Medicare

Each Medicare company offers different plans, and each plan needs to be carefully considered. In addition, Medicare plans may change each year in terms of their premiums, copays or coinsurance, and their benefits. As independent brokers, we have been appointed with every insurance company offering Medicare products in the state of Connecticut, and carefully consider the changes that occur every year in order to better serve our clients. We assist new Medicare clients with finding a plan that best suits their needs as well as providing our current Medicare clients with explanations of changes in their plans for the next year.

Medicare is divided into four different parts : A,B,C, and D.

Part A: hospital care, which covers inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

Part B: medical care, which covers services from doctors, outpatient and home health care, durable medical equipment, and some preventive services.

Parts A&B of Medicare are known as Original Medicare, which is a government program. Medicare is a program for people who are either over the age of 65, have a disability, or people with End-Stage Renal Disease (ESRD). You do have the option of just having Original Medicare coverage, yet this comes with some costs. Parts A&B have a deductible that needs to be met before certain services are provided and Part B also has a monthly premium that needs to be paid. In addition, if you do not have creditable drug coverage, then you could get penalized. Another thing to keep in mind is that Original Medicare will cover about 80% of doctor or hospital bills, leaving the remaining 20% for the insured to pay. In addition to having Original Medicare, you could also have a Medicare plan with a private insurance company.

Part C: Medicare Advantage, includes Medicare Parts A&B and can also include Medicare Part D (Prescription Drug Coverage). Medicare Advantage plans can offer additional benefits such as hearing, dental, or eye coverage for certain services. The amount that the plan covers in terms of hearing, dental, or eye care varies by plan. Medicare Advantage plans are offered by private insurance companies, whose plans vary in terms of their premiums, copays and coinsurance, and benefits.

Part D: Prescription Drug Coverage, covers some of the cost of prescriptions. Part D plans can be incorporated into Medicare Advantage Plans or can also be sold as stand-alone plans. Expenses for prescriptions can be high, so Prescription Drug Plans help to keep costs lower. Prescriptions are divided into Tiers, which each have either a copay or coinsurance which varies by plan. Prescription Drug Plans are also offered by private insurance companies.

In addition to Medicare Advantage Plans and Prescription Drug Plans, there are also Medicare Supplement Plans (Medigap Plans). These plans also offer additional benefits that Parts A&B do not cover. Medicare Supplement Plans are different from Medicare Advantage Plans in terms of what benefits they offer. In addition, if selecting a Medicare Supplement Plan, you may need to also select a stand-alone Prescription Drug Plan, if you do not have one already.

There are certain times when you can join a Medicare Advantage Plan. Knowing these time frames will help you prepare if you’d either like to start a Medicare plan for the first time or switch to a new Medicare plan.

Initial Coverage Election Period (ICEP): When you are first turning 65, you are eligible for an initial enrollment period. This enrollment period is a 7-month window that includes: 3 months before the month you turn 65, the month you turn 65, and then 3 months after the month you turn 65. After this window expires, you either need to have a Special Election Period (SEP) to enroll at a later time or wait until the Annual Election Period (AEP), which begins on October 15th.

Special Election Period (SEP): there are many reasons why you can qualify for an SEP which include, but are not limited to, moving, leaving an employer, etc.

Annual Election Period (AEP): this is the time when all Medicare eligible people who have both Parts A&B are able to join a Medicare Advantage Plan. Starting on October 15th and ending on December 7th, this election period allows you to select a Medicare plan during this time period for a plan effective date of January 1st.

Open Enrollment Period (OEP): this election period allows those who currently have Medicare Advantage plans to switch to another Medicare Advantage Plan. This election period lasts from January 1st to March 31st.

We can help you identify which Medicare plan can best fit your needs! Please call our office or fill out the form to the right and someone will be there to answer your questions.

Disclaimer for Medicare beneficiaries: 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.