Who Is Eligible for Medicare and Medicaid?

Understanding how to qualify for Medicare and Medicaid is vital, especially as you approach retirement age. These two programs provide essential healthcare coverage but differ in their eligibility requirements and benefits. Here’s a comprehensive look at who qualifies for Medicare and Medicaid and how the two programs can work together.

What Are Medicare and Medicaid?

Although they sound similar, Medicare and Medicaid serve different purposes.

Medicare

Medicare is the federal health insurance program primarily serving individuals 65 and older. However, some younger individuals may qualify if they have specific disabilities or conditions, such as end-stage kidney disease (permanent kidney failure). Medicare has four parts:

Part A: Covers hospital insurance, including stays in hospitals and skilled nursing facilities.
Part B: Covers medical insurance, including doctor visits and outpatient services.
Part C (Medicare Advantage): A private insurance plan that combines Part A and Part B coverage and may offer additional benefits like dental, vision, and hearing coverage.
Part D: Covers prescription drug coverage through private insurance plans.

Medicaid

Medicaid is a joint federal and state program that assists with medical expenses for individuals with limited income and resources. Medicaid eligibility can vary by state, but generally, you may qualify if you meet certain income thresholds and belong to one of the following groups:

Adults 65 or older
Children under age 19
Pregnant women
Individuals with disabilities
Parents or caregivers of dependent children

What Does “Dual Eligibility” Mean?

“Dual eligibility” refers to individuals who qualify for Medicare and Medicaid. Approximately 12 million Americans are dual eligible, which means they can benefit from both programs. Medicare typically serves as the primary insurance, covering most healthcare services. At the same time, Medicaid provides secondary coverage for services that Medicare does not cover, such as long-term care and some personal care services.

How Do You Qualify for Dual Eligibility?

To be dual eligible, you must meet the requirements for both Medicare and Medicaid:

Medicare requirements: Be 65 or older or under 65 with a qualifying disability or condition.
Medicaid requirements: Be within the income limits set by your state and fall into one of the eligible categories listed above.

Once enrolled in both programs, Medicaid will work alongside Medicare to help cover additional healthcare expenses.

Benefits of Being Dual Eligible

Being dual-eligible offers several advantages. Here are some of the benefits:

Greater coverage: Medicaid helps pay for healthcare services that Medicare doesn’t, such as long-term care and some medical supplies.
Low to no cost: Medicaid can help cover out-of-pocket costs that may not be fully paid by Medicare, like coinsurance, copayments, and deductibles.
Comprehensive care: Medicaid may also cover dental services, counseling, and vision care, often not included in Medicare plans.

Services Covered by Dual Eligibility

Dual eligibility can give you access to a range of healthcare services:

Durable medical equipment: Items like walkers, wheelchairs, and oxygen equipment.
Doctor visits: Regular checkups, specialist visits, and preventive care.
Hospital services: Both inpatient and outpatient hospital care.
Prescription drugs: Most dual-eligible individuals can access prescription drug coverage through Medicare Part D.
Dental and vision services: Many Medicaid programs cover dental visits, eye exams, and glasses.

What Are Dual Eligible Special Needs Plans (D-SNPs)?

A Dual Eligible Special Needs Plan (D-SNP) is a Medicare Advantage plan designed specifically for eligible people for both Medicare and Medicaid. D-SNPs combine Medicare and Medicaid benefits into a single plan, simplifying the healthcare management process. These plans offer:

Part D drug coverage: No additional cost for prescription drugs.
Care coordination: A care coordinator is assigned to help you manage your health, ensuring you get the best care possible.

Conclusion: Understanding Your Eligibility

Navigating Medicare and Medicaid eligibility can seem complicated, but understanding the requirements and benefits of each program can help ensure you have the coverage you need. If you’re eligible for both programs, dual eligibility offers comprehensive healthcare coverage that can help manage out-of-pocket costs and ensure you get the care you deserve. For assistance with enrollment or to learn more about how these programs work together, contact one of our knowledgeable insurance agents and advisors, who can guide you in your next steps.

A Guide to Paying Medicare Premiums Online

As you get closer to retirement age and you have met all eligibility requirements, you gain the opportunity to enroll in Medicare. Your premiums will be lower but must be kept current, just like any other insurance policy. Thankfully, Medicare has several options for paying your premiums online.

How Often Will I Receive Medicare Bills?

