting denials overturned!¹

So bottom line: If you feel you have had a legitimate Medicare Advantage claim denied, file an appeal! You should be able to contact your Medicare Advantage customer service via the phone number on the back of your member card to find out the process to appeal for your specific plan and company.

1. Source: Report in Brief U.S. Department of Health and Human Services, September 2018 OEI-09-16-00410 (Office of Inspector General)

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

About two-thirds of all hospitals and health systems intend to increase their investments in Ambulatory Surgery Centers (ASCs), according to the third annual national survey of senior executives and clinical leaders at health systems and hospitals. The survey results highlight the growing importance of ASCs to hospitals, which is further magnified by the increasing and ongoing shift of elective cases in the COVID-19 era.¹

"ASCs continue to be the model for providing high-quality, low-cost surgical care, and many hospitals are converting their outpatient departments or migrating cases to ASCs," said Joan Dentler, president and CEO of Avanza. "This was true before the pandemic reinforced the business case for every hospital having at least one freestanding ASC in its portfolio.”¹

Click below web link to read the entire article:

http://savannahceo.com/news/2020/10/majority-hospitals-increasing-investments-surgery-centers/

1. Source: http://savannahceo.com/news/2020/10/majority-hospitals-increasing-investments-surgery-centers/

So why is this important and how does it relate to many Medicare Advantage plans?

Many MAPD plans (Medicare Advantage with Prescription Drug coverage included) have a significantly higher copayment for services received at a hospital owned Ambulatory Surgery Center versus a non-hospital affiliated stand alone Ambulatory Surgery Center, even if both are in-network. A lot of these new Hospital Owned Ambulatory Surgery Centers are not physically located in a hospital setting. Therefore Medicare Advantage plan members may get confused and incorrectly believe that they are only responsible for the lower copay of a non-hospital affiliated stand alone Ambulatory Surgery Center benefit. So it is important to ask in advance if the Ambulatory Surgery Center you plan to go to is a non-hospital affiliated stand alone Ambulatory Surgery Center or you may be responsible for paying a more expensive copay than you thought.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

As I mentioned at the start of some of my other blog posts:

No one type of Medicare Insurance plan fits everybody the same. What may work best for one person, may not work very well for another person. It is a personal choice for you to decide, but it is important to get all the facts first before making a decision. It is equally important to review the Summary of Benefits before picking a specific Medicare insurance plan.

With that said, there will always be conflicting view points on which type of Medicare Insurance plan is better than another type.

For example, I recently read an EBRI article, by Jake Spiegel and Paul Frontin, on which type Medicare insurance plan may have the least amount of savings needed for the average person over the long run, due to their analysis of their simulation model. 

Click on web link below to read that entire article.

https://www.ebri.org/health/publications/issue-briefs/content/projected-savings-medicare-beneficiaries-need-for-health-expenses-increased-again-in-2023

One example was for a 65 year old man enrolled in a Medicare Supplement (Medigap) plan with average premium would need to save $106,000 in order to have a 50% chance of having enough to cover premiums and median prescription drug expenditures, and a woman would will need to have saved $128,000.¹

"To have a 90 percent chance of meeting their health care spending needs in retirement, a man will need to have saved $184,000, and a woman will need to have saved $217,000. Couples enrolled in a Medigap plan with average premiums, meanwhile, will need to have saved $234,000 to have a 50 percent chance of covering their medical expenditures in retirement and $351,000 to have a 90 percent chance.”¹

"Representing an extreme case, a couple with particularly high prescription drug expenditures will need to have saved $413,000 to have a 90 percent chance of having enough money to cover their health care costs in retirement.”¹ 

"Although there is significant individual-level variation, enrollees in Medicare Advantage plans generally have lower savings targets. A man enrolled in Medicare Advantage who has median drug expenditures and is an average user of health care services will need to have saved $57,000 to have a 50 percent chance of meeting his health care spending requirements in retirement, and he would need $99,000 to have a 90 percent chance. Meanwhile, a woman will need to have saved $69,000 to have a 50 percent chance and $116,000 to have a 90 percent chance of having enough to cover her health care costs in retirement. Couples will need to have saved $127,000 to have a 50 percent chance and $189,000 to have a 90 percent chance of covering their health care expenditures in retirement. Of course, there are other factors to consider when it comes to choosing a Medicare Advantage plan over traditional Medicare. Medicare Advantage plans often have limited networks or may require approval before certain medications or services are covered.”¹

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A totally different Barron’s article by Elizabeth O’Brien entitled "Medicare Advantage Is Under Fire. What It Means for your Health-and Wallet” has a completely different view point and conclusion.² 

Click on web link below to read that entire article.

https://www.msn.com/en-us/money/insurance/medicare-advantage-is-under-fire-what-it-means-for-your-health-and-wallet/ar-BB1kcnYG

1. Source: https://www.ebri.org/health/publications/issue-briefs/content/projected-savings-medicare-beneficiaries-need-for-health-expenses-increased-again-in-2023

2. Source: https://www.msn.com/en-us/money/insurance/medicare-advantage-is-under-fire-what-it-means-for-your-health-and-wallet/ar-BB1kcnYG

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

No one type of Medicare Insurance plan fits everybody the same. What may work best for one person, may not work very well for another person. It is a personal choice for you to decide, but it is important to get all the facts first before making a decision. However it is also important to pick the correct plan that fits your needs, since not all Medicare Advantage plans have the same benefits. It is important to review the Summary of Benefits before picking a specific plan.

