Medicare with MH

AEP begins October 15 and ends December 7 each year. During AEP, you can enroll in, disenroll from or change your Medicare Advantage plan or your prescription drug plan. You can also return to Original Medicare. Elections made during AEP are effective January 1 of the following year.

Original Medicare, also known as Traditional Medicare, is the fee-for-service health insurance program offered through the federal government, which pays providers directly for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare.

“It’s hard to beat a person who never gives up.”

Medicare-approved amount is the amount Medicare determines to be reasonable for a covered service. Providers who "accept assignment" agree to accept this amount as payment in full.

In 1965, the passage of the Social Security Amendments, popularly known as Medicare and Medicaid, resulted in one basic program of health insurance for persons aged 65 and older, and another program providing health insurance for people with limited income funded by state and federal sources, respectively.

We believe that the better educated you are about Medicare, the easier it will be for you to make the right decisions about your Medicare health insurance choices.

Medicare Advantage plans work differently from Medigap plans, so make sure you understand all the differences between the two before signing up for an Advantage plan.

Keep your face to the sunshine and you cannot see a shadow.

Medigap is private insurance that fills in the gaps between your Medicare benefits and what you must pay out of pocket.

Confused About Medicare? It is not unusual for a client to bring in a whole bag of mail that he has received at home and ask for our help to identify which things should be kept or tossed out.

Medicare Part C Advantage plans have different networks, premiums, and cost-sharing. Working with an insurance agent that specializes in these plans is a great way to ensure that you consider all the variables before choosing your insurance company.

“If everything seems to be under control, you’re not going fast enough.”

A Medicare Summary Notice (MSN) is a quarterly explanation of benefits statement that Medicare provides to show you the healthcare services received and what Medicare paid toward them. You should review your MSN to determine if you owe any balances that are due.

Like all Advantage plans, Special Needs Plans will have a network, usually either an HMO or a PPO.

Also known as Medicare Advantage, the Part C program is a form of managed care that allows Medicare beneficiaries to get their Parts A and B benefits through a private insurance plan and its network of providers. Many Part C plans offer a built-in Part D drug plan.

What is Medigap Attained-Age Rating?
Attained-Age Rating is a rating class in which a Medigap insurance company determines the rate based on your current age (the age you’ve “attained”). Your premiums tend to go up as you get older.

What does Dual-Eligible mean?
To be dual-eligible means to be eligible for both Medicare and Medicaid.

Quick Tip: Medicare Advantage plans work differently from Medigap plans, so make sure you understand all the differences between the two before signing up for an Advantage plan.

A “Limiting Charge” is in Original Medicare, the highest amount of money you can be charged for a covered service by doctors and other health care suppliers who don't accept assignment. The limiting charge is 15% over Medicare's approved amount. The limiting charge only applies to certain services and doesn't apply to supplies or equipment.

Feeling overwhelmed with Medicare details as you near retirement? You are not alone! Our team is frequently asked about the right time to sign up for Medicare and how to do it!

Here’s what you need to know: Your Medicare enrollment window is a generous seven months, starting three months before your 65th birthday month and ending three months after. Pro tip: Enroll early in this period to ensure your coverage starts just when you need it.

📞 Questions? Let's chat! Medicare doesn't have to be a maze. If you're pondering over medical costs or the ins and outs of signing up as you approach 65, our team is here to help. Give us a call for personalized guidance and peace of mind on your Medicare journey.

Medicare Advantage plans, also known as MA, are NOT similar to Medigap plans – they are different. Members get their benefits from a private insurance company instead of Original Medicare.

Fast Fact: Medicare Advantage plans were created under the Balanced Budget Act of 1997 and signed into law by President Bill Clinton. These plans are commonly called Part C of Medicare . Some doctor’s offices call them replacement plans, more on that below.

Medigap Fast Fact: It’s Medicare Supplement Insurance sold by private insurance companies to fill “gaps” in Original Medicare coverage.

Medicare 101: Retiree coverage, including COBRA, does not count as creditable coverage for Medicare.