The Medicare Annual Enrollment Period (October 15th – December 7th) is the time of year most Medicare beneficiaries make plan changes however, this election period is not the only opportunity to do so. Certain instances, generally connected to a life changing event, may allow for you to make a change outside the Medicare Annual Enrollment period.
1.) You are new to Medicare. If you are turning 65 or new to Medicare for another reason, you have an Initial Enrollment Period that starts three months prior to your birth month or effective date and lasts three months after that month, in which you can enroll in Original Medicare, a Medicare Advantage Plan, a Medicare Supplement plan, or a Part D Prescription Drug Plan.
2.) You move or have a change in your living situation. If you move to a new address outside of your plans service area and have new plan options available in that area, you were recently granted lawful presence status in the US, or there are other changes related to where you reside, you may be able to make a plan change.
3.) You lose or have a change in your current coverage. If you have left employer or union coverage, or other non-Medicare coverage that is as good as Medicare, you may make a plan change. Also, if you had a change in your Medicaid or Extra Help status, or any other loss or change in coverage, you may be eligible to make a change.
4.) Other special situations. If you want to join a 5-star rated Medicare plan, leave a plan rated 3-stars or lower, have dropped a Medicare Supplement to join a Medicare Advantage Plan less than 12 months ago, or have been affected by an emergency or disaster as declared by FEMA, Federal, Local, or State government, you may be eligible to make a change.
Speaking with a local independent agent is a great way to identify opportunities to make plan changes. As a licensed Independent Insurance Agent at Bolte Insurance, I represent the major health insurance companies in our area and can review your current Medicare options and provide guidance with developing an individual plan just for you. For an appointment to schedule a no cost, no obligation plan review, contact the office today at 419-732-3111.
Disclaimer: Not connected with or endorsed by any government or Federal Medicare Program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options.
Many people often inquire, “What is the best way for Medicare to meet my needs?” The truth is, “There is no one-size-fits-all answer.” How you approach your Medicare is a highly personal choice that depends on your unique circumstances and needs. What works well for a sibling or neighbor may not even be an option for you. With Medicare making headlines almost every day, it’s crucial to understand your current coverage, explore all available options, and choose the Medicare plan that aligns best with your priorities.
Typically, Medicare beneficiaries over the age of 65 have three ways to access their Medicare: First is staying on Original Medicare (Parts A & B) and enrolling in a Part D Prescription Drug Plan (PDP). Second, you can remain on Original Medicare (Parts A & B) and cover the gaps in Original Medicare by purchasing a Medicare Supplement plan along with a Prescription Drug Plan (PDP). Third is enrolling in a Part C Medicare Advantage Plan that includes prescription drug coverage. The second and third options provide the same essential services but differ in structure.
Original Medicare consists of Part A (Hospital and Skilled Nursing Insurance) and Part B (Medical Insurance). It is widely accepted and allows visits to any Medicare-participating provider or hospital across the country. There are fixed deductibles, copayments, and coinsurance for each service, but no annual out-of-pocket maximum. To help manage out-of-pocket expenses, you have the option to purchase a Medicare Supplement Plan, which helps cover costs such as the Part A deductible and the 20% Part B coinsurance once the deductible is met. Additionally, you can acquire a Part D Medicare drug plan for prescription drug coverage.
Another way to manage out-of-pocket expenses is by enrolling in a Part C Medicare Advantage plan, offered by private health insurance companies. These plans may require an additional premium on top of the standard Part B premium and typically include coverage for Parts A, B, and often Part D. They usually feature set copays and coinsurance for services until you reach the plan’s annual out-of-pocket maximum. Generally, you'll need to use providers within the plan’s network, and the plan may require prior authorization for certain services or prescriptions.
When considering how to choose your Medicare, think about the following:
If you are already enrolled in Original Medicare, you can purchase a Medicare Supplement at any time, but there are specific periods when you can enroll in, drop, or change your Part C Medicare Advantage or Part D Medicare Drug Plan.
As a Licensed Independent Insurance Agent at Bolte Insurance, I represent major health insurance companies in our region and am well-versed in the diverse plan options available. My colleagues and I guide you through the enrollment process, helping to narrow down plan options and present the Medicare solutions that may best meet your needs. To schedule an appointment to explore your options or initiate your Medicare journey, please contact our office today at 419-732-3111.
Disclaimer: Not connected with or endorsed by any government or Federal Medicare Program.
Before you bust out the birthday candles and start the celebration, you need to ask yourself, “Is now the right time for me to sign up for Medicare?” When it comes to Medicare, there is no one-size fits all solution. When and how you choose to receive Medicare depends on your unique situation. Do you plan to continue working? Will you have group health insurance through your employer? Are you planning to retire and become a snowbird? Your Medicare choices should be specific to your individual needs and the timing of your choices is important to avoid possible breaks in coverage or potential late enrollment penalties.
