Medicare Short Course

Once you are eligible you can enroll into Original Medicare.  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 cover your share of Medicare's deductibles and co-pays either partially or in full.

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

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

To get Original Medicare, you first correspond with Social Security as they handle invoking your coverage in Medicare.

Medicare mandates one be qualified to enroll into Medicare PARTs A/B/C/D/E.

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 have Original Medicare, you can 'enhance' your coverage with a PART D drug plan and/or a Medicare Supplement Plan or, a PART C Medicare Advantage Plan.

Once you've been briefed on your options, should you decide to buy, you can choose whichever purchase process makes the most sense for you in your situation.

You can buy through telemarketers, marketers, directly from companies, online through Medicare, or through local agents appointed with those companies.  No one charges any fees.

Whichever method you choose to enroll, you would expect your insurance will perform as represented.

Medicare has rules that all are mandated to follow.  Medicare has strict rules about how beneficiaries are to be contacted.  Medicare mandates 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 do the companies.

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

And.  Honest and trustworthy, knowledgable people. 

Usually you'll get 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 engage, you'll be handed to an agent who then can legally discuss benefits and switch your coverage with your permission.  While the rules are that you must be told you are talking with an agent and you must consent to be switched from your current coverage to another plan, not everyone follows the rules. 

You can purchase directly from most companies as they have telephone sales representatives to enroll directly from your call.     Because Medicare mandates you be told what you're buying and how it works, this process will mean, usually, as it does with the anyone you speak with on the phone, in the range of 1 to 2 hours on the phone.  There are required disclosures that must be read to you.  Most companies have local appointed agents that you can ask to be handed off to meet with.  No difference in cost or process.  If you understand how Medicare works and how that product works, and you would be content dealing directly with the company representative whenever you need help, this process is workable.

Or.  You can buy exactly the same product at the same price from a local agent who meets with you, discusses your situation and needs.  And, will be the same person in the future you'll talk with should you have questions or need help.  This means your local agent becomes your Agent of Record and has standing to deal with the company on your behalf.    

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 (drug list) from which each plan can select all, most or some drugs to cover in their plans.  All PART D plans follow statutory mandates.   At least 2 drugs from each category.  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 when you are eligible or pay a penalty.  If you do not enroll within the grace period defined for that respective part of Medicare, you must pay the prescribed penalty.  Medicare usually 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 PART D premium.  The Plan collects the amount and forwards it to Medicare.