Most people have their Medicare Part B (Medical Insurance) premiums automatically deducted from their Social Security benefits (or Railroad Retirement Board benefits). However, if you don’t receive these benefits, Medicare will send you a bill for the premium.

Part A: You’ll receive a monthly bill if you pay for Part A (hospital insurance).
Part B: If you only pay for Part B, you’ll receive a premium bill every three months.
Part D: If applicable, you will also receive monthly bills for Part D’s income-related monthly adjustment amount (IRMAA); if you are below a certain income bracket, you do not have to pay this. IRMAA is a sliding scale charge added for those with higher incomes.

Three Ways to Pay Your Medicare Premium Bill

There are four main ways to pay your Medicare premiums online. Each option has advantages. Choose the best one for your needs.

1. Pay Through Your Medicare Account

The fastest and most secure way to pay your premiums is by logging into your Medicare account. Here’s how to do it:

Log in: Create or log into your secure Medicare account (https://www.medicare.gov/account/login)
Select payment: Click on the “Pay My Premium” option.
Choose your payment method: Use a credit or debit card, Health Savings Account (HSA) card, or checking or savings account.

Once your payment is processed, you’ll receive a confirmation number. Payments from checking or savings accounts may take around five business days, while credit card payments are faster.

2. Medicare Easy Pay (Recurring Payments)

Medicare Easy Pay is a convenient service that automatically deducts monthly premium payments from your checking or savings account. You can sign up for Medicare Easy Pay in two ways:

Log in: Log into your Medicare account and select “Sign Up for Easy Pay.”
Complete a form: Complete and send in the paper “Authorization Agreement for Pre-authorized Payments” form. You must print this at home; your local library may also have printing services.
Mail it in: Send your authorization for recurring payments to:
Medicare Premium Collection Center
P.O. Box 979098
St. Louis, MO 63197-9000
Receive your confirmation: Once enrolled, you’ll see a message in your Medicare account confirming that Easy Pay is active.

Deductions typically occur on the 20th of each month, and it can take 6-8 weeks for automatic deductions to begin.

3. Paying Medicare Premiums with Your Bank’s Bill Payment Service

Many banks provide online bill payment services, where you can pay your Medicare premiums through their portals. While convenient, this method requires you to manually update your payment information each year if your premium amount changes.

How to Pay Medicare Part D, Medicare Advantage, and Supplement Plan Premiums

Private insurers often offer Medicare Advantage, Part D, and Medicare Supplement plans. Payment methods for these plans vary by insurer, but common options include:

By Phone
By Mail
Electronic Funds Transfer (EFT)
Online

Always check with your private insurer to determine the available payment methods for your plan.

Why Is My First Medicare Bill Higher Than Expected?

It’s not uncommon for your first bill to be higher than anticipated. This could be due to the addition of the income-related monthly adjustment amount (IRMAA) or other administrative fees. If you’re unsure, you can contact Medicare for clarification or review the details on your bill.

Can I Get Help Paying Premiums and Medicare Costs?

If you’re experiencing financial hardship, assistance may be available to help cover your premiums and other costs, such as deductibles, coinsurance, and copays. You may qualify for programs offering reduced premiums based on income level. Visit your state’s Medicare website for more information about financial assistance.

Online Payments Make Paying for Medicare Easy

By understanding your options and setting up automatic payments, you can simplify paying your Medicare premiums, ensuring your health coverage remains uninterrupted. Stay informed and choose the best payment method for your lifestyle. Please don’t hesitate to ask if you need further assistance or have questions regarding your Medicare coverage. Call one of our Medicare insurance agents for help today.

Common Medicare Myths Debunked

As one of the most vital health programs in the U.S., Medicare serves older adults and individuals with specific disabilities. In September 2024, Medicare enrollment totaled 68 million, as reported by the Centers for Medicare & Medicaid Services (CMS). For many individuals, Medicare is a subject that can inspire confusion. It is surrounded by myths and misconceptions that could lead to missed opportunities for coverage and costly mistakes. Here, we set the record straight by debunking some common Medicare myths.

Myth #1: Medicare Covers Everything

Although Original Medicare (Parts A and B) covers many essential healthcare services, including hospital stays and outpatient care, some notable gaps exist. Routine dental care, vision exams, hearing aids, and most prescription drugs are not covered. If you want more comprehensive coverage, consider opting for a Medicare Advantage Plan (Part C), adding a Medigap (Medicare Supplement) plan, or a stand-alone prescription drug plan (Part D) to help fill the gaps in Original Medicare coverage.

