Medicare Short Course

Once you are eligible you enroll into Original Medicare.  Usually, you'll already have PART A already vested.  If you do not already have medical coverage, you'll enroll in PART B.  If you want to do so, you can stop right there.  Maybe not the best idea, but it's an option.

Once enrolled in Medicare you can 'enhance' your coverage, to better suit your circumstances; you can enroll in PART D or Medigap or PART C.  You can cover partially or all of your share of Medicare's deductibles and co-pays.

Medicare is both simple and complex.  To make it simple, we listen, ask questions, explain, in understandable terms, how all the PARTs of Medicare work and how you can use them for your best interest in your circumstances.

We have affordable offerings.  A variety of plans and companies.

To invoke Original Medicare, you correspond with Social Security because they handle confirming you are qualfied and enrolling you in Medicare.  Eligibility periods vary depending on time of year, your age and other factors.  There are about 35 scenarios of when you can enroll into Medicare.

Please know all health products have moving parts that move in different ways depending on the health events.  Everything has to fit together to make a plan that works for....you.

Once you've discussed your options, should you decide to 'enhance', you can choose whichever purchase path makes the most sense for you.  You buy exactly the same policy whether you do so via phone, online mail or in-person.  Just like any other type of insurance.  No one charges any fees.  Companies pay commission to agents from their revenues; you buy direct, the company retains the commission and becomes your Agent of Record.

So.  The enrollment choice you make determines the service level.  Everyone gets company level service - contact the company.  To get a level of understanding that is maybe different of the vested interest of the company, usually, a local agent is a good option.  Whichever path you choose to enroll, you would expect your insurance will perform as represented.  Here, again, a local agent is a good option to understand what you have and how it works whenever you have issues or questions.  The agent bridges the gaps between the company interest, the providers interest and your interest.

Medicare has rules that all are mandated to follow.  Strict rules about how beneficiaries are to be contacted.  Required mandate that you must give explicit permission before a salesperson may solicit you either by telephone or in-person.  Medicare does not allow high pressure tactics, misrepresentation or providing selective partial information.  Medicare regulates the content and approval of the materials offered to explain the offering.

As we all know, from bitter experience, disreputable people make our lives difficult.  Every industry has its share of fakers and shills.

And.  Honest, trustworthy, knowledgable people. 

While Medicare solicitation process is mandated to follow established guidelines. however,  the pressures of the market have developed various workarounds.  You answer your phone: a call from an unlicensed, unregulated third party whose job is get you to start a conversation by offering 'help' in some form with your current insurance situation.  Once you agree (engage), you'll be handed to an agent who then can legally discuss benefits and switch your coverage with your explicit permission.  The Rules are that you must be told you are talking with an agent and you must explicitly consent to be switched from your current coverage to another plan.  Not everyone follows the rules.

Another part of the Medicare mandate is that you be presented with and agree to the features and disclosures of your plan - a process that requires 1-2 hours of a phone/electronic conversation.

So, yes, you can purchase directly over the phone.  However.  Once all that has been presented, it constitutes a ‘vaccine’ - everything has been presented.  Yes, companies have customer service with menus and whomever (or whatever nationality) picks up the call.  

All you need do is ask to be handed off to a local agent.  No difference in cost or enrollment process.  Same person in the future should you have questions or need help.  Your Agent of Record and has standing to deal with the company on your behalf.  

To be certain, if you understand well how Medicare works, how your product works with Medicare, and you would be content dealing directly with the company representative whenever you need help, enrolling over the phone is a choice.  

The Medicare Statute authorizes private insurance companies to offer PART D:Medicare Rx Plans which cover Medicare approved prescription drugs using statutory provisions mandated by Congress.  Medicare uses a Master Formulary (the complete drug listing of Medicare approved drugs) from which each plan can select all, most or some drugs to cover in their plans.  Know that no company covers all drugs.  All PART D plans follow statutory mandates.  An annual deductible can be waived or partially applied.  Defined coverage stages, each governed by a defined amount threshold and defined co-pays.  Here too, Medicare approves, oversees and disciplines.

Medicare takes the position that, unless you are exempt, you must enroll in Medicare PART B and/or PART D (unless you are exempt) when you are eligible or pay a penalty.  If you do not enroll within the grace period defined you must pay the prescribed penalty.  Medicare makes the insurance company collect the amount which is then paid to Medicare.

Income Related Monthly Adjustment Amount.  Should your income meet certain higher thresholds than the standard amount, set by Congress, you must pay a higher PART B and/or PART D premium.  Usually, the amount is deducted from your Social Security Retirement benefit and forwards it to Medicare.