Part A — Hospital Insurance
Think of this as room and board coverage if your receiving inpatient care. Part A also covers some skilled nursing facility, home health and hospice care.
If you have worked 40 quarters or 10 years are entitled to premium free Part A. Part A has a deductible and per diem for defined benefit periods.
Part B — Medical Insurance
Part B pays for doctors’ services, outpatient hospital care and home health visits not covered under Part A. It also covers laboratory tests such as X-rays and blood work, medical equipment such as wheelchairs and walkers, preventive screening, outpatient physical therapy, mental health care and ambulance services.
Part B has a monthly premium, which is typically deducted from your Social Security check. Depending on your annual income, your Part B premium may vary. Medicare Part B also has an annual deductible.
Part D — Prescription Drug Insurance
Medicare Part D has a separate monthly premium which may vary among plans. Medicare drug coverage is offered through Medicare-approved private insurance plans. Medicare Part D can be purchased through standalone drug plans (called PDPs) or through a Medicare Advantage plan (called MA-PD). Part D is optional coverage, only if you have other creditable coverage Medicare Advantage Plan (Part C)—A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. 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
Medicare Supplement
Supplements also called Medigap plans are sold by private insurance companies. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays. Medicare Supplement may cover outstanding deductibles, coinsurance, and copayments. Medicare Supplement may also cover health care costs that Medicare does not cover at all, like reimbursement for some medical care received when travelling abroad. Remember, Medicare Supplement only work with Original Medicare. If you have a Medicare Advantage Plan, you do not need to buy a Medicare.
Medicare Advantage Plans
Medicare Part C is not a separate benefit. Part C is the part of Medicare that allows private health insurance companies to provide Medicare benefits. These Medicare private health plans, such as HMOs and PPOs, contract with the federal government and are known as Medicare Advantage Plans. Medicare Advantage Plans must offer, at minimum, the same benefits as Original Medicare (those covered under Parts A and B) but can do so with different rules, costs, coverages. And in most cases, offering additional benefits (vision, hearing, dental, transportation, etc.) You also typically get Part D as part of your Medicare Advantage benefits package (MAPD).
Delaying Enrollment (SEP)
If you or your spouse is still working after age 65 for an employer that provides group health insurance, you may be elidable to delay Medicare enrollment until you separate from your employers sponsored coverage. There are special rules and not all employer coverage will qualify to delay your Medicare enrollment. You will need to sign up for Medicare within eight months of leaving the job or the coverage ending to avoid the penalty. Small Group (under 20 employees) Retiree health insurance and COBRA coverage are not forms of health insurance that allow you to avoid Medicare's late enrollment penalty.
Medical Deadline Part D
Medicare Part D prescription drug coverage has the same initial enrollment period of the seven months around your 65th birthday as Medicare parts A and B, but the penalty is different. The late enrollment penalty is applied if you go 63 or more days without credible prescription drug coverage after becoming eligible for Medicare.
Caution: If you delayed your Medicare enrollment because you had Employer sponsored coverage, part D has a different penalty period. 63 days. *The penalty is calculated by multiplying 1% of the "national base beneficiary premium" by the number of months you didn't have prescription drug coverage after Medicare eligibility and rounding to the nearest 10 cents. This amount is added to the Medicare Part D plan you select each year. And as the national base beneficiary premium increases, your penalty also grows.
Annual "Open" Enrollment Deadline
You can make changes to your Medicare coverage during the annual open enrollment period from Oct. 15 to Dec. 7. During this period, you can switch to a new Medicare Part D prescription drug plan, join a Medicare Advantage Plan or drop a Medicare Advantage Plan and return to original Medicare. Changes made during this period will take effect on Jan. 1 of the following year.
Medicare Advantage Open Enrollment Deadline
Medicare Advantage Plan participants can switch to another Medicare Advantage Plan or drop their Medicare Advantage Plan and return to original Medicare, including purchasing a Medicare Part D plan, from Jan. 1 to March 31 each year. You can only make one change per year during this period, and the new plan will begin on the first of the month after your request is received.
Call 877-795-9201/TTY 771 (Mon-Fri 8:30am - 5pm) to speak to a Licensed Agent - Agency #0F44279
People who are new to Medicare often have a hard time sorting things out in the beginning. There are all these parts and plans with similar letters, which makes it hard to figure out what is what — the typical signs are:
Your mailbox has likely been bombarded.
You have a stack of Medicare mail.
And you think to yourself... THIS IS CRAZY!!
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When it comes to considering your Medicare options, you can spend hours doing your own research or you can work with your own Medicare Concierge, a licensed and certified Medicare Agent. Your Medicare Concierge will compare your options to find the coverage that is right for you… at a price that fits your budget.
All at no cost and no obligation to you.
With your own Medicare Concierge, you get the benefit of great counsel along with great choices and Free lifetime customer support.
You have researched where you would like to go, BUT there are so many options. You want to make sure you do not miss a thing, and you do not really want to overpay. You rely on a highly educated travel consultant who helps you coordinate all aspects of your dream vacation and even saves you money along the way.
You Choose What's Best For You!
We built this uniquely different program because the face of Medicare is changing and frankly... we thought it was time the whole process changed.
You could spend countless hours researching Medicare yourself, but why?
