Medicare Plan Options & Enrollment

Creative Health Insurance provides Medicare plan information and enrollment assistance and help to people living in Connecticut. If you are new to Medicare or just want to understand Medicare and what your Medicare Options are, we can help you. As an Insurance agent, I will assist you through the Medicare enrollment process of Part A and Part B. Then we can look for your doctors and your prescriptions, and what your specific and prescription medical needs and other desires are. There are many Medicare Plan Options including Original Medicare, Medicare Advantage Plans, Medicare Supplement Plans, Prescription Drug Plans and Dental Plans. Also, if you are eligible, I will help you with Medicare Extra Help, Low Income Subsidies, and Medicare Savings Programs. These programs can help pay for premium costs, copay’s, deductibles, and other benefits.

Medicare Health Plans are complicated because every Medicare plan has different doctors, hospitals, pharmacies, and drugs that are in their network. I will help you by removing those Medicare Plans and Options that don’t have your doctors, or your prescriptions, and explain to you those plans and options that fit your needs and desires, so you can make a good decision.

You do not have to do this alone. I am licensed and “Certified” by the local insurance companies to explain their Medicare Health Plan benefits to you. As an insurance broker, I represent many Medicare Health plans that are available in Connecticut. I am paid directly from the Medicare Health plans to help you enroll, to assist you during the year, and to explain your plan changes at renewal time.

Call us today 860-647-7353

Here are some common questions we will cover:

What is Medicare?

Medicare is a federal health insurance program in the United States. The Center for Medicare and Medicaid (CMS) is the government division that is responsible for Medicare. CMS develops rules and regulations that must be followed by all Medicare plans, all medical providers and all Medicare beneficiaries.

Who is eligible for Medicare?

Medicare can provide health care coverage for these persons:

• People who are age 65 and older
• People under 65 with disabilities
• People with End-Stage Renal Disease, (this is a permanent kidney failure that requires dialysis, or a kidney transplant.)
  
  The term “Medicare Beneficiary” is the proper term which refers to people who are on Medicare.

Medicare Part A and Part B

Medicare is managed by the Federal Government and only offers an individual health plan.
This means your spouse , partner, or children cannot be covered by your Medicare plan.
When they become eligible for Medicare, they must enroll and get their own Medicare health plan.
(This is a good rule because everyone can get a health plan that best fits their desires and medical needs.)

The government issues the Medicare Part A and Part B claim card which is red white and blue.
Generally speaking, If you are just turning age 65, Medicare allows you 7 months to enroll in Medicare Part A and Part B. This window starts 3 months before you turn age 65, the month of your birthday ,and the following 3 months after your birthday month. There are other special enrollment periods when you can apply to be enrolled into Medicare Part A & B.

Within the Medicare plan system there are many rules and regulations to watch out for. If you fail to follow these rules, you can be assessed penalties or could be left without health coverage.

What does Medicare Cover?

Medicare is very different from the health plans you had from work or from your spouses work. With work plans, you had a single plan for your family and yourself, which covered everyone for hospitals, doctors, prescriptions, and other medical services. The Medicare health plans allow only one person on a plan. So an eligible husband and wife are written on 2 separate Medicare plans. Medicare health plans are broken into 4 different expenses and coverage’s.

Medicare is made up of 4 different parts and each part covers different medical expenses:

The 4 Parts to Medicare are:

• Part A: Hospital
• Part B: Medical Services
• Part C: Medicare Advantage Plans
• Part D: Prescription Drug Plans
  

Part A: Hospital Insurance
Hospital insurance helps pay for inpatient care in a hospital and/or skilled nursing facility and some home health care and hospice care. Many people do not have to pay for Medicare Part A: Hospital Insurance coverage.

Part B: Medical Services
Medical services helps pay for medical provider services and many other medical services and supplies that are performed without a hospital overnight stay. Most people pay a monthly charge for Medicare Part B: Medical Services. (When Medicare Part A and Part B are together . . . . they are referred to as “Original Medicare”.)

How do I sign up for Medicare?

