Frequently Asked Questions
Unless you are already receiving Social Security Benefits or RRB Benefits, you will NOT be automatically enrolled in Medicare Parts A&B at 65. You will need to submit a Medicare application yourself. You will have an Initial Enrollment Period for Parts A, B and D that lasts for 7-months. This starts 3-months before your 65th birthday month, includes your 65th birthday month, and 3-months after your 65th birthday month. If you enroll within those 7-months there will be no late enrollment penalties. Call the Medicare Sharks licensed experts to guide you through the Medicare enrollment process!
The best time to apply for a Medigap Plan is when you are within 6-months of turning 65. At this time, a Medicare Supplement company CANNOT ask you any medical questions and you CANNOT be turned down because of any health conditions. You will be GUARANTEED ISSUE of any Medicare Supplement Plan you choose. Call the Medicare Sharks licensed experts to guide you through the application process when choosing your Medigap plan!
Once you get Medicare Part B, you have 6-months to purchase a Medicare Supplement Plan (Medigap) and you WILL NOT be subject to passing medical underwriting (health questions). Also, you WILL NOT be subject to a pre-existing condition waiting period. This 6-month open enrollment period is your one-time window where you WILL NOT be denied coverage for health reasons. Once you pass this opportunity, a company may deny your application for a Medicare Supplement Plan (Medigap) forever. FYI you can submit an application up to 6 months in advance of your Medicare Part B effective date if you are a first time Medicare Supplement applicant 64 ½ or older. Don’t miss your chance to get a Medicare Supplement Plan! Call the Medicare Sharks licensed experts to help!
You can change your Medicare Supplement Plan (Medigap) at ANY TIME you want! You DO NOT have to wait for Annual Enrollment Period in the Fall to switch your Medigap plan. It’s always a smart idea to check with the Medicare Sharks licensed experts to see if changes to your Medicare Supplement Plan (Medigap) would benefit you!
In most cases, you must keep your Medicare Prescription Drug Plan for the full year Jan-Dec. During the Annual Enrollment Period (Oct 15 – Dec 7) you can make changes to your Prescription Drug Plan and coverage will start Jan 1. However, you may be entitled to a Special Enrollment Period (SEP) where you can change your plan mid-year. It’s always a smart idea to check with the Medicare Sharks licensed experts to see if changes to your Medicare Prescription Drug Plan would benefit you!
In most cases, you must keep your Medicare Advantage Plan for the full year Jan-Dec. During the Annual Enrollment Period (Oct 15 – Dec 7) you can make changes to your Medicare Advantage Plan and coverage will start Jan 1. There’s another opportunity to make changes to your Advantage Plan during the Medicare Advantage Open Enrollment Period (Jan1 – Mar 31). However, you may be entitled to a Special Enrollment Period (SEP) where you can change your plan mid-year.It’s always a smart idea to check with the Medicare Sharks licensed experts to see if changes to your Medicare Advantage Plan would benefit you!
If you only have Medicare A&B and have not chosen a Medigap or Advantage Plan, you will be completely responsible to pay the deductibles and 20% coinsurance of your medical bills that Medicare does not cover. Most people don’t realize that Medicare only covers about 80% of your medical bills leaving you to pay the remaining costs. Depending on your health needs and budget, you need to make a smart choice to get a Medigap Plan or Advantage Plan. The decision you make today will determine your future! You can’t wait to get sick before you decide to get a Medigap Plan, because you may be subject to medical underwriting and can be denied coverage. Call the Medicare Sharks licensed experts who can help discuss your options so you can get the BEST COVERAGE and also SAVE MONEY!
Any doctor or hospital NATIONWIDE who accepts Medicare MUST ACCEPT your Medigap plan regardless of which insurance carrier you have! Unlike Medicare Advantage plans, the Medicare Supplement Plans (Medigap) have NO network restrictions and DO NOT require referrals for specialists!
Since Medigap plans are accepted by ANY doctor, specialist, hospital that accepts Medicare, you will always have coverage wherever you travel! You may use your coverage NATIONWIDE!
If you have the following Medicare Supplement Plans (Medigap) you will have Foreign Travel Emergency coverage: Plan C, Plan D, Plan F, Plan G, Plan M, Plan N.
The most comprehensive plan for anyone who is eligible for Medicare BEFORE1/1/2020 is Medigap Plan F.
The most comprehensive plan for anyone who is eligible for Medicare ON or AFTER1/1/2020 is Medigap Plan G.
|Medicare Benefits||Plan F||Plan G|
|Medicare Part A coinsurance & hospital coverage|
(plus coverage for additional 365 days after Medicare benefits are used up)
|Medicare Part B coinsurance (20%) or copay||100%||100%|
|Blood: first 3 pints each year||100%||100%|
|Medicare Part A deductible ($1,408 in 2020)||100%||100%|
|Medicare Part B deductible annually ($198 in 2020)||100%||✘|
|Medicare Part B excess doctor charges|
(possible charge above Medicare approved amount)
|Skilled Nursing Facility coinsurance||100%||100%|
|Hospice: Part A coinsurance or copay||100%||100%|
|Foreign Travel Emergency (up to plan limits)||80%||80%|
You have to compare the premium price of Plan F and premium price of Plan G and if the annual savings is not greater than the current cost of the Part B annual deductible than you should choose Plan F.
