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Medicare Insurance

What is to know? A LOT!

Who is eligible – If you or your spouse have worked 10 years (or 40 quarters) and paid into Medicare Tax. When are you eligible – The 1st of the month of your birth month when you turn 65, unless your birthday is the 1st of the month then Medicare will be effective the month prior. Medicare is available for certain people with disabilities who are under age 65. These individuals must have received Social Security Disability benefits for 24 months or have End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's disease). You should enroll in Part B approx. no more than 4-months prior to your birth month, Medicare can take 60 days to issue the plans.

What does it cover?
  • Medicare Part A - Covers Hospitals, Skilled Nursing, Home Health & Hospice Care. This premium was paid by your Medicare Tax that you paid while working. So now you do NOT pay anything additional for Part A and you are automatically enrolled on the 1st of your birth month. (deductibles & copays apply)

  • Medicare Part B - Covers Medically necessary services, Preventive, Clinical research, Ambulance, Durable Medical Equipment. He average cost for Part B in 2020 is $144.60, low income earners may have the cost waived and high-income earners will pay more (deductibles & copays apply)

  • Medicare Part D - Prescription Drug Insurance Coverage (deductibles & copays apply)

  • Medicare Part C - Medicare Advantage Plans provided thru Insurance Companies – These plans must provide the same services that Medicare Part A & B Cover and they can also include Part D. Many of these plans offer additional benefits not covered under Original Medicare. The network would be the insurance company! You need to continue to be enrolled in Medicare Part A & B.

  • Medicare Supplements - These plans are offered by Insurance companies and they work together with Original Medicare and the provider network is Medicare. These Plans have letters A-N, Plan F (pays 100% of the co-pays and coinsurance of Part A & B and includes Excess) is the richest for those entitled to Medicare prior to January 1st 2020. Those starting Medicare January 1st 2020 or later Plan G is the best, works just like Plan F except you have to pay the Part B Deductible.

Why Do I Need This?
  • If you are not on a large employer group health plan and you do not elect Part B & Part D when you are eligible, there will be a special enrollment period (Part B Jan-Mar with July effective) and once you decide you want it there will be a penalty for each month you were not enrolled and that penalty will last for the rest of your life

  • Part C & Part D - Open Enrollment after your initial enrollment is October 15 – December 7th each year with a plan effective date of January 1st.

  • Guarantee Issue – Medicare Supplements are medically underwritten and after your 1st 6-monhs of your Part B effective you may be turned down due to health conditions.

  • Understand your options – Very important to understand all of your options as it can affect you in the long run. Should you stay on the group plan, does it really make sense? Staying on a group plan because your spouse is on your employer plan may also not be the best choice.

Where Can I Get Help?
  • We are here to help and we do not charge for our service!

  • 239-362-0855


  • 2161 McGregor Blvd, Suite C, Fort Myers, FL 33901