Myth #2: Medicare Is Free

Medicare is a valuable program that makes healthcare more affordable for older adults, but it is not free. Although most people pay no premium for Part A (hospital insurance), Part B (medical insurance) requires a monthly, income-based premium. In 2025, the standard Part B premium was $185 per month. Higher earners pay more based on Medicare Income Related Monthly Adjustment Amounts (IRMAA). Individuals with yearly incomes above certain thresholds pay additional fees on top of Part B and Part D premiums.

Myth #3: You Are Automatically Enrolled in Medicare at Age 65

If you already receive Social Security benefits when you turn 65, you may be automatically enrolled in Medicare. For those not yet collecting Social Security benefits, you must actively enroll during your Initial Enrollment Period. This is the seven-month period that begins three months before your 65th birthday and ends three months after. This timeline is crucial, as missing your enrollment period could result in late penalties and gaps in coverage. Individuals who delay enrollment because they have employer-sponsored coverage may qualify for Special Enrollment Periods, but strict rules apply.

Myth #4: Medicare and Medicaid Are the Same

Although Medicare and Medicaid are government programs that make healthcare more accessible, they are not the same. Medicare is for people who are older or disabled, and Medicaid is for individuals or families with limited income and resources. Medicare is a federal program, and individual states control Medicaid programs. A person qualifying for Medicare and Medicaid is “dual eligible.” These two programs combined could cover most healthcare costs.

Myth #5: Medicare Covers Long-Term Care

The myth persists. Medicare does not cover long-term care in nursing homes or assisted living facilities. It only covers short-term stays in skilled nursing facilities following hospital admissions under specific conditions. Options to explore for your long-term care needs should include long-term care insurance, personal savings, and Medicaid.

Debunking myths and understanding the facts about Medicare allows you to make informed decisions about your healthcare coverage. Our friendly agent can answer any questions you may have and help you choose the best Medicare options for you.

Retiring in 2025? 5 Medicare Enrollment Tips for Success

Retirement marks the beginning of a new chapter of your life. If you are planning to retire in 2025, navigating Medicare enrollment may seem like decoding a puzzle. Nevertheless, with the right guidance and a little preparation, you can confidently make informed decisions and tackle Medicare enrollment. The following are some tips for success:

Know Your Enrollment Timeline

Timing is everything with Medicare enrollment. The Initial Enrollment Period (IEP) spans seven months, beginning three months before the month you turn 65 and ending three months after. For example, if you turn 65 in September 2025, your IEP runs from June through December 2025. Missing this enrollment window could mean costly penalties and delayed coverage.

If you continue working beyond age 65 and have employer-sponsored health coverage, you may qualify for a Special Enrollment Period when you retire. This allows you to enroll in Medicare without penalties. However, you must coordinate the transition carefully to avoid any gaps in coverage.

Understand the Different Parts of Medicare

Medicare is divided into four main parts:

Part A (hospital insurance): Most people do not pay a premium for Part A. It covers inpatient hospital care, skilled nursing facility stays, and some home health services.
Part B (medical insurance): This covers doctor visits, outpatient care, and preventive services. Part B comes with an income-based monthly premium.
Part C (Medicare Advantage Plans): An all-in-one alternative to Original Medicare, Part C plans are offered by private insurers. These plans often include Part A, Part B, and additional benefits, such as dental, vision, and prescription drug coverage. All Medicare Advantage Plan members pay Part B premiums. Some plans require additional premiums, while many others do not.
Part D (prescription drug coverage): Part D helps cover the cost of prescription medications. Even if you do not currently need any prescription meds, enrolling in Part D when you first become eligible can help you avoid late enrollment penalties for life.

Evaluate Your Healthcare Needs

Take a close look at your healthcare needs and budget. Are you managing chronic health conditions or visiting specialists frequently? Do you need specific prescription medications? Are dental, vision, and other additional benefits important for you? The answers to these questions can help you determine whether Original Medicare (Parts A and B) or a Medicare Advantage Plan (Part C) is a better choice for you. While Original Medicare offers broader provider access, it does not have an out-of-pocket maximum. Although Medicare Advantage Plans offer more limited provider access, they cap out-of-pocket expenses and often bundle additional benefits.

