Medicare

• Would you like to review multiple Medicare company plans?
• Which is better for you? Personal in-person, phone or Zoom appointments. We are flexible for you.
• Would you like us to explain the limitations of each plan? We can do that for you.
• Would you like us to provide detailed information on time frames and enrollment periods? We can do that.
• Would you like help finding Medicare plans that are accepted by your physician(s)?
• Would you like help finding a plan that is accepted by your choice of hospital or clinic?

We can do all that at no cost to you.

Contact Us to speak to a licensed agent.

Do you need Dental or Vision?

Here are a few options. More to come soon.

IS YOUR DOCTOR IN NETWORK?

Each plan has it’s own network of doctors if you are in a Medicare Advantage Plan.

CHECK PRESCRIPTION COSTS

WHAT IS MEDICARE?

PARTS OF MEDICARE

Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance) Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Part C (Medicare Advantage HMO or PPO) Medicare Part C is a health coverage choice for Medicare beneficiaries. Medicare Advantage Plans are offered by private companies approved by Medicare. The plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. In all plan types, you are always covered for emergency and urgent care. Medicare Advantage Plans Must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you are in a Medicare Advantage Plan. Medicare Advantage Plans are not considered supplemental coverage. Most include Medicare prescription drug coverage. In addition to your Part B premium, you usually pay one monthly premium for services provided.

Medicare Part D (prescription drug coverage) Helps cover the cost of prescription drugs (including many recommended shots or vaccines).

THERE ARE 3 WAYS TO GET MEDICARE

1. Original Medicare
2. Medicare Advantage
3. Medicare Supplement

MEDICARE STARTS WITH ORIGINAL MEDICARE

Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you get them. When you get services, you’ll pay a deductible at the start of each year, and you usually pay 20% of the cost of the Medicare-approved service, called coinsurance.

If you want drug coverage, you can add a separate drug plan (Part D). Original Medicare pays for much, but not all, of the cost for covered health care services and supplies.

You can go to any doctor, health care provider, hospital, or facility that is enrolled in Medicare and accepting new Medicare patients.

With a few exceptions, most prescriptions aren’t covered in Original Medicare. You can add drug coverage by joining a Medicare drug plan (Part D).

• Hospital stays.The amount covered depends on how long you’re in the hospital. In 2023, for the first 60 days, you pay a deductible of $1,600 for each benefit period and Medicare pays the rest. After that, the longer you stay, the more you pay.
• You pay $400 per day for days 61 through 90.
• Original Medicare covers up to 90 days in a hospital per benefit period and offers an additional 60 days of coverage with a high coinsurance. These 60 reserve days are available to you only once during your lifetime. However, you can apply the days toward different hospital stays.
• For days 91 and beyond in the hospital, you will pay $800 per each “lifetime reserve day” until the 60 days over your lifetime. Then, you pay all the costs.

• Skilled nursing facility care. This is to allow you to recover and rehabilitate after a stay in the hospital; Medicare does not pay for long stays in a nursing facility. Medicare will cover the cost of skilled nursing care for a maximum of 100 days. Medicare pays in full for the first 20 days. From the 21st to 100th day, you pay a co-pay of $200.00 per day in 2023. After that, you pay all the costs of your stay in a skilled nursing facility.

Let’s talk about how a Medicare Advantage or Medicare Supplement plan just might alleviate some of these costs. Please call (702) 541-0882 to speak with a licensed representative

MEDICARE ADVANTAGE PLANS

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare.

Most Medicare Advantage Plans include drug coverage (Part D). In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs.

Some plans offer out-of-network coverage, but sometimes at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. 