If you currently have health insurance, you probably already have some similarities of a Medicare Advantage plan, such as a PPO or HMO plan. There are some major differences as well.

Medicare Advantage plans are administered through private insurance companies and not through the government like Original Medicare is.

I’ll start with some of the Pro’s of a Medicare Advantage plan and then list some of the Con’s.

Pro’s

• Many Medicare Advantage plans have a $0 monthly premium!
• Many Medicare Advantage plans do not have a Medical deductible!
  
• Many Medicare Advantage plans include drug coverage in the same plan with no additional monthly premium.
• Medicare Advantage plans have to give you at least the same (or more) Part A and Part B benefits than what Original Medicare allows you for Part A or Part B benefits.
• Medicare Advantage plans may include additional benefits that Original Medicare and/or Medical Supplements may not, such as:
  • Dental Benefits
  • Vision Benefits
  • Hearing Benefits
  • Fitness Memberships At Gyms
  • Nurse Helplines (Available 24 hours a day & 365 days a year)
  • Heath Screening Tests
  • Over The Counter (OTC) Benefits
• All Medicare Advantage plans have a Maximum Annual Out Of Pocket Limit
• True Emergency coverage at in-network rates within the U.S., even if out of network.
• Medicare Advantage plans cover Urgently Needed and Emergency Services Worldwide! (Original Medical generally doesn’t cover emergency services out of the U.S.) 
• Medicare Advantage PPO plans allow you the flexibility to go out of network, but you will pay more to do so. However if you stay in-network, generally you will have lower costs.
• Some plans allow you to travel in other states and still be covered in-network.
• Medicare Advantage plans generally try to keep the emphasis on heather living and preventive care.
• Medicare Advantage plans must enroll any eligible beneficiary who applies regardless of health. (Starting 2021 - Including those with ESRD!)
• Some Medicare Advantage plans may cover additional days of hospitalization vs Original Medicare.
• Some Medicare Advantage plans may cover skilled nursing and rehabilitative services without a prior 3 day inpatient Hospital stay. 

Con’s

• Most Medicare Advantage plans have a network of doctors.
  Note: HMO’s require you to use a provider in-network or you are NOT covered. (With the exception of a true emergency. All Medicare Advantage plans cover true emergencies, even if out of network.)
  However, PPO plans have more flexibility allowing you to go out of network, but you will pay more if you do.
• Your favorite doctors possibly may not be in-network. That is why it is important to make a list of your doctors and have your agent look all of them up in the specific plan you choose before enrolling. That way you shouldn’t have unpleasant surprises later in the year.
• You need to be living in a Medicare Advantage plan service area in order to enroll in a specific Medicare Advantage plan. If you move out of that service area later, you will be required to change plans.
• Most Medicare Advantage plans have copays, co-insurance, and possibly deductibles. So you kind of pay as you go.
• Some covered items may need preauthorizations. 
• Generally, unless you have a special circumstance that qualifies you for a Special Election Period (SEP) you may be locked into your the Medicare Advantage plan you chose for up to one year until the next Annual Election Period (AEP).
• Note: Not necessarily a con, but just like with a Medicare Supplement plan, you are required to be enrolled in Part A and Part B in order to be enrolled (and stay enrolled) in a Medicare Advantage plan. So you will still need to continue to pay Part B premiums to the government.
• Note: Not necessarily a con, but just like with a stand alone Part D plans, Medicare Advantage plans that include drugs have a formulary. (A formulary is a list of drugs covered under that specific plan.) If your drugs are not included in their formulary for the plan you choose, they won’t be covered. So it is important for you or your agent to check in advance to make sure all your drugs are covered and estimate how much each will cost.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Let's start with the basics:

There are four Medicare “Parts.”

• Part A (Gives you help with hospital costs)
• Part B (Gives you help with doctor’s care and outpatient care) 
• Part C (Medicare Advantage Plans)
• Part D (Prescription Drug Plans)

Side Note: Letters are also used for different types of Medicare Supplement Plans, so don’t get the “Part" letters and “Plan" letters confused! They are for totally different things!

Part A: Hospital Insurance
(Includes skilled nursing facilities or hospice, and some home health care.)