It is true that each company that offers a Medicare Supplement Plan (Medigap) such as Plan G, must offer the SAME BENEFITS, however they can charge DIFFERENT PREMIUMS for that same Plan G. In some cases, if you compared prices from company to company, you may find that you can save $1,200 on average per year! The key is to speak with a licensed broker from Medicare Sharks since we are appointed with ALL the Top Carriers Nationwide! We can give you choices for any of the top standardized Medigap plans (Plan F, Plan G, Plan N,) therefore SAVING YOU MONEY!!! Many agents across the country are only appointed with one company, so that’s the only company they can offer you, but it may not be the best way for you to get the best coverage for the lowest cost. Calling the Medicare Sharks will SAVE YOU MONEY!!!
When dealing with something as important as your health and financial well being, you will benefit from using a licensed and knowledgeable insurance broker, to help you find a Medicare insurance plan that’s right for your health needs and budget. In addition to insider knowledge, you will gain FREE advice from a licensed insurance professional, who can give you unbiased comparisons of companies and plans to help you make an informed intelligent decision. Call the Medicare Sharks licensed experts to help you COMPARE & SAVE!
This can be a costly mistake for not enrolling in Part D when you are first eligible. First of all, you may not be taking medications at this time, however two years may pass and all of sudden you are diagnosed with a condition that may require expensive prescriptions. You would have to pay the full out-of-pocket cost of those medications until the next time that you can enroll in a Part D Drug Plan during the Annual Election Period (Oct 15 – Dec 7) and the plan won’t start until Jan 1. In addition to that, you will have to pay a late-enrollment penalty for your Part D Drug Plan calculated by the government for every month that you did not have creditable drug coverage. This penalty will last forever for your lifetime! Call the Medicare Sharks licensed experts who can find you a low-cost prescription drug plan to satisfy your medical needs and avoid penalties!
(see both charts below)
|Medicare Supplement Plans vs. Most Medicare Advantage Plans|
|Concerns of Most Seniors:||Medicare Supplement||Medicare Advantage|
|Visit ANY doctor, specialist, hospital nationwide that accepts Medicare||YES||NO|
|Restrictive Networks of|
Doctors & Hospitals
|Referrals Needed for Specialists||NO||YES|
|Expensive Out-of-Pocket Costs|
(Copays, Deductibles, Coinsurance)
|High Maximum Out-of-Pocket Costs (approx. $6,700 – $10,000)||NO||YES|
|Health Plan Determines Approval for Tests, Services, & Procedures||NO||YES|
|Unwanted Plan Cancellation|
(Not By Your Choice)
|Pre-Authorization Required for Some Tests, Services & Procedures||NO||YES|
|Potential Hidden Costs or Fees||NO||YES|
|Medicare Supplement (MEDIGAP)||Advantage Plan (HMO/PPO)|
|Original Medicare A&B is your Primary coverage.|
Medigap Plan is your Secondary coverage to pay your expenses.
|REPLACE Original Medicare A&B with ALTERNATIVE coverage.|
Primary coverage comes from the insurance company’s plan.
|FREEDOM & CHOICE to get superior quality healthcare!|
Visit ANY Medicare doctor, specialist, hospital in the USA including elite providers who accept Medicare
(NO restrictive networks)
|Limited to providers in the plan’s network who must accept your specific plan (HMO/PPO). Typically, you cannot visit providers outside of your area’s network or you may pay additional costs or possibly have no coverage at all.|
|NO referrals to see specialists|
Get immediate treatment which saves time and money!
|Usually required to get referrals for specialists and may be required to use limited network specialists. This can delay your time before getting treatment and cost money for extra visits.|
|Coverage goes with you across the United States. No network restrictions. Some plans cover foreign travel emergency outside of the US.||Usually have network restrictions limited to your plan’s local area. Some plans allow you to go out of network, but you’ll pay much higher/full costs. Most do not cover you outside of the US.|
|You can get a Medigap plan anytime you want once you have Medicare Part B||Limited to certain times of the year when you can enroll or switch to another advantage plan|
|Affordable premiums to help limit various out of pocket costs|
Plan F covers 100% ALL costs
|Usually no premium but you will pay expensive copays, coinsurance, deductibles. Most max-out-of-pocket costs can average $6,700 – $10,000|
|Part D Prescription Drug Plans provide broader coverage and reduce your out of pocket costs||Some plans include drug coverage, but your out-of-pocket costs tend to be much higher|
|SAVE MONEY! Eliminate or reduce out-of-pocket costs, copays and deductibles|
Factor a fixed cost into your budget with NO surprises!
|You are responsible to pay the plan’s copays, deductibles, out-of-pocket costs. Becomes expensive when you need quality healthcare as bills will add up and you can get surprises anytime!|
Although, some Advantage Plans may have a zero-dollar monthly premium, there are many out-of-pocket costs associated with Advantage Plans. Every Advantage Plan has a maximum-out-of-pocket amount, so it stands to reason that there are costs associated with Advantage Plans which you have to pay. Maximum-out-of-pocket costs can range anywhere from $3,400 to $6,700 to $10,000 and each carrier’s plans are completely different. There are copays for doctors’ visits and even higher copays for specialists. There are deductibles for things like hospitalization. You’ll pay coinsurance for lab tests, bloodwork, X-rays, MRIs, CAT Scans, ambulance rides, chemo drugs, and most procedures. By the time you end up paying for all these out-of-pocket costs, it may be more beneficial for you to pay a premium for a Medicare Supplement Plan (Medigap) and not have to pay anything else. Call the Medicare Sharks licensed experts who can help discuss your options so you can get the BEST COVERAGE and also SAVE MONEY!
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