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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.

December 15th is the deadline to enroll or make changes to your health insurance for individuals and families. If you need assistance understanding the current options available to you or help in completing your enrollment application, call Suder Group Health Insurance Consultants at (206)569-5415. 

There will not be an extension this year as we have done in the past in WA, so now is the time to act and make sure you have coverage!

The Annual Enrollment Period, which is the time for making changes to Medicare coverage, ends on December 7th. If you have not reviewed your current plan to assure it is meeting your needs, now is the time to do it!  SuderGroup Health Insurance consultants are available to help you define your needs and find the plan that will work the best for you in 2019. Call Loy Suderman at 206-569-5415 to get the help you need.

If you missed open enrollment for Individuals and Families for a January 1 coverage start date, you still have time to get coverage in place for February 1st. Washington State has extended open enrollment to January 15th for those who missed the December 15th deadline. January 15th is the absolute deadline unless you qualify for a Special Enrollment Period. If you need help and advice, contact an expert - Call Loy at 206-569-5415 or email Loy@Sudergroup.com. Get the help you need!

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.

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.

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