Medicare ~ MedAdvantage & Supplemental

What is 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 who have 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.

Medicare is financed by a portion of the payroll taxes paid by workers and their employers. It also is financed in part by monthly premiums deducted from Social Security checks.

Medicare has four parts:

  • Part A:  Hospital Insurance – helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care.
  • Part B:  Medical Insurance – helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance.
  • Part C:  Medicare Advantage – plans are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organizations under Part C.
  • Part D:  Prescription Drug Coverage – helps pay for medications doctors prescribe for treatment.

When should you enroll?

Medicare Timeline
 Pre-Enrollment  Oct. 1 – Oct. 14

  • Compare your options and costs
  • Be ready to enroll by Oct. 15
Annual Election  Oct. 15 – Dec. 7

  • If eligible, you can enroll in Medicare health benefits
  • Medicare Advantage plan with or without prescription drug coverage
  • Stand-alone prescription drug plan
Annual Disenrollment  Jan. 1 – Feb. 14

  • Medicare Advantage plan members can return to Original Medicare and enroll in a stand-alone drug plan
  • You cannot switch Medicare Advantage or stand-alone prescription drug plans during this time
Feb. 15 – Oct. 14

  • You are not allowed to make a plan change unless special circumstances arise – you move, you qualify for or lose eligibility for Medicaid, etc.

Next steps?

A few months before you turn age 65 it is a good idea to review all of your options in order for your transition off of individual or group coverage to be a smooth one.

Sound Benefit Solutions represents MedAdvantage plans through AARP/United Healthcare, Aetna, Humana, Regence/Asuris, Premera, Kaiser, and Providence. Sound Benefit Solutions also represents Supplemental and Part D coverage through AARP/United Healthcare, Aetna, Humana, Wellcare, and Regence/Asuris, Mutual of Omaha.

Please contact us via email or phone if you would like a Medicare Specialist to help find you a great plan that needs your coverage needs as well as your budget!