1. Apply early to avoid gaps in coverage and potential penalties. If you receive Social Security benefits prior to your 65th birthday generally you will be enrolled automatically in Medicare Part A & Part B. If you are not receiving Social Security benefits prior to your 65th birthday, you can apply for Medicare three months prior to your birth month.
2. Work with a local Independent Agent who represents multiple Medicare plan carriers. An agent who represents multiple companies has the information available for the plans in your area and can narrow down the options to best match what is most important to you. They can help determine which plan covers your preferred providers and facilities and review cost-effective prescription drug plan solutions, if keeping to a budget is a priority.
3. Decide what type of Medicare plan is right for you. In most Ohio counties, there can be over 250 plan combinations from which to choose your Medicare benefits and several options on how to receive your coverage. You can keep Original Medicare Part A & Part B or pair it with a Medicare Supplement plan and a Part D Prescription Drug plan. Another option is to enroll in a Medicare Part C plan, also known as Medicare Advantage, or simply, MA. MA plans can also include prescription drug coverage (MAPD). Like any life decisions, there are pros and cons. The most important thing to consider when choosing your Medicare plan is that it meets your specific needs.
4. If cost is important, find a Medicare drug plan that saves you the most money. There are two ways to receive your Part D Prescription Drug benefits. You can choose a stand-alone drug plan or enroll in a Medicare Advantage plan that includes Part D Prescription drug benefits. Covered medications and out- of-pocket costs can vary widely from plan to plan. An agent can help you find a drug plan that fits your budget and allows you to fill your prescriptions at your preferred pharmacy.
As a Licensed Independent Insurance Agent at Bolte Insurance, I represent the major health insurance companies in our area and have knowledge of the many plan options available. My fellow agents and I provide guidance through the enrollment process, narrowing the plan options, and helping to find the Medicare solution that is the best fit your needs. For an appointment to get started with Medicare, contact the office today at 419-732-3111.
Disclaimer: Not connected with or endorsed by any government or Federal Medicare Program.
Spring has arrived, and while the Medicare Annual Election period may feel like a thing of the past, the agents at Bolte Insurance are dedicated to assisting current clients and educating newly eligible Medicare beneficiaries about their plan choices. Despite some beneficiaries attempting to select their Medicare options independently, utilizing a local licensed agent offers numerous advantages.
1.) Understands Medicare. Licensed agents must complete 24 hours of continuing education every two years to stay updated on the industry's evolving landscape. They need to pass an annual test to demonstrate completion of mandatory Medicare training and proficiency in selling Medicare compliant with the Centers for Medicare & Medicaid Services (CMS) guidelines. Additionally, agents must obtain annual certifications for each carrier they represent.
2.) Knows the Deadlines. A Licensed agent can help you meet important enrollment deadlines to avoid late enrollment penalties. Not all Medicare beneficiaries are alike, and everyone has their own unique situation. A licensed agent can assess your individual circumstances to determine if you are required to enroll in Medicare or if enrollment can be postponed, preventing unnecessary premium payments.
3.) Represents Multiple Insurance Plan Carriers. Most local licensed agents are insurance brokers which allows them to represent multiple insurance carriers. An agent can work with you to determine what plan benefits are most important to you and help pair them with the plan that best fits your needs.
4.) Knowledge of Local Healthcare Providers. When you go it alone and reach out to a number you see on the television, chances are the person answering the phone doesn’t live in your community. They know nothing about the local hospitals, doctors, dentists, and other providers. A local agent has in-depth knowledge of the providers in your area and can verify, using a provider search, whether the providers that are important to you participate in the a given plans network.
5.) Offers Part D Prescription Look up and Cost Comparison. A licensed local agent can help you compare multiple Part D prescription drug plans and costs to find one that covers your prescriptions and allows you to fill them at your preferred pharmacy.
6.) Provides Support After Enrollment. A licensed local agent serves as your local point of contact for questions regarding your plan and can help with many service-related requests. Instead of waiting on hold to talk with someone you don’t know you can call or stop in the office and ask your question.
7.) No Additional Costs. There are no additional costs and no obligation to enroll if you use the services a licensed agent provides. You will not pay more for your Medicare plan if you enroll using an agent. The agent is compensated by the Medicare plan if you choose to enroll.
As a Licensed Independent Insurance Agent at Bolte Insurance, I represent the major health insurance companies in our area and have knowledge of the many plan options available. My fellow agents and I provide guidance through the enrollment process, narrowing the plan options, and helping to find the Medicare solution that is the best fit your needs. For an appointment to get started with Medicare, contact the office today at 419-732-3111.
Disclaimer: Not connected with or endorsed by any government or Federal Medicare Program.