For more details on Part A, click on this link

Part B: Medical Insurance
(Includes doctor services, outpatient care, durable medical equipment and some preventive services.) 

For more details on Part B, click on this link

Part C: Medicare Advantage

Medicare Advantage plans are offered by private insurance companies as an alternative to Original Medicare; plans are government subsidized and regulated. A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. 

If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most Medicare Advantage plans (but not all) include Medicare prescription drug coverage (Part D).

For more details on Medicare Advantage plans, click on this link 

To learn more about costs for Medicare Advantage Plans, click on this link (Then look half way down the page under Part C)

Part D: Prescription Drug Coverage

Part D Plans are offered by private companies to provide coverage for prescription drug costs; plans are government subsidized and regulated.

For more details on Part D, click on this link

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Medicare Supplement Plans

A Medicare supplement (Medigap) insurance policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

For more details on Medicare Supplements (Medigap) click here.

Source: Medicare.gov

These are some of the Medicare Supplement Benefit Plan Letters that may possibly be available. Plans A, B, C, (High Deductible Plan C), D, F, (High Deductible F), G, K, L, M, N. However, not all plans may be available in your state and not all plans are offered by every insurance company.

Related Blog Posts:

1. Medicare Questions - Plans, Parts, & More
2. Medicare - When To Enroll
3. Medicare – What Do I Need To Do To Enroll?
4. Medicare - Questions To Ask When Enrolling
5. Medicare - Part A & Part B - Do I Have To Sign Up Or Does That Happen Automatically?
6. Medicare Part D - When To Enroll & More

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Are you a senior on Medicare or about to be on Medicare and confused about this new Obamacare's (Affordable Care Act) Health Exchanges and how it will affect you? If so, this USA Today article by Susan Jaffe from Kaiser Health News is for you! 

It states that Medicare is taking steps to help seniors understand that their benefits won't be affected by the Affordable Care Act's Health Insurance Marketplace. "We want to reassure Medicare beneficiaries that they are already covered, their benefits are not changing and the marketplace doesn't require them to do anything," said Michele Patrick, Medicare's deputy director for communications. To read more, click on the web link below.

http://www.usatoday.com/story/money/business/2013/08/24/medicare-health-insurance-marketplace/2692977/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

I read an Associated Press article by Ricardo Alonso-Zaldivar regarding the possibility of a cut in 2022 Part B premiums and thought I’d share. However, it is NOT a done deal yet, so don’t get too excited quite yet! Time will tell if this decrease in Part B premiums turns into a reality.

Excerpts:

"WASHINGTON (AP) — Medicare said Thursday it’s considering a cut in enrollee premiums, after officials stuck with an earlier decision to sharply limit coverage for a pricey new Alzheimer’s drug projected to drive up program costs."¹

"The agency “is looking at that, and is still going through the process,” spokeswoman Beth Lynk said of a potential reduction in premiums….”¹

"The projected cost of Aduhelm was a major driver behind a $22 increase in Medicare’s Part B premium this year, boosting it to $170.10 a month.”¹

"Doctors have been hesitant to prescribe it, given weak evidence that the drug slows the progression of Alzheimer’s. Insurers have blocked or restricted coverage over the drug’s high price tag and uncertain benefit.”¹

"Officials said that if it or any other similar drug in its class were to receive what’s called “traditional” FDA approval, then Medicare would open up broader coverage for patients. Such approval is granted when a medication shows a clear clinical benefit.”¹ 

To read the entire Associated Press article by Ricardo Alonso-Zaldivar, click on the web link below:

https://apnews.com/article/business-health-lifestyle-clinical-trials-medication-e261886b344ed61af3606c29efcd9ed5

1. Source: Associated Press article by Ricardo Alonso-Zaldivar
https://apnews.com/article/business-health-lifestyle-clinical-trials-medication-e261886b344ed61af3606c29efcd9ed5

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

I read this informative Medicare Rights Center blog post by Julie Carter (dated 10-26-17) and thought I’d share it.

Pasted below is an excerpt:

"Currently, the HHS Secretary is not allowed to negotiate drug prices in the Medicare program, though drug prices are negotiated in the Medicaid program as well as in the U.S. Department of Veterans Affairs.”¹

Can you believe that in this day and age that Medicare Drug Costs (with all the volume and clout of the U.S. government) are still not allowed to be negotiated, even though other departments of the U.S. government such as, Medicaid and the VA, are allowed to negotiate prices? No wonder the prescription drugs costs have skyrocketed for Medicare prescription drugs over the last several years!

Click on link below to read entire article.

The Medicare Drug Price Negotiation Act Would Lower Costs and Preserve Care

1. Source: https://blog.medicarerights.org/medicare-drug-price-negotiation-act-lower-costs-preserve-care/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews