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Frequently Asked Questions

Medicare is a health insurance program for people age 65 or older. Some younger people are eligible for Medicare–including people with disabilities, kidney failure, or ALS.

Supplemental and Advantage [link to resources] are two different options available to you when choosing your plan, with considerations and advantages to both.

In essence, Medicare Advantage streamlines coverage with added perks but with provider access through networks like HMO/POS or PPOs. Medigap or Medicare Supplement plans pay all or a portion of the costs not paid by Original 
Medicare but only cover those services covered under Original Medicare. Medicare Supplement plans allow consumers the ability to seek services from any provider that accepts Medicare. The choice that’s right for you will depend on your individual healthcare needs, budget, and preferences in healthcare providers. 

There is typically no initial enrollment fee for Medicare itself. The premiums for Medicare Advantage and Medicare Supplement can vary depending on your income, coverage, and specific needs. To find out about average Medicare premiums, visit Medicare.gov.

We are proud to partner with many terrific carriers, including United Healthcare, Aetna, Blue Cross Blue Shield, Gerber Life, Guardian, Humana, Mutual of Omaha, WellCare, and AARP.

Although we do not represent every carrier available in your area, we partner with many of the top-rated insurance
carriers in the area. For a complete list of plans and carriers available in your area visit Medicare.gov.

It can be confusing to navigate how Medicare interacts with the Veterans Administration and TriCare. We’re able to help veterans understand the role each of these entities play and how you can make maximum use of their benefits.

Original Medicare: Once you are enrolled in Original Medicare (Part A and Part B), you do not need to re-enroll each year. Your coverage will automatically renew as long as you continue to pay any necessary premiums.

Medicare Advantage: Although you don’t have to re-enroll, it’s a good idea to review your Medicare Advantage plan and Prescription Drug plan (Part D) annually during the Medicare Open Enrollment Period (October 15 to December 7) to ensure that the plan still affords the best possible coverage for your individual needs.

Medicare Supplement: Supplemental (Medigap) policies renew automatically each year as long as you continue to pay the premiums. 

The Initial Enrollment Period (IEP) for Medicare is a 7-month period that starts three months before the month you turn 65, includes the month you turn 65, and ends three months after your birth month. This is the first time you can sign up for Medicare if you’ve become eligible due to your age.

If an employer has 20 or more employees, you have the option to delay Medicare enrollment, drop employee group coverage and enroll in Medicare, or have both Medicare and employee group health coverage.

If an employer has fewer than 20 employees, generally you will need to enroll in Medicare during your Initial Enrollment Period (IEP).

If you have health coverage through a spouse’s employer, your options will depend on the employer’s rules. You may be able to delay Medicare enrollment, or you may need to enroll when you reach age 65.

We recommend that you attend one of our no-cost seminars, which provide a comprehensive overview of the Medicare enrollment process. If you can’t make it to a seminar, don’t be shy–reach out to us [link] for a one-on-one consultation.

A carrier’s drug formulary is a list of prescription drugs that your carrier provides insurance coverage for. Your formulary can be divided based on drug types: generic, preferred brand, non-preferred brand, and specialty. Drugs in higher tiers will cost more than those in the lower tiers. Insurance companies differ in how they categorize their formularies; a drug that is in tier 1 with a certain company may not be in tier 1 of another insurer.

Medications not listed are subject to a one-time “transitional fill,” but are not covered thereafter without the approval of a Request for Exception by the insurance carrier. 

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