Q: What do you charge?

We don't charge anything to help you find the right coverage.  We have contracts with various insurance companies and when you enroll using us, we are compensated directly from the carrier.  You are not paying more for insurance because we helped you.  

Q: How do I sign up for Medicare?

If you are already receiving Social Security, you are automatically enrolled in Medicare Parts A and B (known as Original Medicare) at 65. You'll receive a Medicare card two or three months before your birthday, and coverage starts on the first day of your birthday month. 

Part A covers hospitalization and usually comes with no premiums, assuming you or your spouse paid into Medicare while working.  Part B, which covers medical services, does require premiums, but you have the option of withdrawing if you wish.

If you aren't yet receiving Social Security, you will need to apply for Medicare during one of the designated annual enrollment periods. Your initial enrollment period lasts for seven months, beginning three months before the month in which you turn 65. To help avoid a potential gap in coverage, consider enrolling during the three months prior to your 65th birthday.

Q: Should I enroll at 65 if I'm still working and covered?

Consider enrolling in Part A anyway, as it is generally premium-free and may cover some expenses not included in your employer's health plan. Premiums for Part B may be higher because of your income, so it may be wise to delay enrollment in Part B until after you retire as long as you work for a company with 20 or more employees.  If your company has fewer than 20 employees, consider enrolling in Part B as well because Medicare is considered your primary insurance. You can enroll without penalty at any time during the eight months after you stop working or your employee health coverage ends. If you miss that window, you may be subject to penalties that, in the case of Part B, could last as long as you remain covered.

You will need these forms to be filled out and returned to your local Social Security office.  A tip is to drop off the forms into the box at the front of most offices, there is no need for an appointment or to wait in line.

CMS-L564 is to be completed by your human resources department representative.  This form is proof to Social Security that you indeed had coverage at your employer and qualifies you for PENALTY FREE enrollment in Part B ANYTIME of the year.

CMS-40B is to be completed by yourself and turned in with CMS-L564.  This is the form that requests Part B and when it will start.

Please complete this at least 3 months ahead of when you plan on retiring to ensure enrollment in part B immediately after you retire and lose your employer coverage.

Q: Where do Parts C and D come in?

Part C, known as Medicare Advantage, includes plans administered by private companies such as health maintenance organizations(HMO) and preferred provider organizations(PPO). They offer the benefits of Parts A and B, and often include such additional benefits as vision, hearing and dental coverage. Costs for Part C plans vary according to the insurer. Some plans may require referrals or restrict you to doctors in a network, and you must already have Parts A and B in order to enroll. Another consideration: Some plans may limit their coverage to a certain geographic area, so if you anticipate traveling a great deal or relocating, Medicare Advantage might not be for you.

Part D offers prescription drug coverage for both brand-name and generic prescription drugs. You must be enrolled in Medicare to enroll in a Part D plan, which you purchase from a private insurer. Although premiums, deductibles and co-payments vary by plan, the Affordable Care Act of 2010 limits the amount you can be charged for prescription drugs. Before enrolling in Part D, check whether you're already covered for prescription drugs under a Part C Medicare Advantage plan. You may not need it. And if you decide later on that you need additional coverage or want to change your existing plan, you can do so during designated enrollment periods.

Q: Which services aren't covered by Medicare?

What’s NOT covered by Part A and Part B? Medicare doesn’t cover everything. If you need certain services that aren’t covered under Medicare Part A or Part B, you’ll have to pay for them yourself unless:

• You have other coverage (including State funded Medicaid) to cover the costs.

• You’re in a Medicare Advantage Plan that may cover these services.

 Some of the items and services that Medicare doesn’t cover include:

✖  Most dental care.

✖  Eye examinations related to prescribing glasses.

✖  Dentures.

✖  Cosmetic surgery.

✖  Massage therapy.

✖  Acupuncture.

✖  Hearing aids and exams for fitting them.

✖  Long-term care.

✖  Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care).

Original Medicare (Parts A and B) won't cover co-payments, co-insurance or deductibles, nor will it cover medical care when you travel outside the U.S.. Some of these services are likely to be covered if you enroll in a Part C plan. Long-term care, however, is not among them.

As an alternative to Part C, you may supplement Original Medicare with Medicare Supplement Insurance, also known as Medigap. Plans providing such coverage follow strict federal and state standards, and costs vary by policy and insurer. To buy a Medigap policy, you must be enrolled in both Parts A and B. It’s best to enroll in a Medigap when you are first eligible for Medicare to avoid medical underwriting. 

Can I go to any doctor I choose when I join Medicare?

You would want to check with you doctor’s office to see if they accept Medicare.  Most doctors do accept Medicare. 

If you join a Medigap plan, your doctor will bill Medicare(primary) and then Medicare will coordinate with the supplement carrier you are enrolled with to take care of the rest of the covered charges.  So with a Medigap plan you typically can go to any doctor you choose as long as they accept Medicare.

Medicare Part-C or Advantage plans typically have a network to follow (HMO,PPO,PFFS), so checking if your doctor participates on the company’s physician finder web tools would be the best way to check.

Q:  What's the best medigap plan?

I can't say which plan is best however, I can say that the vast majority of my clients choose plan G for it's very comprehensive coverage and affordable premiums. 

                                        Get Started Today!

Please note that the 'Get Started Today' link will take you to our partner website Medicare Insurance Direct. If you decide to enroll, Jim Beran of Beran Insurance Agency will be your agent of record.  Any post enrollment questions can be directed Beran Insurance Agency LTD.