Do Not Overlook Medigap Coverage

If you opt for Original Medicare, consider purchasing a Medicare Supplement Insurance (Medigap) plan. These policies help cover out-of-pocket costs, such as deductibles and co-insurance. Medigap Open Enrollment runs for six months, beginning the month you enroll in Part B.

Compare Plans Carefully

Medicare Advantage and Part D plans can vary widely. It is important to compare your options based on premiums, coverage, and provider networks. Ensure your medications are covered and your preferred doctors and hospitals are in-network. Factor in premiums, deductibles, and copayments to get a full picture of the costs.

Our friendly agent will be happy to help you determine your best Medicare options and find a plan that suits your needs and budget.

What Does a Home Safety Assessment Involve?

As one gets older, getting around can become a little more challenging. One gets tired more easily; maybe one’s back is painful, or the knees or hips have become troublesome. Keeping things organized in your home environment can give you greater physical security and peace of mind. This is what a home safety assessment focuses on.

What is a Home Safety Assessment?

A home safety assessment reviews your living space and daily habits to find ways to improve the environment and reduce potential hazards. A licensed healthcare professional or medical social worker performs these assessments.

Does Medicare Cover a Home Safety Assessment?

Yes, if you have specific types of Medicare coverage. A home safety assessment can be covered for individuals with Medicare Part B, or Medicare Advantage plans when referred by a medical professional for a home safety assessment. You must have been enrolled in Medicare Part B for at least 12 months to be eligible. Many Medicare Advantage covers these assessments.

What To Expect During a Home Safety Assessment

A medical social worker will visit you to do the home safety inspection. Areas they will inspect to identify hazards will include the following:

Kitchen
Bathrooms
Stairs and steps
Bedrooms
Patios
Carpeting
Electrical cords in the home
Tripping hazards
Overall fire safety

Locating and addressing potential hazards helps you enjoy living in the comfort of your home without risking your health and well-being.

What Could Be Corrected by a Home Safety Assessment?

Types of issues that could be addressed include:

Repairing broken steps or worn or uneven carpets could be a tripping hazard.
Removing unsecured rugs or securing them to the floor.
Moving frequently used items to lower, easy-to-access cabinets.
Keeping walking areas clear of clutter.
Addressing slippery floors in bathrooms or showers.
Installing shower grab bars, safety rails, or handrails where needed.

How Long Does a Home Safety Assessment Take?

Each home is different, but you can expect a home safety assessment to take about one hour. At the end of the inspection process, the medical professional will review their findings with you. The inspector will then work with you to develop a plan to address any safety issues in your home.

When Should I Get a Home Safety Assessment?

You and your family members or loved ones can decide when a home safety assessment is a good idea, or it will happen as part of your insurance coverage, but only with your consent. Some reasons older adults decide to have their homes reviewed include:

To allow older adults to continue to live in the comfort of their homes.
To update a home for individuals facing physical changes due to a medical condition.
To help an individual recover more safely from a recent surgery.
To assist a loved one experiencing a cognitive decline.
To prevent another injury after a fall at home.
To assess potential hazards when moving into a new home.
To identify risks before a problem arises.

Live Comfortably: Increase Your Medicare Coverage

If you only have Medicare Part A, enrolling in Part B or a Medicare Advantage plan could open the door to many additional benefits, including home safety assessments. Contact one of our agents to schedule a one-on-one meeting today and to help yourself or a loved one stay comfortable and safe.

Medicare & Heart Disease: What is Covered

Heart disease is the leading cause of death in the United States. It accounts for over 600,000 deaths annually and affects both men and women across all racial and ethnic groups. It also primarily affects older adults. Here’s what you need to know about heart disease coverage if you have Medicare.

What is Heart Disease?

Heart disease is a broad term encompassing a range of heart conditions. These include:

Heart valve malfunctions
Irregular heartbeats, called arrhythmias
Congenital heart defects
Blood vessel disease near or in the heart
Heart muscle disease

What Heart Disease Treatment Does Medicare Cover?

The amount of coverage you have, including treatment for heart disease, depends on the type of Medicare you have enrolled in. If you are enrolled in Medicare Part A, you are covered only for emergencies. You will need Medicare Part B to participate in preventative actions like cardiovascular risk reduction treatments.

