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Posted by Suder Group, LLC

New to Medicare?

Medicare can be confusing for many people – for instance, often people do not realize that Original Medicare does not cover all of their medical expenses - there are out of pocket costs that can really add up with deductibles, copays and coinsurance. There are a variety of plans available to help protect you from these costs, including Medicare Supplement (Medigap) or Medicare Advantage plans. And, you need to purchase Part D prescription drug coverage to avoid paying a penalty later on.

If you are approaching your 65th birthday, it is very likely you have been receiving information from a variety of health insurance companies about their plans – understanding the differences can be a challenge, there are so many options to choose from and there is no one size fits all.

As an independent health insurance agent, I represent several Medicare plans and I can help you understand your options so you can find the coverage that is right for you. You are not charged a fee to work with an independent agent; I earn commissions from the insurance companies and my goal is to help you find the plan that best meets your needs.

Before I or any agent can work with you, you must have your Medicare card that indicates the effective date of your Hospital (Part A) and Medical (Part B) enrollment. There are three ways you can enroll:

• By Phone: Call Social Security toll-free at 1-800-772-1213 (TTY 1-800-325-0778).
• In Person: Take proof of your age and W-2 forms for the past two years to any Social Security office. Your local phone directory will list the office location nearest you.
• Online: Apply online at www.ssa.gov.

If you have questions, or if I can be of assistance to you, please call me at (206)569-5415 or send me an email to loy@sudergroup.com. I’m happy to select the plan that will meet your unique needs.

November 1 - December 15, 2019    There are several changes in the Washington Individual and Family Health Insurance market and now is the time to enroll for 2020 coverage. There are changes to the counties that health plans are participating in and changes to the providers (physicians and hospitals) that are contracted with (in-network) with the various insurance companies. If you want to learn more about what coverage is available in your area, or if you have questions about the coverage that is available to you, I am available to assist you. I am an independent health insurance agent and have been in the WA health insurance industry for many years. I would be happy to answer your questions and help you select the coverage that is the best for you. You may contact me at (206)569-5415 or at loy@sudergroup.com. 

For those of you on Medicare, now is the time to review your current coverage and the new plan options to make sure you enroll in the best plan for you. A variety of new benefits have been added to Medicare Advantage plans such as hearing aids, travel to doctor appointments, meals after a hospital discharge, naturopathy/acupuncture and more; not all plans have added the same features. There are also some changes in premium and per service copays, depending on the plan you are on and the specific benefit. 

When reviewing your current coverage or selecting a new plan, there are several factors to consider, such as provider network, pharmacy coverage (is your specific medication included in the plan formulary), out of pocket costs and limitations, premium and the service area, just to name a few. 

I am a licensed agent, certified with several health plans representing multiple Medicare Advantage, Medicare Supplement and Part D Prescription Drug Plans in Washington and I can help you find the plan that best fits your unique needs.

One of the most frequent questions I get about Medicare is “Do I need to sign up for Medicare when I turn 65 if I have employer group coverage?” And the answer is:  It depends…. on the size of the employer group and some other factors:

-  Your cost for the coverage (including premium contribution and out of pocket expenses for deductibles, copays and your annual out of pocket maximum)

- If the employer plan benefits meet your needs (benefits, provider network)

- If your employer group is less than 20 employees, you should sign up for Medicare Part A and Part B when you are first eligible or face a lifetime late enrollment penalty. You have a 7-month Initial Enrollment Period:       

      - 3 months prior to your 65th birthday
      - your birthday month
      - 3 months after your birthday month

In this case, Medicare is the primary payer and your employer group coverage pays secondary based on the benefit plan.

If your employer group is more than 20 employees, and has medical and prescription drug coverage that is at least as good as Medicare, you may not need to sign up for Medicare Part B right away. However, you should review the benefits and cost of your employer plan compared to the benefits and cost of Medicare plus a Supplement or Medicare Advantage plan. In many cases, people save money by enrolling with Medicare.

There are several options for Medicare Advantage and Medicare Supplement plans available, and the key is determining which one will offer you the best coverage based on your healthcare needs, your lifestyle and your budget.

Medicare agents must be licensed in the state they sell products and must complete an annual certification and insurance company specific product training each year to assure they are qualified to help beneficiaries in making good choices. 

If you need assistance with your Medicare decisions, please contact me at 206-569-5415 or by email at suderloy@gmail.com. I am a licensed and certified health insurance agent in WA State and represent multiple health insurance companies. I can help you with your decision and enrollment for the plan that best meets your needs.

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