Get Assistance With Your Medicare Insurance and Put Your Mind At Ease
There’s a lot to take in and learn when you become eligible for Medicare, and lots of options to choose from. We walk you through those options and guide you through the timely process of Medicare Enrollment, helping you to select the right Medicare solution for your healthcare needs, and to avoid common, and often, costly mistakes made along the way.
We offer quality Medicare Advantage and Medicare Supplement Plans, along with Medicare Part D Rx plans that provide more coverage and/or help fill in that gap between your out-of-pocket healthcare and what your original Medicare covers (see below for more info). We’ll personally help you add up all your costs (copays, premiums, etc.) so you can pick the best option for your healthcare needs and budget, while maximizing your Medicare benefits.
Medicare Insurance 101 – Learn more about Original Medicare, Medicare Supplements and when you become eligible to enroll in a Medicare plan.
Medicare & Medicare Plans
Original Medicare (Part A) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Here’s how Medicare Advantage Plans and Medicare Supplement Plans work to offset your healthcare costs:
Medicare Advantage Plans replace your Original Medicare and are designed to give you more coverage. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage, or you can purchase an additional Part D plan.
Medicare Supplement Insurance policies complement your original Medicare and will pay some, if not all, of the expenses that Part A and B do not cover.
Medicare Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans.
Signing up for Medicare
To sign up for Medicare Parts A & B, most will have a 7 month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.
Once enrolled, if you wish to change or purchase Supplement Plans, you must act during the open enrollment period.
When open enrollment is closed, there are special circumstances in which one may qualify to enroll outside of the enrollment period. Listed below are the qualifying events:
- You are turning 65
- You move to a new area that is not in your current plan’s service area
- Recently moved back to the US
- You lose your current coverage (either Group or Medicaid)
- You now need a SNP (Special Needs Plan) or you no longer need a SNP
Additional Information About Medicare
Frequently Asked Questions
No, Medicare is not automatic unless you are receiving Social Security benefits.
Your initial enrollment period starts 3 months before your 65th birthday, and includes your birthday month, and ends 3 months after your 65th birthday.
You can apply online or call your local Social Security office. You’ll enroll, create your Medicare account, track your Medicare information such as bills, claims, health information and more, as well as print your Medicare card.
To enroll, you will be required to provide proof of your eligibility. Some acceptable documents are birth certificate, proof citizenship if not born in the US, W-2 or tax forms, and or military records.
Know your needs. Make a list of your healthcare costs and needs, including regular health maintenance visits, specialists you see, prescription drug costs and any procedures you know you will need.
Check your providers. Do your current healthcare providers accept Medicare? While most do, some doctors opt out of Medicare and are not required to follow Medicare rules, which could cost you.
Ask for help. We’ll do the hard work for you, helping you to add up all your costs (copays, premiums, etc.) so you can pick the best option. Our guidance is provided at no cost and no obligation!
When you are eligible for Medicare, signing up right away helps you to avoid premium surcharges, however, if you have “credible” coverage through an employer you may not have to.
Does your employer have less than 20 employees? If so, you still will need to enroll in Medicare Parts A & B which will serve as your primary insurance, with your employer coverage as secondary. If you fail to enroll, your employer plan may not pay your medical claims.
Are you on COBRA? If so, you will need to enroll in Medicare to avoid premium surcharges.
If you are not on COBRA, and your employer has more than 20 employees, in this instance, you can stay on your employer coverage. In order to avoid premium surcharges, you have an eight-month special enrollment period to sign up for Medicare when you leave your job, or if your employer stops offering coverage. It will start the month after you separate from your employer, or the month after your group health coverage ends – whichever happens sooner.
Most people get Part A for free, which is Hospital Coverage. Most people will pay a standard Part B premium for Medical coverage which varies depending on income. Additionally, you will pay a separate premium for Part D, prescription drug coverage. See our page on Medicare Premiums for more info.
Original Medicare does not. There are copays, coinsurance, and deductibles. You may get more of your costs covered with an Advantage Plan, which may or may not have additional benefits such as vision, dental and hearing. OR, you can purchase a separate Medigap policy to fill in the gaps of your Original Medicare. For more info, visit our Medicare Premiums page or view our Medicare Options Compared chart.
Both of these Medicare options are sold by private carriers. You do, however, have to be already enrolled in Original Medicare before you can buy or switch to these options.
Once enrolled, you must act during annual open enrollment if you need to switch to Medicare Advantage or change your existing Advantage plan.
For Medicare Supplements – note you have a once in a lifetime window that begins the month you become eligible for Medicare and allows you to enroll in any Medigap plan without answering health questions, meaning you won’t be denied coverage or pay higher premiums for health problems. After this window closes, if you wish to buy a Supplement plan, you can do so at any time of the year, but you’ll most likely have to go through medical underwriting.
Prescription drug coverage is Part D of Medicare and is offered by private carriers who contract with Medicare. Even if you do not take medications routinely, you should enroll in a plan as soon as you are eligible to avoid penalty surcharges. Because premiums vary greatly, you should carefully weigh your prescription costs against all variables of these plans. Selecting the wrong plan can wind up costing you thousands. Some Medicare Advantage plans may offer prescription coverage as well.
Typically, Medicare does not cover these costs unless they are related to services received in a hospital. Medicare does however cover some eye care services for diabetics, such as testing and treatment for diabetic retinopathy, or glaucoma. It also covers other eye disease, such as age-related macular degeneration (AMD).
They only way to have most of these types of services paid for by Medicare is through a Medicare Advantage plan.
Educational Videos
Medicare & You
The following videos are provided by and copyright of The Centers for Medicare and Medicaid Services (CMS) and are for informational purposes.
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Important Disclaimers:
Benefits: Any benefit information provided on our website is a brief summary, not a comprehensive description of benefits, and may contain inaccuracies. For more information contact the plan administrator or carrier directly. Limitations, copayments, and restrictions may apply, depending on the plan.
Contact Forms: By providing information via our contact forms or quote request forms, you agree that an authorized representative or licensed insurance broker of True Choice Benefits LLC may contact you by telephone, email, or mail to answer your questions or to provide additional information.
Agents: True Choice Benefits LLC is a fully licensed insurance agent/agency authorized to market health, life and Medicare Supplement insurance plans. This is a solicitation for insurance. You have no guaranteed issue or other benefits. Offerings of insurance are made by carriers/insurers based only on submitted applications. True Choice Benefits LLC is an independent insurance brokerage and is not an insurance carrier/insurer. True Choice Benefits LLC or Shelly Winson is not part of the Federal Medicare System.