Your Medicare, Your Way: Free Personalized Help to Secure the Best Coverage and Savings

Medicare Insurance and the multitude of health insurance options may seem confusing at first glance.  But, My Medicare Solution will help you navigate and select your options, understand deadlines, meet your budget, and fill gaps in coverage as needed.

Original Medicare is the federal government program that provides health insurance for individuals that are 65+.  Medicare also covers those under 65 who receive Social Security Disability Insurance (SSDI) or have certain conditions like End-Stage Renal Disease (ESRD) and ALS.

My Medicare Solution will assist you throughout your entire Medicare journey following the five general steps below:

There are multiple times in a person’s life that they can enroll in Medicare. Choosing when to make that transition is something we can assist with.  Timing is an incredibly important part of the consultation, as choosing the wrong time can mean loss of coverage, or even penalties. Here are some of the basics when it comes to selecting the right timing for you:

Your Initial Enrollment Period (IEP) is a seven-month window around your 65th birthday:

• Starts three months before the month you turn 65
• Includes the month you turn 65
• Ends three months after your birthday month
• Note, if your birthday is the 1st of the month, your enrollment window is shifted back by one month. (Example: If your birthday is May 12th, your enrollment window is February 1st through August 31st and the earliest your Medicare can start is May 1st. If your birthday is May 1st, your enrollment window is January 1st through July 31st and the earliest your Medicare can start is April 1st.)

If you already receive Social Security or Railroad Retirement Board (RRB) benefits prior to age 65, you’ll likely be automatically enrolled in Medicare Parts A and B by the Social Security Administration and receive your Medicare card in the mail.

If you’re not receiving these benefits, you must sign up for Medicare through the Social Security Administration.

If you’re still working and have health coverage through your employer or union, you may qualify for a Special Enrollment Period (SEP) to sign up for Medicare without a late enrollment penalty after your Initial Enrollment Period ends. The SEP typically lasts for eight months after your employment or group coverage ends, but please note that you may accrue penalties for prescription coverage if you don’t transition to Medicare within two months of leaving employer coverage.

We recommend a consultation even if you are working as Medicare can be a stronger option than the insurance provided by the employer or union and, in some cases, your insurance through the employer may not be considered “creditable” by Medicare, which will mean losing your enrollment window and facing penalties (detailed below)

The General Enrollment Period (GEP) for Medicare is from January 1st through March 31st each year. This annual period is for people who missed their IEP and SEP to enroll in Medicare Parts A and/or B. During the GEP, you can enroll in Medicare, with coverage usually beginning the month after you sign up, but you may also face late enrollment penalties.

These can occur when you do not sign up for Medicare at the right time and will stay with you for the rest of your life:

If you keep working after age 65, you need to confirm that the medical and prescription coverage that your employer is providing is “creditable”. Creditable means insurance that is at least as good as the coverage provided by Medicare Part A, Part B, and Part D.

Your group health plan is required to provide you with a Notice of Creditable Coverage on a yearly basis and you can ask your Human Resources or Benefits Coordinator if your coverage is creditable.

If your coverage is NOT considered creditable, you may:

• Face unexpected bills. For example, if an employer group is under 20 people, the coverage is considered secondary to Medicare and without Medicare Part A and Part B, your insurance company will not be able to provide coverage as the primary coverage does not exist.
• Lose your enrollment window. If you are over 65 and retire from coverage that is not creditable, you may not be able to enroll in Medicare right away, leaving you with no coverage until next year’s General Enrollment Window
• Accrue penalties. If your group coverage is not considered creditable, Medicare will consider you as being without coverage for the duration of the time you were on this insurance and apply the above-mentioned penalties.

Contact us to choose the time that is right for you.

Once you know your target date to transition to Medicare, the next step is applying for Original Medicare. This is done through the Social Security Administration, via this website: https://www.ssa.gov/medicare/sign-up.

How can we help with this step?

1. We can walk you through the online application process
2. We can check your Medicare status on your behalf and keep you updated
3. We can work with you to make sure that your Medicare is processed in a timely manner

You may ask, why do I need anything other than Original Medicare (Medicare Part A and Part B)? This is because Original Medicare has large gaps in their medical and hospital coverage and doesn’t include other benefits such as Prescriptions, Dental, Vision, Hearing, or Long-Term Care.

During our free, no-obligation consultations we can assist in:

1. Understanding your options beyond Original Medicare
2. Compare what is available on the market in your county and state
3. Find the coverage plan or package that closely aligns with your budget and health needs

• Medigap plans are secondary to Original Medicare and can help pay for health care costs not covered by Original Medicare for an upfront cost (premium). They do not include any additional benefits and Prescription coverage will need to be added separately.
• Medicare Advantage plans combine medical benefits with prescription benefits as well as additional benefits like vision, dental, and hearing.

We are here to explain those options in detail. By listening to your unique needs, we can collaborate on finding the best option for you. We’ll also handle all the paperwork of signing up.

There are two types of changes in the Medicare world and we’re with you for every one of them.

1. Insurance company changes
2. Changes in your life

Every year, we work meticulously to find out the changes to the Medicare market as well as each Medicare plan and make sure that you continue to have the best coverage and are not in danger of being left without coverage.

Here are the yearly enrollment periods to review your options with us:

1. Moving – not every plan is available in every state and county. If you move, please reach out to us so we can make sure you aren’t left without appropriate coverage
2. Income changes – if your income is below certain thresholds, you may be eligible for state or federal sponsored programs. If you are, then you may be eligible for different Medicare plans as well. Talk to us about your income or see the financial options in the section below.
3. Chronic conditions – if you are diagnosed with certain chronic conditions like diabetes or cardiovascular issues, you may be eligible for special plans with additional benefits

As your life situation changes, My Medicare Solution is here for you. We’re here not just to help you choose the right insurance. We can also connect you to financial planners, life coaches, assisted living coordinators, movers, or most any other service you might need.

And if your family wants to be involved in your health insurance solutions, they are welcome to be part of the conversation.

We are here all year long to support you. As questions come up, feel free to reach out with any questions or concerns. If you’d like to know more, let us know.