Below are the most common types of Medicare Advantage Plans:

• Health Maintenance Organization (HMO) Plans  
• Preferred Provider Organization (PPO) Plans
• Special Needs Plans (SNPs)
• Veterans Medicare Plans 

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HMO – HEALTH MAINTENANCE ORGANIZATION

In HMO Medicare Plans, you generally must get your care and services from providers in the plan’s network, except:

• Emergency care
• Out-of-area urgent care
• Out-of-area dialysis

In some Medicare plans, you may be able to go out-of-network for certain services. But, it usually costs less if you get your care from a network provider. This is called an HMO Medicare with a point-of-service (POS) option.

In most cases, prescription drugs are covered in HMO Medicare plans.

In most cases, yes, you need to choose a primary care doctor in HMO Medicare Plans.

In most cases you have to get a referral to see a specialist in HMO Medicare Plans. Certain services, like yearly screening mammograms, don’t require a referral.

• If you get health care outside the plan’s network , you may have to pay the full cost.
• It’s important that you follow the plan’s rules, like getting prior approval for a certain service when needed.

Let’s talk about how a Medicare Advantage or Medicare Supplement plan just might alleviate some of these costs. Please call (702) 541-0882 to speak with a licensed representative

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PPO – PREFERRED PROVIDER ORGANIZATION

A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PPO Plans have network doctors, other health care providers, and hospitals. You pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You pay more if you use doctors, hospitals, and providers outside of the network. In most cases, you can get your health care from any doctor, other health care provider, or hospital in PPO Plans. Each plan gives you flexibility to go to doctors, specialists, or hospitals that aren’t on the plan’s list, but it will usually cost more.

In most cases, prescription drugs are covered in PPO Plans. Ask the plan. If you want Medicare drug coverage, you must join a PPO Plan that offers prescription drug coverage. Remember, if you join a PPO Plan that doesn’t offer prescription drug coverage, you can’t join a Medicare drug plan (Part D).

You don’t need to choose a primary care doctor in PPO Plans. In most cases, no. But if you use plan specialists (in-network), your costs for covered services will usually be lower than if you use non-plan specialists (out-of-network).

• Because certain providers are “preferred,” you can save money by using them.
• A PPO Plan isn’t the same as Original Medicare or a Medicare Supplement Insurance (Medigap) policy.
• It usually offers extra benefits than Original Medicare, but you may have to pay extra for these benefits.
• Check with the plan for more information.

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Let’s talk about how a Medicare Advantage or Medicare Supplement plan just might alleviate some of these costs. Please call (702) 541-0882 to speak with a licensed representative

MEDICARE STAR RATINGS

Each year the Centers for Medicare and Medicaid Services (CMS) measures the quality and value of certified health plans. Medicare certified health plans, both Part C (Medicare Advantage) and Part D (Prescription Drug), are rated on a star scale. The scale ranges from one to five stars, with five stars representing the highest quality. Scores are based on more than 37 care and service quality measures across several categories. Some examples of the categories include:

• Staying healthy: How well the plan covers and helps its members receive recommended health screenings, vaccinations, and other check-ups, including programs that encourage wellness and help members stay healthy.
• Managing chronic (long-term) conditions: How often members with different chronic conditions receive certain tests and treatments that help them manage their condition.
• Member experience: How members rate their satisfaction with plan benefits (e.g., coverage, copays, and customer service).
• Member complaints and plan performance: How often Medicare found problems with the plan and how often members had problems with the plan, including how well the plan handles member appeals and new enrollment request.

Why Do Star Ratings Matter?

What information does Medicare use to determine Star Ratings?

• Member satisfaction, plan, and provider surveys.
• Reviews of claims and other info submitted by health plans.
• Monitoring and auditing performed by Medicare.

Medicare rewards plans that achieve four- and five-Star Ratings with extra money that must be reinvested back into the health plan’s programs and benefits. This means, the better the plans serve you, the better your benefits for you can be in the future.

SNP – SPECIAL NEEDS PLANS

Medicare SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics. Medicare SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve.