Medicare Part A (hospital insurance): This plan does not cover preventative actions or screenings. However, it can help cover expenses if you have an emergency, such as a heart attack, or need surgery, such as a coronary artery bypass.
Medicare Part B (medical insurance): Part B covers outpatient services like visits to a cardiologist or blood tests to check cholesterol levels. However, you may still be required to pay your deductible for these services.
Medicare Part C (Medicare Advantage): Medicare Advantage plans are offered by private providers approved by the Centers for Medicare & Medicaid Services (CMS). They can be adapted to your needs. If you have heart disease, you can ensure services of interest to you are included in your plan.
Medicare Part D (drug coverage): Heart medications are covered under Medicare Part D if you need prescription medication to manage a heart condition.

Medicare Advantage Can Also Help Fill Your Prescription

Medicare Advantage, or Medicare Part C, can also provide prescription drug coverage to manage heart conditions such as high blood pressure, arrhythmias, and Coronary Artery Disease (CAD). This is not automatically included in a Part C plan but should be requested when you enroll.

How Can I Prevent Heart Disease Using Medicare Resources?

Medicare Part B covers preventative services:

Diabetes screenings: Diabetes is closely linked to heart disease.
Smoking cessation counseling: Quitting smoking can cut the risk of heart attack and stroke in half within a year.
Obesity counseling: Maintaining a healthy weight can keep your heart healthy, too.
Cardiovascular disease screenings: As a preventative measure, all Medicare Part B patients can receive a heart disease screening every five years.

What Heart Disease Items Are Not Covered by Medicare?

Virtually any type of treatment for heart disease, preventative or remedial, is covered in whole or part by some portion of Medicare. The question is, do you have the coverage you need to receive the proper treatment? Contact our office today to find out what your Medicare plan covers and how you can improve your coverage to include more treatment options. One of our Medicare insurance agents will be glad to assist you.

Useful Apps for Tech-Savvy Seniors

People don’t go anywhere without their phones these days. Cell phones can provide critical assistance to seniors, regardless of their location. Protections are provided through certain “apps” or software applications. These helpful little programs are usually represented by a colorful tile or icon on your phone’s menu screen. Recent reports show that nearly 4,000 new apps are uploaded daily, but which ones are right for you? Read about some of the most valuable apps for tech-savvy seniors.

Forgot Where You Parked? There’s An App for That!

There are a few options to choose from, but “Find My Parked Car” does just what the name says it does. It can help you to take a photo of your parking spot and save your location. Later, when you’re ready to return to your car, the app will guide you back to its position. You can even turn on voice prompts to tell you to turn left or right as you walk through the parking garage or lot.

“What’s Covered” Medicare App

Most people have concerns about what falls under Medicare coverage and what doesn’t. This app, provided by the Centers for Medicare & Medicaid Services, offers simple answers to what you are looking for. Just type in the item or service, for example, “flu shots,” in the central search bar, and it will tell you it’s covered, in this case, under Medicare Part B. Services not covered by Medicare Part A and Part B are only available through Medicare Advantage plans. These include more comprehensive wellness options like dental and vision care. For help with your Medicare Advantage needs, contact one of our agents to get your questions answered.

Brain-Training to Improve Cognitive Performance

Keeping your mind sharp as you age can require some additional effort. Luckily, handy apps like Luminosity, Elevate, and CogniFit make it easier. Download one, and you’ll be provided with brain training and brain games to keep your mind flexible and alert. The CogniFit app even provides a tailored program just for you by using assessments to locate your current mental condition and guide you to the next level.

Medication Management Apps

Medisafe, which boasts 4.7 out of five stars and nearly 100,000 ratings, makes tracking and taking your medications easy. It helps you set reminders, make a schedule, and make sure you pick up a refill before you run out. Beyond the basics, it can also provide important information regarding any potential side effects or interactions between meds. It makes it possible to track the whole family, or just you and your partner, in one place. Other top-rated apps include MedManage, RoundHealth, and Pillboxie.

Apps For Staying Connected with Friends and Family

Relatively simple to use and less likely to be overwhelmed with the latest fads, Facebook is a great way to connect with family and friends. You don’t have to stop there either; many older adults find it fulfilling to reconnect with their high school class, groups, and old friends around the globe. Facebook makes it possible to be social without leaving the comfort of your home. If you are looking for a more sophisticated company, Senior Planet Community is another excellent app reserved for adults over 60. You’ll be able to connect and interact with your peers while the interface and everything about the app is designed with your ease of use in mind.

