We explain, in understandable terms, how insurance works.
We explain, in understandable terms, how insurance works.
Once you are eligible you enroll into Original Medicare. To do so, you correspond with Social Security because they handle confirming you are qualfied and the actual 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.
Once you are enrolled into Original Medicare, you can stop there or continue into 'enhancements that 'customize' your Medicare coverage to best suit your needs. You can add a PART D or a Medicare Supplement (aka Medigap) or, a PART C. You can cover your share of Medicare's deductibles and co-pays either partially or in full.
Medicare coverage is both simple and complex. To make it simple, we listen, ask questions, then explain to you, 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.
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 and understand your options, you can choose whichever path makes the most sense for you. Remember, no matter how you enroll (by phone, online mail or in-person) you buy exactly the same policy. Just like any other type of insurance. No one charges any fees to you. Companies pay commission to agents. Should you buy direct from the company, the company retains the commission and becomes your Agent of Record.
The enrollment choice you make determines the service level. Everyone gets company level service. To get a level of understanding that is perhaps different from the vested interest of the company, a local agent is a good option. No matter whichever path you choose to enroll your insurance will perform as represented. Here, again, a local agent is a good option to understand what you have and how it works. And. The local agent is available whenever you have issues or questions. The agent bridges the gap between the company interest, the providers interest and your interest. Something to keep in mind.
Medicare enrollment has rules that all are mandated to follow. There are strict rules about how beneficiaries are to be contacted.
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 by everyone 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, the financial pressure of the market have developed various workarounds. Especially on the phone. 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. 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.
Should, at any time during your enrollment process, you decide it would be better to sit with a local agent, all you need do is ask. There is no difference in cost to you or the enrollment process.
The advantage to you is you deal with the same person in the future should you have questions or need help.
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 Prescription Drug 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 the drugs they'll 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, just as it is in medical coverage, Medicare approves, oversees and disciplines.
Whether or not you take any prescription drugs, Medicare takes the position that, unless you are exempt, you must enroll in Medicare PART B and/or PART D when you are eligible or pay a penalty. If you do not enroll within the grace period defined you must pay the statute 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.