Medicare is the health insurance program provided by the U.S. government to people who are 65 & older. Younger people with certain disabilities may also qualify.

Learn more at www.medicare.gov.

Original Medicare refers to Medicare Parts A & B, which are run by the federal government. Part A covers hospital-related services and emergency care. Part B covers services like doctor visits, lab tests, immunizations, & necessary equipment like wheelchairs.

Note: If you don't enroll in Part B when you’re first eligible, or if you drop it and get it again later, you may have to pay a late-enrollment penalty for as long as you have Medicare.

Offered by private insurance companies, Medicare Advantage plans replace Original Medicare. They cover benefits that Parts A & B cover & can offer additional benefits such as vision, hearing, & dental. Most plans also include prescription drug coverage. Plans may have lower out-of-pocket costs than Original Medicare. Call to speak with one of our licensed insurance agents to learn more.

Medicare Part D plans help pay for prescription medications. They are only available from private insurance companies.

If you are eligible for Medicare coverage, you are also eligible for the Medicare drug benefit (Part D). You must be enrolled in Medicare Part A and/or Part B to enroll in Part D.

Note: You might not need a Prescription Drug Plan if you buy a Medicare Advantage plan that includes prescription drug coverage. Call to speak with one of our licensed insurance agents to learn more.

Medigap / Supplemental Insurance is available from private insurance companies & helps pay out-of-pocket costs not covered by Medicare Parts A & B. Call to speak with one of our licensed insurance agents to learn more.

Choosing Medicare Supplement may be your best option if:

- You want to be able to choose your doctors & medical providers. (Medicare Advantage plans may have more limited networks.)

- You want to see a specialist without a recommendation. (Some Medicare Advantage plans may require you to get a referral from your primary care physician.)

- If you’d rather have more flexibility in your monthly premium and out-of-pocket costs.

- No network restrictions as long as they accept Medicare patients. Coverage goes with you across the United States.

Choosing Medicare Advantage may be your best option if:

- You take prescription drugs. (You'd have to pay extra for Part D if you have a Medicare Supplement plan, but most Medicare Advantage plans include prescription drug coverage.)

- You expect your out-of-pocket spending to be high. (Medicare Advantage plans have an out-of-pocket maximum)

- If you would rather pay a low or $0 monthly premium and co-pays for services as you use them.

An important point to understand is that there’s a gap in coverage for many Medicare Prescription Drug Plans. It’s also called the Medicare Donut Hole. Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. Once you and your plan have spent $4,130 on covered drugs in 2021, you're in the coverage gap. This amount may change each year. Also, people with Medicare who get extra help paying Part D costs won’t enter the coverage gap. Extra Help is a program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. Find out if you qualify for Extra Help. Call to speak with one of our licensed insurance agents to learn more.

For more information on getting extra help, visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/lower-prescription-costs

1. Take generic drugs. Talk to your pharmacist about whether you can switch to a generic prescription that might cost less.

2. Price-shop for durable medical equipment. Find the best deal on a blood sugar monitor, cane, walker, wheelchair, etc. through a government-approved supplier.

3. Use your yearly Medicare Wellness Visits. You & your doctor can use these appointments to create plans to help manage your health.

4. Manage everyday health costs. Speak to your doctor about switching to lower-cost, over-the-counter products.

Are you newly eligible for Medicare?

You can sign up for Medicare three months before your 65th birthday, & three months after you turn 65. If you enroll before your birthday, coverage usually begins the first day of your birth month. There is a penalty for enrolling late, so enroll in that seven-month period. Some people get enrolled automatically: those under 65 with certain disabilities, or those already receiving Social Security benefits. Visit  www.medicare.gov to see if you’ll be automatically enrolled.

Are you already enrolled in a Medicare plan?

Open enrollment is from Oct. 15 - Dec. 7 every year. During this time, you can change, enroll in or add additional Medicare coverage. Changes take place Jan. 1 of the following year. You don’t have to re-enroll every year, and you will have the chance to make changes during this time period. However, plans do change from year to year, so it’s important to read the info your plan sends you—especially the Evidence of Coverage and the Annual Notice of Change. To make sure you’re getting coverage that is a good fit for you & that you can afford, review your monthly premiums & benefits.

Have you experienced a life event that impacts your coverage?

There’s a special enrollment period for making changes following a qualifying life event. For instance, if you move to a new area with different plan options, you may be able to switch plans for two months after you notify your carrier. Or, if you’re no longer eligible for Medicaid, you may be eligible to make changes for two months after losing coverage. For more information on special enrollment periods, visit: www.medicare.gov.

Call to speak with one of our licensed insurance agents to learn more.