When It Comes to Health Insurance: You Don’t Need an App

Considering how to make your life easier or more secure? You don’t need an app when deciding on the best health insurance to complement your existing plan. Just call us. Our Medicare insurance agents are ready to walk you through the steps you need to take to get the best coverage to suit your situation. Schedule an appointment or come in to speak with one of our helpful agents today.

Your Guide to Medicare Advantage Open Enrollment

In addition to helping to maintain our health as we age, having a reliable healthcare insurance plan also provides real peace of mind. As a Medicare Advantage enrollee, you may know that it offers additional benefits not available with traditional Medicare, such as vision, dental, and prescription drug coverage. As we welcome the new year, a new enrollment period begins.

When Is Medicare Advantage Open Enrollment?

The Medicare Advantage Open Enrollment period is between January 1 and March 31 each year.

Who is Medicare Advantage Open Enrollment For?

The Medicare Advantage Open Enrollment period is only for people already enrolled in a Medicare Advantage plan. You heard that correctly; this is not for you if you do not yet have a Medicare Advantage plan. When enrolling in a Medicare Advantage plan, you will need to do so through your existing plan’s open enrollment period (Medicare’s Open Enrollment Period is later in the year, from October 15 to December 7).

What is Medicare Advantage Open Enrollment For?

There are only two specific purposes of the Medicare Advantage Open Enrollment period:

Changes: Those who have a Medicare Advantage plan are given the opportunity during this time to switch to another type of Medicare Advantage plan. For example, if your Advantage plan currently doesn’t have prescription coverage, but you have recently found that you will need it, you could speak to one of our agents during this time to get you signed up for a more suitable policy. It could work in reverse if you decide you don’t need drug coverage and want to drop it or want to try another Medicare Advantage provider that seems better for you.

Cancellations: During this time, you can cancel your Medicare Advantage plan and return to your original Medicare coverage.

What Can’t I Do During the Medicare Advantage Open Enrollment Period?

The window from January to March is provided only for changes to or cancellations of your Medicare Advantage plan. Therefore, anything else is not allowed, including the following:

Enrolling for the first time: If you don’t already have Medicare Advantage, you must wait until October 15.
Joining other plans: If you want to join a Medicare drug plan, you can’t do it during this time.
Switching between Medicare drug plans: Again, anything to do with basic Medicare plans (not Medicare Advantage) can’t be done during this period.

When Do My Medicare Advantage Changes Become Effective?

If you changed or canceled your Medicare Advantage plan between January 1 and March 31, your changes will start on the first day of the following month.

Have More Questions? We Can Help.

It’s not always easy to wade through the options to find the best Medicare Advantage plan for you. That’s why we’re here. Just tell us what you are looking for regarding coverage, and we’ll do the homework to find you the best plans to suit your needs. Call to set up an appointment with one of our Medicare Advantage insurance agents today.

What to Do if You Missed Medicare Open Enrollment

Medicare’s Annual Enrollment Period (AEP), or Medicare Open Enrollment Period, offers beneficiaries a once-a-year opportunity to change their health coverage. If you missed it, don’t panic. There are still options. Here are the key dates and periods to remember to sign up at the next convenient time.

Winter Enrollment

The annual open Medicare enrollment period is always in the winter. By signing up for Medicare or making changes to your plan between October 15th and December 7th each year, your changes will be able to be processed and will go into effect on January 1st of the coming year.

Spring Enrollment, Better Late Than Never

If you missed Medicare’s annual enrollment period at the end of the year, a secondary period, called the “General Enrollment Period” or GEP, is available from January 1st to March 31st each year. When you sign up during the secondary period, your coverage won’t start until July 1st.

Medicare Advantage Enrollment and Window of Change

Medicare Advantage (MA) is health insurance provided by a private company approved by the government. All providers under the Medicare Advantage umbrella allow you to make one change to your plan each year between January 1st and March 31st. This period coincides with Original Medicare’s GEP; sometimes, policyholders choose to return to Original Medicare, and overlapping enrollment and change periods make the transition smoother.

