Senior Insurance Plans
WHat you Need for a Supplement, PDP Advantage PlaN or DSNP
You need to have your Medicare Card 1st! For Supplements, or Advantage Plans: You need to be Eligible for Part A and Enrolled into Part B. Aging into or Qualifying for Medicare Rules at age 65: You have a 7 month window for your Initial Enrollment: 3 months prior to your birth month, (This is the best time to sign up), Your Birth Month and up to 3 months after your birth month. OR being disabled on Social Security Income for 24 months. You may choose to work past the age of 65, which you can but you need to have what Medicare considers to be "Credible Coverage".
PDP: You need to have your Medicare Card - Be eligible for Part A and/or Enrolled into Part B. There is a Penalty for not signing up for Part D when it was 1st available to you if you did not have qualifying prescription insurance, "Credible Insurance". The highest percentage of the populace that I meet with could not afford the Medications they need without a Drug Plan.
If you are 65 & do not receive your Medicare Card, you need to contact Social Security to enroll or obtain a coy. Call them at 800-772-1213 or enroll on-line at www.socialsecurity.gov .
You can still work after you turn 65. Many employers offer credible coverage to their employees. There is a penalty for not taking Part B, when it was 1st offered to you. There are time limits when your credible coverage ends. You need to sign up for Part B before the time limit to avoid a penalty.
Are you on Indiana or Ohio Medicaid AND Medicare?
If you are on Medicare & Medicaid you need your State Medicaid Card Also
There are specific Medicare Plans for those receiving Medicare & Medicaid both. Many of these plans offer a wide range of benefits and some with a 0 premium. Call me 260-517-8182 for more informaton.
Starting in April 2023: Medicare Members to Be Impacted by Medicaid Redetermination
Starting in April 2023, states will have the ability to resume the Medicaid Redetermination process after three years of being paused due to the COVID pandemic. States can begin to initiate the redetermination process as early as February 1, 2023, and disenrollment's can be effective as early as April 1 if adequate notice is given to the enrollee. Each state will set the date for when redetermination will start.
Approximately 15 million individuals will be at risk of losing Medicaid coverage. Anyone who is no longer eligible for Medicaid will be disenrolled.
Make sure you check your mail carefully for any mailings form your state Medicaid.
WHo Else Qualifies?
Are you Disabled?
Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period. The first 24 months of disability benefit entitlement is the waiting period for Medicare coverage.
SUmmary of Medicare Supplement "MediGap" Plans
Supplement Letter Plan
A Medicare Supplement policy (LETTER PLAN ), covers many out-of-pocket medical expenses Original Medicare does not cover. You can go to any facility that accepts Medicare in the U. S. With a Supplement: Most citizens that work for 10 years qualify for Part A, You Pay for your Part B, Your Supplement Premium and Part D Premium if you also want Prescription Drug Coverage.
Yes, that is 3 payments, Every Month. The Supplement "Medi Gap" is Guaranteed Issue when you are first eligible for Medicare.
You need to have your Medicare Card. If you want a Drug Plan, “Part D” there is a separate monthly premium. This is in addition to your Part B premium, and your Supplement premium.
That is 3 payments monthly, if you want a Supplement "MediGap" plan and a PDP Prescription Plan.
There is a Penalty for not signing up for Part D when it was 1st available to you if you did not have qualifying prescription insurance, "Credible Insurance". The highest percentage of the populace that I meet with could not afford the Medications they need without a Drug Plan.
There is a penalty for not taking Part B, when it was 1st offered to you.
PDP Plans
If you want a Drug Plan, “Part D” there is a separate monthly premium. This is in addition to your Part B premium.
You can use Original Medicare that covers on average 80% of Medical Costs and buy a PDP plan. You must qualify for Part A and be eligible for Part B.
There is a Penalty for not signing up for Part D when it was 1st available to you. Or if you did not have qualifying prescription insurance, usually through an employer.
The highest percentage of the populace that I meet with could not afford the Medications they need without a Prescription Drug Plan.
Advantage Plans, Part D Plans, and Special Needs Plans
Many Advantage Plans combine Medical and Prescription Drug Costs for a $0 to low monthly premium. Many also offer extra benefits like hearing, dental, vision, transportation plus more benefits depending on the plan, state, zip code, and the county you live in.
You need to be Eligible for Part A and Enrolled into Part B.
Advantage Plans have been Guaranteed Issue.
Advantage Plans vary from county to county within each state and in some instances by specific zip code depending on where you live. Some plans combine Hospital, Doctors, and Prescription Drug Coverage. Some plans are Hospital and Doctors only. Not all doctors choose to participate in every Advantage plan. A doctor could accept 3 plans with the same carrier but not the other 4 plans offered in your county for that same carrier.
Doctors can leave any plan throughout the calendar year. Each year, plans, prescription drugs and carrier benefits change, as do costs.
Every year I take Federal Medicare training, test out, then take specific courses, and test out for each carrier that I write advantage plans for. Additionally, I complete 24-Credit Hours of training and tests every two years to comply with Indiana Insurance Training Requirements
AEP
AEP October 15th Through December 7th
Open Enrollment
Open Enrollment for specific changes to Advantage Plans & Original Medicare: Open Enrollment is from January 1st through March 31st.
