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If you're looking for expert guidance and support in navigating the complex world of Medicare, Hollie Cohen and Steven Kind are here to help. Contact them today to schedule a consultation and learn more about how they can help you make the most of your Medicare benefits.
If you're new to Medicare, you may feel overwhelmed by the choices available to you. Our team of experts has years of experience in the healthcare industry and is dedicated to providing you with the information you need to make informed decisions about your healthcare coverage. We can help you understand the basics of Medicare, including Parts A, B, C, and D, as well as the various Medicare Supplement Plans and Part D Prescription Plans available to you.
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Medicare Supplement, also called Medigap, is a type of insurance sold by private companies that helps pay for the “gaps” in Original Medicare — like copayments, coinsurance, and deductibles. Unlike Medicare Advantage, Medigap plans work with Original Medicare (Parts A and B), allowing you to see any doctor or hospital nationwide that accepts Medicare. These plans offer predictable coverage with fewer out-of-pocket surprises and no networks or referrals required. Popular plans include Plan G and Plan N, with Plan G being the most comprehensive coverage available to new enrollees.
What is Medicare Advantage?
Medicare Advantage (also known as Part C) is a private insurance alternative to Original Medicare. These plans are offered by Medicare-approved insurance companies and must cover everything Original Medicare (Parts A and B) does — but they often include extra benefits like dental, vision, hearing, gym memberships, and sometimes prescription drug coverage (Part D). While the premiums may be low or even $0, Medicare Advantage plans often come with restrictions such as limited provider networks, prior authorization requirements, and out-of-pocket costs that vary based on services used.
How Do I Enroll in Medicare?
You can enroll in Medicare by making an appointment with your local Social Security office, calling 1-800-772-1213, or applying online at www.ssa.gov/medicare. If you’re turning 65 and already receiving Social Security benefits, you may be enrolled automatically. If not, your Initial Enrollment Period (IEP) starts three months before your 65th birthday and ends three months after. Enrolling on time ensures you have full access to your Medicare benefits without delays or penalties.
If you delayed enrolling in Medicare because you had creditable coverage through an employer or union, you can typically enroll during a Special Enrollment Period (SEP) once that coverage ends. This SEP lasts for 8 months after your employment or group coverage ends—whichever comes first. To enroll, you'll need to complete the Medicare Part B application (CMS-40B) and provide proof of prior coverage using form CMS-L564. It’s important to apply promptly to avoid late enrollment penalties. If you no longer have employer coverage, you won’t want to delay. Our licensed agents can walk you through the process and ensure everything is submitted correctly.
Both Plan G and Plan N are popular Medicare Supplement plans that offer strong coverage, but with a few key differences. Plan G covers everything Medicare doesn’t, except for the small Part B deductible ($240 in 2024). Once that’s met, you’re covered 100 percent for Medicare-approved services — no copays, no surprises.
Plan N, on the other hand, has a lower monthly premium but comes with some cost sharing. You may pay up to a $20 copay for doctor visits and $50 for ER visits (unless admitted), and it doesn’t cover Part B excess charges, which are rare but possible if your doctor doesn’t accept Medicare assignment.
Yes, but there are important rules to know. If you're already on a Medicare Advantage plan and want to switch to a Medicare Supplement (Medigap) plan, you may need to pass medical underwriting in most states. This means you could be asked health questions and potentially denied coverage based on your current conditions. The only time you’re guaranteed the right to switch without medical questions is during certain limited windows — such as your first year on a Medicare Advantage plan (called a “trial right”) or if you qualify for a guaranteed issue period due to plan changes or loss of coverage. Timing and health status are key, so it's important to speak with a licensed broker who can help you navigate your options.
Want to follow with “What is the difference between Part D and Medicare Advantage with drug coverage?” or something about guaranteed issue rights by state?
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Finding the right Medicare Part D prescription drug plan depends on the medications you take, the pharmacy you prefer, and your overall budget. Since every Part D plan has its own list of covered drugs (called a formulary), premiums, copays, and preferred pharmacy networks, it’s important to compare plans carefully each year during the Annual Enrollment Period (October 15 through December 7).
A licensed independent broker can help you run a personalized drug comparison using Medicare’s Plan Finder tool to ensure you’re not overpaying — and that your prescriptions are covered affordably. Even if you don’t take many medications now, choosing the wrong plan can lead to higher costs later, so getting expert help is key.
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If you miss your Initial Enrollment Period (IEP), you could face delays in coverage and financial penalties. Your IEP begins three months before your 65th birthday, includes the month you turn 65, and continues for three months after. If you miss that window and don’t qualify for a Special Enrollment Period (such as coming off employer coverage), you may have to wait until the General Enrollment Period (January 1 to March 31) to sign up — and your coverage won’t begin until July 1. It’s important to enroll on time to avoid unnecessary gaps in coverage and long-term penalties.
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