Generally, you must get your care and services from doctors or hospitals in the Medicare SNP network, except:

• Emergency or urgent care, like care you get for a sudden illness or injury that needs medical care right away
• If you have End-Stage Renal Disease (ESRD) and need out-of-area dialysis

Medicare SNPs typically have specialists in the diseases or conditions that affect their members.

A plan must limit membership to these groups: 1) people who live in certain institutions (like a nursing home) or who require nursing care at home, or 2) people who are eligible for both Medicare and Medicaid, or 3) people who have specific chronic or disabling conditions (like diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure, or dementia). Plans may further limit membership. You can join a SNP at any time.

All SNPs must provide Medicare prescription drug coverage.

In most cases, SNPs may require you to have a primary care doctor. Or, the plan may require you to have a care coordinator to help with your health care.

In most cases, you have to get a referral to see a specialist in SNPs. Certain services don’t require a referral, like these:

• Yearly screening mammograms
• An in-network pap test and pelvic exam (covered at least every other year)

Plans should coordinate the services and providers you need to help you stay healthy and follow doctor’s or other health care provider’s orders.

If you have Medicare and Medicaid , your plan should make sure that all of the plan doctors or other health care providers you use accept Medicaid.

If you live in an institution, make sure that plan providers serve people where you live.

Let’s talk about how a Special Needs plans just might alleviate some of these costs. Please call (702) 541-0882 to speak with a licensed representative

We’d love to help. Contact Us

DSNP – DUAL-SPECIAL NEEDS PLANS

If you have both Medicaid and Original Medicare, you have more choices. There are several plan options with several companies that you can combine your doctor, hospital and prescription drug coverages into one plan. Plus you’ll get additional benefits. This plan is designed to coordinate care among Medicare and Medicaid to improve care more effectively while also lowering costs.

Let’s talk about how a Dual Special Needs plan just might alleviate some of these costs.

Contact Us to speak with a licensed representative.

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VETERANS MEDICARE PLANS

Thank you for your service to the American people and our United States of America. Our team is here to help you find what you need. We’ll sort through the top-rated veteran’s health insurance plans so that you don’t have to, matching you only with those that are best for you.

Tap here for the history of Veterans Day.

Question: What type of plan can Veteran get with Tricare? A. An Medicare Advantage Plan only because Tricare has RX coverage. There are plans that will allow veterans to see doctors outside the VA. Additionally, some plans provide money for Part B costs as a “giveback” to their Social Security.

Question: What type of plan can a Veteran get who has VA only? A: Two part answer: If the Veteran is filling their RX at the VA, a Medicare Advantage only plan would provide access to doctors and hospitals that would include Part A and Part B. Some plans will provide a “giveback” to your Social Security. Even if you only use the VA, you will have additional coverage and the extra benefits to back you up.

Or, if you do not use the VA for RX, then a Medicare Advantage with Prescription drug Plan would help.

Many veterans may be unsure about how Medicare works with their VA benefits. Here are seven things every veteran should know about Medicare.

Medicare covers veterans in the same way as it covers most other Medicare beneficiaries. But there are a few things that veterans of the armed forces should know about Medicare.

1. Medicare and VA coverage do not coordinate benefits

Medicare and VA (Veterans Affairs) insurance do not coordinate coverage. The only instance in which the two programs might team up to offer dual coverage is when the VA approves qualified care to be received at a non-VA facility.

Medicare coverage for people with VA insurance typically works like this:

If you receive care at a VA facility, it will be covered by your VA insurance.

If you have Medicare and receive Medicare-approved care at a non-VA facility, Medicare will provide coverage. Medicare will not provide coverage at a VA facility, and VA benefits will not provide coverage at a non-VA facility.

In other words, you must visit a VA hospital or medical facility in order to use your VA coverage, and you must visit a civilian hospital or medical facility in order to use your Medicare coverage. VA benefits and Medicare coverage do not overlap.

2. There can be advantages to having both types of coverage

There can be some definite advantages in having VA benefits and Medicare insurance.