Special Enrollment Periods

Special Enrollment Periods (SEPs) occur not based on time but on circumstances. Certain life situations call for changes during this period. It is best to check with your insurance agent to find out if you qualify for an SEP, but some examples of when one might apply to you include:

Marriage
Divorce
Moving to a new location
Losing job-based medical coverage
Major income changes
Becoming a U.S. Citizen

Each SEP has a set of rules. Contacting one of our licensed Medicare agents can provide valuable insight into whether you can enroll during the Special Enrollment Period.

Late Enrollment Penalties

If you miss your enrollment period, you should know that the longer you wait, the more likely you will have to pay a penalty. When everyone enrolls in Medicare, it makes it possible to care for those needing medical attention. If people only apply when suffering a health condition, the program is less viable. This is why penalties exist.

If you miss the GEP for Medicare Parts A and B, your premium for Part B can be increased by ten percent for each 12-month period that you could have signed up for but didn’t. This penalty is permanent for as long as you have the policy.
If you go without Part D or other prescription drug coverage for 63 days or more after your Initial Enrollment Period (the seven months surrounding your birthday), you will have to pay a late penalty, which is added to your monthly Part D coverage.

Take Your Next Step to Get Coverage

Discovering you missed your open enrollment period can be stressful, but there are solutions. By talking to one of our qualified agents, we can help you prepare for the next enrollment period or see if you qualify for a Special Enrollment Period so you can apply sooner. You have options. Call our office today to see how we can help you get the coverage you qualify for and stay on top of your health needs throughout the year.

Senior Health Tips for the Holiday Season

Everyone loves the holidays. The fabulous food, families coming together, the cooking, shopping, and decorating make the holidays an exciting—and somewhat stressful–time. As seniors, it is crucial to put your health first while enjoying the best of holiday joy. Here are a few things seniors can do to stay healthy and happy during the holidays.

Stay Hydrated

Staying hydrated seems simple, but it bears repeating. Medical doctors recommend drinking eight glasses of water a day. With all the extra running around for shopping, drinking liquids can be easy to forget. An easy way to track your water intake is to drink two glasses at breakfast, lunch, and dinner and two more in the afternoon with a light snack. If you are not a water drinker, other healthy drinks, such as herbal tea or juice, can be substituted—but watch the sugar content!

Eat in Moderation

Holiday gatherings are a perfect excuse to break your diet. Consider enjoying indulgent foods in moderation and only after you have filled your plate with healthy fruit, vegetables, proteins, and whole grains. Eating nutritious foods first with a smaller portion of something sweet afterward can help you avoid over-consuming desserts loaded with sugar and fat.

Stay Active

When your schedule has been turned upside down with holiday shopping and family events, it’s essential to squeeze in some time to stretch. Taking a brisk walk or doing some light exercise at home goes a long way to maintaining your strength and boosting your mood.

Prioritize Your Mental Well-being

Don’t stress out trying to meet the standards of what you used to do—be gentle with yourself. It’s okay to ask for help instead of trying to cook a turkey dinner for ten on your own! If the grandkids want to go sledding, but you’d like to rest, take the opportunity. Give yourself the time and space for a quiet rest, and don’t feel you have to do everything you used to. Children and relatives are often more than happy to lend a hand if you need help shopping or wrapping presents; don’t be afraid to ask.

Schedule a Medicare Check-Up

Medicare’s open enrollment period ends on December 7th, and the holiday season is a great reminder to review and update your plan. New programs come out yearly—you might be eligible for a more affordable plan at a lower cost. Medicare can be challenging to understand—get help from one of our local agents and save yourself from frustration!

Get Good Rest

The excitement of the holidays can disrupt your regular sleep schedule. Keep an eye on the clock and gracefully retire when it gets too late. If you are accustomed to an afternoon nap, your family will understand. A good night’s sleep helps support your immune system and keeps your mood positive.

Take Advantage of Preventative Health Services

If you are enrolled in Medicare Part B, you can access preventative services that could help you during the holidays and all year round. Services like annual wellness visits, screenings, and vaccinations are covered, helping you stay on top of potential health issues before they get out of control.

Enjoy a Happy, Healthy Holiday Season

The holidays are a special time to reconnect with family and friends. While you celebrate, stay mindful of your health needs, take advantage of Medicare benefits, and focus on your well-being, you will enjoy the festivities far more.

If you need Medicare guidance for the new year, contact one of our local agents to learn more about new programs or options that could benefit you. We can help you support your health and wellness goals all year long.

Category: Medicare