What Can You Do During Open Enrollment
Switch from Original Medicare to a Medicare Advantage Plan, or Switch from a Medicare Advantage to Original Medicare & add a Part D Plan (penalty may apply See Below), Switch from one Medicare Advantage plan to another Medicare Advantage Plan, Enroll in a Part D Prescription Drug Plan for the first time. If you are outside of “When you are/were 1st eligible": (a late enrollment penalty may apply) The late enrollment penalty (also called the “LEP” or “penalty”) is an amount that may be added to a person’s monthly premium for Medicare drug coverage (Part D). A person enrolled in a Medicare plan may owe a late enrollment penalty if they go without Part D or other creditable prescription drug coverage for any continuous period of 63 days or more after the end of their Initial Enrollment Period for Part D coverage.
Testimonials
Teri T. Carla has helped me with my insurance for many years. She is your best bet to get ahold of. She actually cares and knows the rules.
You May Be Missing Benefits
You may not be getting all of the benefits through your current Medicare plan and may not know what you are eligible for. There are new plans, costs, inclusions, exclusions, and different prescription drugs every year that you should be aware of. You may be missing out on benefits you are eligible to receive through new plans offered. Some Prescription costs may be cost-prohibitive through one plan and more affordable on another.
One of the 1st things I do, when I sit down with clients every year, is go over their current prescriptions. Every year the formularies (what drugs are listed on every specific plan) and the costs of those prescriptions can and often change. You will need to check every medicine every year to make sure it is on the plan formulary you choose, what tier it is on, and what the cost is.
If you are on Medicaid and Medicare both, you may be missing many benefits. There are Special enrollment periods for Dual Special Needs Plans throughout the year. Your income determines if it meets the criteria for being a Medicaid Beneficiary in your state. Each state has its own base monetary limit.
The Annual Enrollment Period (AEP) is from October 15th through December 7th. These plans have an effective date of January 1st, of the following year.
The Open Enrollment is from January 1st through March 31st.
Dental Indiana & Ohio
Qualifications
I work tirelessly to stay informed about the latest changes in the healthcare markets. This requires Federal Medicare training every year with every Carrier through which I write Advantage Plans, PDP Plans, and training through the ACA "Affordable Health Care" nicknamed Obama Care for Family and Individual Plans. I can provide you with the information that is current for each Annual Enrollment Period, and for those Special Enrolment Periods. I started in insurance with AH&D in the late 1970's
Beware
Did you know if you click on certain websites and provide as little as your email, your information will be sold to SEVERAL agents and companies that will start calling you, sending emails, texts, and may knock on your door even if that is not compliant with CMS (Centers for Medicare Services). Unfortunately, people have become prey, and become victims from telemarketers, SPAM Email’s, clicking on the wrong web site, and other unscrupulous tactics.
Examples of Bait & Switch are “benefits you may be missing”, have you received your free food card, have you received your free Life Alert, do you have free transportation, free dental & vision, no cost hearing aids and more. Too often unsuspecting people end up with no policy or not the right policy for them. Please, don't fall for the Bait & Switch tactics. When you can't or don't want to shop local in your, area, call me: Carla J Mattingly, I can help you with plans in Indiana & Ohio, Phone 260-517-8182.
Prscription Cost Saving Sites
PDP Drug Cost Saving Web Sites Listed below are free to use
National Drug Card https://nationaldrugcard.com/
Good RX: https://www.goodrx.com/
SingleCare Prescription Discount Card: www.singlecare.com
Know this?
Robo Calls Telemarketers and 3rd Party Telemarketers for a Carrier or Sales Agent
2023 Marketing Compliance Guidelines
- Without your written permission or now Recorded Permission, Robo or telemarketers are not allowed to contact you by Phone, Text, or Knock on Your Door for Medicare Sales or Added Benefits that are used as a bait and switch to get your information and connect you to a thief or agent that has used non-Medicare compliant means to get in contact with you. Only with your written permission or Recorded Call permission is it compliant for anyone to call you, send a text, or knock on your door for Medicare Sales. It is best not to answer calls from any number you do not recognize. Do not ever say "Yes" to an incoming call from someone you do not know.
- Interrupt Marketing calls for Medicare Sales or "Benefits" you may be missing are NOT Compliant with Medicare Contact Guidelines Unless you gave them Written or Recorded Permission to contact you. Do not say yes to any question, hang up immediately. Better yet, do not answer any calls from a number you do not recognize. THESE ARE BAIT & SWITCH calls.
- Most non-compliant callers use local phone numbers that are not in service or disconnected as a rouse to get you to answer. Many of these calls originate from outside the United States. Using local numbers that are unassigned or disconnected, makes it difficult to trace, and helps them avoid prosecution and fines. It requires legal action to trace numbers. There are ways and places to report people and numbers calling you.
- Every year I hear horrible instances from people that have been taken advantage of by Telemarketers.