• Having both types of coverage can give you more health care options. If you only have VA insurance, you are limited to receiving covered care at only VA facilities. But adding Medicare coverage can open up the range of hospitals, doctor’s offices, pharmacies and other types of health care locations in which you may receive covered care.
• Having both types of coverage can benefit you in the event that an emergency occurs when you are not in close proximity to a VA hospital.
• Most people do not pay a premium for Part A Medicare.

3. You may not have the same VA coverage forever

Another reason you may consider enrolling in Medicare is the possibility that you may lose your VA benefits at some point, leaving you without health insurance coverage.

VA health benefits depend on an annual appropriation of funds by Congress, and it’s unpredictable if enough funding will be approved in future years to care for all veterans. Those veterans in the lower priority groups are at particular risk to see a reduction or even a complete loss of their veteran’s benefits.

4. Prescription drug coverage can vary

VA coverage includes prescription drug benefits, and for this reason, many VA members may choose not to enroll in Medicare Part D (Medicare prescription drug plans).

And because VA drug benefits are considered “creditable coverage” by Medicare, VA members are not required to pay a late enrollment penalty if they choose to sign up for Medicare Part D at a later date.

There are a few instances in which enrolling in a Part D plan or a Medicare Advantage plan with prescription drug coverage may make sense:

• VA coverage includes its own drug formulary (a list of drugs covered by the plan). If the VA does not cover a specific drug that you need to take, you might consider enrolling in a Medicare Part D plan that covers that drug.
• A drug prescribed by a doctor at a non-VA facility may not be covered by VA benefits without authorization.
• A non-VA pharmacy may be a more convenient way to obtain your drugs, especially if you reside in a nursing home or other long-term care facility.
• If you qualify for Medicare Extra Help, your overall drug costs may be lower with a Part D plan than under VA coverage.
• Check the VA formulary.

6. Medicare Advantage plans can be good options for veterans

A Medicare Advantage plan may be worth considering if you are a veteran.

A Medicare Advantage plan will provide all the same coverage as Original Medicare, and some Medicare Advantage plans may cover some additional benefits that Original Medicare doesn’t.

Medicare Advantage or Medicare Supplement plan for Veterans just might alleviate some of these costs. Please call (702) 541-0882 to speak with a licensed representative

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MEDICARE SUPPLEMENT

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:

• Copayments
• Coinsurance
• Deductibles

Some Medigap policies also cover services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. Before you travel outside the U.S., talk with your Medigap plan or insurance agent to get more information about your Medigap coverage while traveling.

If you have Original Medicare and you buy a Medigap policy, here’s what happens:

• Medicare will pay its share of the Medicare-approved amount for covered health care costs.
• Then, your Medigap policy pays its share.

8 THINGS TO KNOW ABOUT MEDIGAP OR MEDICARE SUPPLEMENT

• You must have Medicare Part A and Part B.
• A Medigap policy is different from a Medicare Advantage Plan.  Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
• You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
• A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
• You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
• Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
• Some Medigap policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments.
• It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you’re switching back to Original Medicare.

MEDIGAP POLICIES DON’T COVER EVERYTHING

Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

You also need a separate Prescription Plan.

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INSURANCE PLANS THAT ARE NOT MEDIGAP

Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

You also need a separate Prescription Plan.

Some types of insurance aren’t Medigap plans, they include:

• Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
• Medicare Prescription Drug Plans
• Medicaid
• Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
• Tricare
• Veterans’ benefits
• Long-term care insurance policies
• Indian Health Service, Tribal, and Urban Indian Health plans

You may want a completely different Medigap policy (not just your old Medigap policy without the prescription drug coverage). Or, you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage. If you decide to drop your entire Medigap policy, you need to be careful about the timing.

Let’s talk about how a Medicare Advantage or Medicare Supplement plan just might alleviate some of these costs. Contact Us to speak with a licensed representative

SIGN UP FOR MEDICARE

ELECTION PERIODS

You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.