When people talk of Medicare they are usually talking about “Original Medicare” Parts A and Part B. These coverages are issued by the Federal Government on a red, white, and Blue card. You must enroll in Medicare Part A or Part B from Social Security. Some people receive Medicare cards in the mail with Part A and Part B within 3 months before they turn age 65. Note: This is not the rule for everyone. Every person is different and therefore many different rules and regulations apply to each person separately.

PLEASE NOTE! I have found that sometimes you need to be involved with enrolling into Medicare with your local Social Security office. With the Covid 19 pandemic, many offices have shut down and many employees are working at home. If you would like me to be like an advocate to assist and walk with you through this process, I would be glad to help you. I will be available to you every step of the way, sometimes just to answer questions or to affirm you are on the right track.
Call Robin Dubord today! 860-647-7353

Medicare Part A and Part B will only help pay your health care bills. Part A and Part B have a large hospital deductibles and coinsurances and other medical costs that can leave you with large bills to pay. However you have Options!

Medicare Supplement Plans (Medigap Plan)
Insurance companies offer health plans that helps supplement and fill these gaps of coverage.  In Connecticut,  these Medicare plans are referred to as a Medicare Supplement Plans. These plans will help pay for the deductibles and coinsurance “gaps” for Part A and Part B.

Part D: Prescription drug coverage
Prescription drug coverage helps pay for medications doctors prescribed for treatment outside of a hospital. (outpatient drugs) These are offered through private health and drug companies. Each company has a list of drugs (formulary) that are covered and each plan has different copays for every prescription drug.

Medicare General Rules for Prescription Drug Plans

• A Prescription Drug Plan is not required by law, but, if you do not have a prescription plan or you don’t stay enrolled in prescription drug plan, there could be a 1% penalty each month you do not have drug coverage, for the rest of your life.
• There are specific time periods during the year when Medicare will allow you to enroll or change your prescription drug plan.
• Medicare Beneficiaries may also get additional financial help with drug coverage. Government can provide assistance to people with low incomes.
• You can only Have 1 drug plan.
  

PART C Medicare Advantage Plans

Medicare Advantage plans are available in many states. People with Medicare Parts A and B can choose to receive all of their health care services through a Medicare Advantage plan.

Medicare Advantage Plans must provide hospital and medical services coverage you find under Medicare Part A and Part B. Some plans also include  prescription drug coverage. These advantage plans can offer extra coverage’s like: dental, vision, hearing aids and more.

When you enroll in a Medicare Advantage plan, you must continue to pay your premiums for Medicare Part B. You may also need to pay a premium to the Medicare Advantage Plan.

There are specific time periods during the year when Medicare allows you to enroll in a Medicare Advantage Plan or change your Medicare Advantage Plan.

For more information or enrollment assistance Call us today 860-647-7353

New to Medicare?

If you are going to be new to Medicare, the first step for you is to enroll in Medicare Part A and Part  B. If you are still working you may need to apply for Medicare Part A and/or Part B.

Generally speaking, some people will be enrolled automatically into Medicare Part A and Medicare Part B. If you are under age 65 and disabled, there could be a waiting period of up to 24 months. If you are working you may want to talk with your human resource person at work. If you do not want your employer to know you may be leaving them, give me a call and we will see if you need to talk with human resources or not. Call me, Robin Dubord 860-647-7353.

Medicare has rules and regulations. I am trained, tested, and certified every year to help you. I will guide you through the enrollment process to avoid problems and can help explain your Medicare options with other insurance plans that are available in Connecticut.

There are subsidies for Medicare beneficiaries who have a lower income. I will analyze your situation and when appropriate, help you with those benefits.

I will prescreen plans with you to see which plan has your doctors and prescriptions and the yearly costs to help you decide which medicare plan would best fit you medical needs.

I am a local insurance agent that enjoys helping people with health care and Medicare. I have a professional office to help people. If you have any questions or could use my help, don’t hesitate to call me at 860-647-7353. or you can email me at robindubord@comcast.net

As a reminder, we offer many virtual tools that will enable you to practice social distancing, and continue business as normal.

Please feel free to call our office 860-647-7353, or email RobinDubord@comcast.net.