Helping Seniors navigate Medicare
Enrollment process and select health
benefits to meet their specific needs
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Helping Seniors navigate Medicare
Almost 65? We can help you enroll in Medicare!
Our local Medicare Consultant can walk you through a FREE step by step process to ensure peace of mind regarding your Medicare enrollment options.
What are my options?
Confused, have questions or need help? Contact us!
We are available for phone appointments, video calls, or face to face appointments.
Serving Texas
New to Medicare?
- Medicare Part A pays for hospital stays and inpatient care.
- Medicare Part B helps pay for doctor visits and out patients care.
- Medicare Parts A and B represent “Original Medicare”.
Individuals turning 65 who have enough work credits can enroll in Medicare Part A at no cost. If you have paid Social Security taxes for at least 40 quarters/10 years, you must enroll in Part B to purchase Part A coverage and pay an additional premium.
If you are taking your Social Security retirement benefits, you should automatically be enrolled in Part B when you turn 65. If you are not taking any Social Security benefits, you will need to proactively sign up for Part B.
Pick the options that apply to you:
“I don’t or will not have employer insurance and I’m turning 65.“
You qualify for your initial enrollment period (IEP) for Medicare Parts A and/or B. This is a 7-month rolling window based on your birthday month. This period includes 3 months prior to the month you turn 65, the month of your birth and 3 months after. Please note if you were born on the 1st day of the month, your 7-month window starts a month earlier. In most cases, you will want to enroll for both Medicare Part A and B.
On average, Medicare Enrollment takes 2 – 4 weeks to process. If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), your enrollment is automatic, you do not need to apply, and you will receive a Medicare card automatically.
Note: Different dates may apply if you are under age 65 and if you have been on Social Security Disability for at least 24 months.
“I am past age 65 and 3 months and have had credible employer health insurance. I’m getting ready to retire or have recently retired and my 7 month initial enrollment window has passed.”
If your 7-month initial enrollment window has passed, and you currently have employer health insurance (or have had it within the last 8 months), you will need to complete a paper Medicare Part B application. Also, your employer must complete the Medicare Employer Verification form. (Both forms are below.)
We recommend obtaining the completed original Employer Verification form and faxing it directly to your local social security office along with your application for Part B. Always keep originals. It is highly recommended that you call your local Social Security office about 3 days after you have faxed your paperwork to verify that they have received all your documents.
What are my options?
OPTION 1
Medicare Advantage
Medicare Advantage (Part C) is a private Medicare insurance plan that offers an alternative to Original Medicare. The government pays the Medicare Advantage company on your behalf to take on your medical risk.
Many plans have low and even zero-dollar monthly premiums. You pay for medical services as you use them in the form of copays and coinsurance
Unlike Original Medicare, Medicare Advantage plans have an out-of-pocket maximum to protect your finances. Many plans also include benefits for things like dental & vision coverage. Limitations, copayments, and restrictions may apply.
OPTION 2
Medicare Supplements
A Medicare supplement or Medigap policy helps cover the costs such as deductibles, copays, and coinsurance that Original Medicare does not pay.
These plans are secondary to Original Medicare, offer various levels of coverage, and are offered by insurance companies who are licensed by the states to sell them.
You pay a monthly premium to the insurance company for the plan you select in addition to your Part B premium. Some plans have additional benefits that Medicare does not cover, such as free gym memberships to help you stay active.
Medicare Part D
Medicare Part D Plans work like pharmacy cards that give you lower-cost medications. Instead of paying the full cost for your prescriptions, you will pay only the copays required by the plan.
Up until 2006, there was no retail prescription drug coverage for Medicare beneficiaries.
Medicare Part D is voluntary, which means each individual can decide whether or not to enroll. However, you should think about not just the medications you are taking now, but also those that you may need in the future. Part D plans are very affordable, so you should look into your options.
Medicare Part A, Part B and Part D may charge you penalties if you sign up after your Initial Enrollment Period; unless you qualify for a Special Enrollment Periodo.
Dates & Timelines
Annual Enrollment Period (AEP)
- October 15 – December 7
- Change or leave your Medicare Advantage Plan.
- Happens every year October 15 – December 7.
- You can join, switch or drop a Part C or Part D plan without penalty.
- Any changes made will go into effect on January 1 of the following year.
Open Enrollment Period (OEP)
- January 1 – March 31
- You can switch to a new Medicare Advantage Plan.
- You can drop your Medicare Advantage Plan and return to Original Medicare.
- If you qualify you may also enroll in a standalone Part D.
- Any changes you make will be effective the first of the month after the plan gets your request.
General Enrollment Period (GEP)
- January 1 – March 31
If you have to pay Part A but don’t sign up for it and / or don’t sign up for Part B (for which you most pay premiums) during your Initial Enrollment Period , and you don’t qualify for Special Enrollment Period, you can sign up during this time.
BEGINNING JANUARY 1, 2023, when you sign up during this period, your coverage starts the first day of the month after you sign up.
Medicare Supplement Open Enrollment Period
- Dates vary by person, 6 months
- This 6-month period begins once you are 65 or older and enrolled in Part B.
- During this time, you’re guaranteed the right to buy a Medicare supplement insurance plan regardless of health history & cannot be denied coverage or charged more due to pre-existing conditions.
- You can enroll in a Medigap plan at any time, but maybe denied coverage or charged higher premiums if enrolling after this period.
Special Enrollment Period (SEP)
- Dates vary by person, 2-8 months
If you have a Medicare Advantage (Part C) or Part D prescription drug plan & experience a “qualifying” life event (change of residence or change out of plan coverage).
- You may qualify for a 2-month Special Enrollment Period.
- You can change or drop a Medicare Advantage (Part C) or Part D prescription drug plan.
- You can if you have any Chronic Conditions like Diabetes, Chronic Heart Failure or Cardiovascular Disorder depending on the area your living in.
Beginning January 1, 2023 if you miss an enrollment period because of certain exceptional circumstances, like being impacted by natural disaster or an emergency, incarceration or losing Medicare coverage.
Not sure if you qualify for a enrollment period? Visit Medicare.gov or call
1-800-MEDICARE(1-800-633-4227). TTY users can call 1-877-486-2048
Social Security 1800 772 1213
Monday through Friday
8:00am – 7:00pm
NEW!! Beginning January 1,2023, if you sign up the month you turn 65 or during the last 3 months of your Initial Enrollment Period, your coverage starts the first day of the month after you sign up.