Did you move to a new address that isn’t in your plan service area?

You can switch to a new Medicare Advantage Plan or Medicare Prescription Drug Plan.

If you’re in a Medicare Advantage (MA) Plan and you move outside your plan’s service area, you can also choose to return to Original Medicare. If you don’t enroll in a new MA Plan during the time explained below, you’ll be enrolled in Original Medicare when you’re disenrolled from your old Medicare Advantage Plan. When?

If you tell your plan before you move, your chance to switch plans begins the month before the month you move and continues for 2 full months after you move.

If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months.

Did you move to a new address that’s still in my plan’s service area, but I have new plan options in my new location.

What can you do?

Switch to a new Medicare Advantage Plan or Medicare Prescription Drug Plan.  

When?

If you tell your plan before you move, your chance to switch plans begins the month before the month you move and continues for 2 full months after you move.

If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months.

Did you move back to the U.S. after living outside the country?

What can I do?

Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month you move back to the U.S.

Did you move into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital)?

What can I do?

• Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
• Switch from your current plan to another Medicare Advantage Plan or Medicare Prescription Drug Plan.
• Drop your Medicare Advantage Plan and return to Original Medicare .
• Drop your Medicare prescription drug coverage.

When?

Your chance to join, switch, or drop coverage lasts as long as you live in the institution and for 2 full months after the month you leave the institution.

Did you just get released from jail?

Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month you’re released from jail.

Did you lose Medicaid?

What can I do?

• Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
• Switch from your current plan to another Medicare Advantage Plan or Medicare Prescription Drug Plan.
• Drop your Medicare Advantage Plan and return to Original Medicare .
• Drop your Medicare prescription drug coverage.

When? 

Your chance to change lasts for 3 full months from either the date you’re no longer eligible or notified, whichever is later.

Did you leave coverage from an employer or union (including COBRA coverage?

What can I do?

Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month your coverage ends.

Did you involuntarily lose other drug coverage that’s as good as Medicare drug coverage (credible coverage), or my other coverage changes and is no longer credible?

What can I do?

Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Your chance to join lasts 2 full months after the month you lose your creditable coverage or you’re notified that your current coverage is no longer creditable, whichever is later.

Did you have drug coverage through a Medicare Cost Plan and you left the plan?

What can I do?

Join a Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after you drop your Medicare Cost Plan.

Did you drop coverage in a Program of All-inclusive Care for the Elderly (PACE) plan?

What can I do?

Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month you drop your

Program Of All-Inclusive Care For The Elderly (Pace)plan. 

Do you have a chance to enroll in other coverage offered by your employer or union?

What can I do?

Drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan to enroll in the private plan offered by your employer or union.

When?

Whenever your employer or union allows you to make changes in your plan.

Do you have or are enrolling in other drug coverage as good as Medicare prescription drug coverage (like TRICARE or VA coverage)?

What can I do?

Drop your current Medicare Advantage Plan with drug coverage or your Medicare Prescription Drug Plan.

When?

Anytime.

Are you enrolled in a Program of All-Inclusive Care for the Elderly (PACE) plan?

What can I do?

Drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Anytime.

Did your Medicare plan take an official action (called a “sanction”) because of a problem with the plan that affect you?

What can I do?

Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.

When?

Your chance to switch is determined by Medicare on a case-by-case basis.

Did Medicare end (terminates) your plan’s contract?

What can I do?

Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.

When?

Your chance to switch starts 2 months before and ends 1 full month after the contract ends.

Did Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare non renew?

What can I do?

Join another Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

December 8–the last day in February.

Are you eligible for both Medicare and Medicaid?

What can I do?

Join, switch, or drop your Medicare Advantage Plan or Medicare prescription drug coverage.

When?