Let Make Medicare Work provide you the concise information based on YOUR individual needs – with out having to invest countless hours of painstaking study.
Trying to navigate Medicare’s complex and confusing landscape is enough to give anyone a headache.
Our process is simple. It consists of answering some simple questions and then sitting back while we roll up our sleeves and create a step-by -step Medicare plan “just for you”.
Unlike insurance carriers or brokers who have a vested interest in “selling” you their insurance plan, we simply work for you.
We will provide clear and concise options specific to your needs, insuring both your heath and financial needs are met…
We understand that sometimes you just need to ask a question or need help understanding a bill or claim.
We're more than happy to share our years of expertise with you. It may be your first time with a Medicare issue but we can almost guarantee it is not ours.
Words from the heart of our past clients who used Make Medicare Work
If you aren't sure who to turn to for Medicare advice, give this group a call. We've used Denise for 6 years and have been very happy with her advice and follow-up. We've also recommended them to friends who've found their help and advice invaluable.
Los Alamitos
Great service to facilitate understanding Medicare. Based on my personal needs, we were able to find the best matches of Supplemental and Drug plans. Denise has a deep, thorough understanding of the plans and I highly recommend her!
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Denise is amazing!!! She does all the leg work to find the best medical insurance and prescription drug plans for us each year. She is professional, accessible and easy to work with. I highly recommend her!
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WARNING:
Medicare Advantage and prescription drug plans change yearly. These changes can cost you if you are not paying close attention:
Premiums can go up.
Deductibles can change.
Co-pays can increase.
Reading through the insurance carriers “notifications” is sometimes mind boggling. Approximately 52.6m Americans are enrolled in Medicare and only 13% review their coverage annually. That is a lot of surprises come January.
Medicare rules and complexities can be confusing and scary. Who has the time and interest in becoming an expert on Medicare regulation? (Well we did, but that's a long story).
Timing is critical when it comes to Medicare. One wrong move can cost you tens of thousands of dollars and leave you without critical coverage.
We see too many people get confused early on.
They try to jump right into figuring out Medigap plans and Medicare Advantage plans or how Medicare will coordinate with their employer coverage. That is putting the cart before the horse, so let’s set that aside for now. Before you worry about all that, let’s first familiarize you with the Medicare basics.
Medicare has PARTS - Insurance has PLANS – this little tip will help you decide if you're talking about Medicare or an Insurance Plan that works with Medicare.
Together, Parts A and B are known as Original Medicare. They cover some, but not all, health care expenses. Original Medicare has deductibles and co-insurance and does not pay for long-term personal care services at home or long-term care. Original Medicare also does not cover eye exams, eyeglasses, hearing aids, dental care or non-emergency care provided outside the U.S. It also does not cover deductibles and coinsurance.
Original Medicare may not be enough coverage to protect both your health and well-being. Original Medicare’s cost sharing, deductibles and co-pays can be unpredictable and difficult to discern. There is no annual limit on what beneficiaries could be expected to pay out-of-pocket. Choosing a coverage option that works with Original Medicare can help protect beneficiaries from unexpected costs.
Individuals who are receiving Social Security benefits may be automatically enrolled in Medicare parts A and B, and coverage begins the month they turn 65. But those who haven't claimed Social Security will need to take action to sign up for Medicare. Your coverage can begin as early as the first day of the month you turn 65, or the first day of the prior month if your birthday falls on the first of the month.
Is Medicare mandatory?
No part of Medicare is mandatory, but if you choose to enroll in any part of Medicare after your Initial Enrollment Period, you could face financial penalties unless you qualify for a Special Enrollment Period with creditable employer coverage.
What is the late enrollment penalty for Medicare Part B?
Medicare Part B enrollment is complicated, and the wrong decision can leave you without health coverage for months – and lead to lifetime premium penalties.
Can I keep my doctor and/or specialist?
Keeping your doctors and/or specialists is our number one priority. We will always try our best to find a plan which your doctor accepts. Each situation is different, and we will discuss all your options in further detail at your benefit review.
Will my medications be covered?
Our Medicare Concierge will always do a complete review of your medications to ensure you are placed on a plan that covers your specific drug needs.
Does Medicare cover long-term care?
No. This is a surprise for most people. Medicare covers up to 100 days of skilled nursing care only, and that’s following a hospitalization and based on doctor’s orders. Medicare does not cover custodial care at all. This is the type of care older people need when they have trouble bathing and dressing themselves. Medicare won’t pay for it.
Is there a cost for your service?
Our services are no cost to you and there is no fee or extra charge for working with an MMW agent. We are a free, non-biased public service for Medicare beneficiaries.
Do you represent all Medicare plans?
MMW brokers represent most Medicare plans in the market. We are happy to give you our expert opinion on all available plans and we will not hesitate to recommend a plan we do not represent if it is the best fit for you.
Am I automatically enrolled in Medicare Part A and Part B if I file for social security?
Yes, IF you have been receiving social security benefits for at least 4 months before your 65th birthday. IF YOU HAVE NOT been receiving social security benefits at least 4 months before turning 65, then you will need to complete the Medicare Benefits application.
How do you get paid?
Our agents are compensated by the health plan. Compensation is regulated by Medicare. Our services are always at no cost to you and there is no extra fee or charge for working with an MMW Concierge.
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