One time during each of these periods:

• January–March
• April–June
• July–September

If you make a change, it will take effect on the first day of the following month. You’ll have to wait for the next period to make another change. You can’t use this Special Enrollment Period from October–December. However, all people with Medicare can make changes to their coverage from October 15–December 7, and the changes will take effect on January 1.

Did you qualify for Extra Help paying for Medicare prescription drug coverage?

What can I do?

Join, switch, or drop Medicare prescription drug coverage.

When?

Most people with Medicare can only make changes to their drug coverage at certain times of the year. If you have Medicaid or receive Extra Help, you may be able to make changes to your coverage one time during each of these periods:

•  January – March
•  April – June
•  July – September

If you make a change, it will begin the first day of the following month. You’ll have to wait for the next period to make another change. You can’t use this Special Enrollment Period October – December. However, all people with Medicare can make changes to their coverage October 15 – December 7. The changes will begin on January 1.

Are you enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility?

What can I do?

Join either a Medicare drug plan or a Medicare Advantage Plan with prescription drug coverage.

When?

Once during the calendar year.

Did you drop a Medigap policy for the first time you joined a Medicare Advantage Plan?

What can I do?

Drop your Medicare Advantage Plan and enroll in

Original Medicare. You’ll have special rights to buy a Medigap Policy.

When?

Your chance to drop your Medicare Advantage Plan lasts for 12 months after you join the Medicare Advantage Plan for the first time.

Did you have a severe or disabling condition, and there’s a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with your condition?

What can I do?

Join a Medicare Chronic Care Special Needs Plan (SNP).

When?

You can join anytime, but once you join, your chance to make changes using this SEP ends.

Are you enrolled in a Special Needs Plan (SNP) and no longer have a condition that qualfies as a special need that the plan serves?

What can I do?

Switch from a Special Needs Plan (SNP) to a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

You can choose a new plan starting from the time you lose your special needs status, up to 3 months after your SNP’s grace period ends.

Did you join a plan, or chose not to join a plan, due to an error by a federal employee?

What can I do?

• Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
• Switch from your current plan to another Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
• Drop your Medicare Advantage Plan with drug coverage and return to Original Medicare.
• Drop your Medicare prescription drug coverage.

When?

Your chance to change coverage lasts for 2 full months after the month you get a notice of the error from Medicare.

Were you not properly told that your other private drug coverage wasn’t as good as Medicare drug coverage (credible coverage)?

What can I do?

Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month you get a notice of the error from Medicare or your plan.

Were you not properly told that you were losing private drug coverage that was as good as Medicare drug coverage (credible coverage)?

What can I do?

Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month you get a notice of the error from Medicare or your plan.

HELPFUL LINKS

WHAT DO YOU DO FIRST TO GET MEDICARE?

Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare too, including those with disabilities and those who have permanent kidney failure. The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have Original Medicare (Part A and Part B) coverage, you can buy a Medicare Supplement Insurance (Medigap) policy from a private insurance company. Las Vegas Henderson NV

You can fill out a form and mail it. Contact Us when you get your cards.

APPLY FOR PART B MEDICARE

WHEN WILL MEDICARE START?

LOW-INCOME ASSISTANCE

Low-income assistance or Extra Help is offered by the Social Security Administration. It provides beneficiaries, with limited income and resources, financial assistance towards the cost of paying plan premiums and may assist with deductibles and copayments.

Some beneficiaries automatically qualify and do not need to apply. Those who do not automatically qualify will need to contact the Social Security Administration.

To qualify for Extra Help, annual income may not exceed 150% of the Federal Poverty Level (FPL). The Social Security Administration offers 4 levels of low-income assitance based on Federal Powerty Level data. Once a beneficiary qualifies for low-income assistance, they will receive a “low-income subsidy” until such time as they fail to meet the qualifications. Qualifications for low-income assistance are reviewed on an annual basis.

Once you qualify for Extra Help you will need to enroll in a Medicare Plan to receive the benefits. Contact Us for assistance at no cost to you.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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