Medicare & Private Insurance

Located in west Fort Worth, TX

(817) 874-7569  -- -- Call or Text

For most people, your Initial Enrollment period (IE) to enroll in Medicare without any late penalties is related to your birth month. 

3 Months Prior – Your Birth Month – 3 Months After

So total, you have 7 months to enroll in Medicare and sign up for a prescription drug plan from a private insurance company to avoid any late penalties.

There are exceptions, such as you are still working and have credible insurance and drug coverage, or under special circumstances, you are already enrolled. Please ask if you think you might be an exception, so I can help you with that.

There are numerous enrollment periods, each with limited options.
To keep this simple, I’ll just mention the most common ones.
See Medicare.gov for a complete list.

Your Initial Enrollment Period (IEP)- When you are turning 65. (See above.)

After your Initial Enrollment Period, to enroll or change plans is based on a set of election periods established by the federal government’s Centers for Medicare and Medicaid Services – cms.gov.

• Annual Enrollment Period (AEP) – October 15 – December 7 – Each year.
• Open Enrollment Period (OEP) – January 1 – March 31 – Each Year.
• Special Enrollment and Guaranteed Enrollment  Periods (many options).

That’s the basics, there are a number of variations depending on the type of insurance plan you wish to change to and from, your possible Medicaid circumstances, physically moving out of HMO service area, etc.
We can discuss your possible options, when and if the need arises.

(See Medicare.gov for a complete list of enrollment periods.)

As noted above, most people can enroll in Medicare at age 65 and add a private insurance prescription drug plan (Medicare does not include drug coverage). For many people, enrollment into Medicare is automatic when they sign up for Social Security if they are turning age 65. Once you are signed up for Social Security and turning 65, you should receive your Medicare card in the mail. (see Medicare.gov for exceptions) 

If you are confused about Social Security, I will try to help you find the answers, who to talk with, and how to check out the government’s Social Security website, ssa.gov. Social Security provides an online application, with how-to info, calculator, and estimator, see page “Retirement Benefits – Ready To Retire?” at ssa.gov

Social Security notes: Don’t miss out on getting all of the income available to you, such as spousal benefits, check out the Social Security website, you never know what you might not know.  And you may also qualify for Medicare insurance under your spouse’s work history.

Private insurance Medicare plans can supplement or replace original Medicare and many insurance companies also have prescription drug plans available. Private insurance plans are under the strict rules of Medicare (CMS – Centers for Medicare and Medicaid Services). Private insurance must meet CMS criteria for benefits and services. CMS’s strict criteria help you, along with your insurance agent, to be able to make good, informed decisions about your Medicare options, always keeping you as a priority.

The private insurance plan options which most people are interested in are Medicare Supplement Insurance Plans (also known as Medigap Plans) and Medicare Advantage Plans. There are variations of these plans and also other Medicare plan options, these two are simply the most popular. We can certainly discuss other options if you are interested. (See medicare.gov for these additional options.)

For most Medicare private insurance options it is required that you maintain your enrollment in Medicare Part A and continue to pay your Medicare Part B premium to the government.

How to remember the difference between private Medicare Insurance Plans.

Medicare Supplement Insurance Plans – Supplement Original Medicare. For cost.

Medicare Advantage Plans – Replaces Original Medicare. Zero to low cost.

Most people I speak with are busy and simply want the basic information they need to make an informed decision about their Medicare and private insurance plan options prior to enrolling in a plan. I can help you. What I can do to help you is ask a few basic questions that will help us narrow down what plan might be best for you.
(See “Questions To Ask Yourself” below.)

If you are a DIYer and want to know everything about Medicare and private insurance plan options, I will be glad to give you an in-depth overview of how it all works before you enroll, and also you can visit Medicare.gov website. At the Medicare.gov website, there is a helpful booklet you can download or order titled “Medicare & You”. Also, if you will contact me I can provide you with some really good information booklets from private insurance companies.

Are you looking for a low or zero cost plan?
Such as a Medicare Advantage Plan.

Are you willing to possibly pay more for a Medicare Supplement Insurance Plan?

Do you plan to travel extensively? 

Do you have Plans for extended stays away from home?

Are you a Veteran?

How often do you see a doctor?

I am happy to speak with you anytime before or after you qualify for Medicare to answer your questions or to help you understand your choices, even if you are not my client I am always available to answer questions.

For me to help you enroll in a Medicare Advantage Plan, Medicare Supplement Insurance Plan, or Prescription Drug Plan you must have qualified for and signed up for Medicare, generally when you are turning age 65.

When you are ready to enroll in a Medicare Supplement Insurance Plan, Medicare Advantage Plan, or Prescription Drug Plan provided by a private insurance company, please contact me, and here is what to expect from me.

Patience, I know Medicare is confusing. Honesty, enrolling in a Medicare Plan, provided by a private insurance company, is not required, it is an option. I will try to help you determine if moving from Original Medicare to a private insurance plan is the right choice for you. Integrity, I will always protect your private information.

If you decide to enroll in an insurance plan from a private insurance company, I will be thorough in explaining your insurance plan, because I sincerely want you to understand your benefits, it’s your plan.

If you elect to enroll in a Medicare private insurance plan, here is what I need.
(See “What You Need To Provide” list below.

You will need to have your Medicare Card, this information is required.

A street address is required, but we can add a different mailing address if needed.

If you are enrolling after your Initial Enrollment period (when you turned 65), or you are wanting to change plans, please let me know, there may be some additional information needed.

Often people are not comfortable with people coming into their homes, that is fine, we can meet in a public place such as a restaurant. We can also do your enrollment over the phone with email signatures.

I will be providing you with an enrollment booklet, which is yours to keep and includes a Summary of Benefits. We will go over this booklet carefully, and it should answer your questions about the insurance plan you have chosen. I will also provide you with information about how to access the complete Evidence of Coverage.

In most instances, you and I will complete the enrollment form online via the insurance company’s secure website. 

The material to be covered and the requirements that I must meet in presenting your selected insurance plan takes about an hour, plus allow time for questions and to fill out the enrollment form.

Remember to bring your Medicare Card.
And I look forward to meeting with you!
Marilyn-Kaye*

Medicare and the related private insurance plans are a complex set of options, possibilities, and rules. This page about Medicare and private insurance plans can not possibly summarize hundreds of pages of Medicare and private insurance companies’ information. It is only intended to give a brief overview of Medicare and private insurance companies’ related senior products to get you started.

Insurance agents, such as myself, study extensively to learn the ins and outs of Medicare and related private insurance plans so we can help people like you.

For more information about Medicare and the various related private insurance plans, please contact me.

If you are a Do-It-Yourselfer who wants to study this subject before our meeting, please visit the Medicare.gov website, and also download or order the booklet “Medicare & You.

Here are a few helpful webpages.

Medicare.gov:
Medicare Advantage Plans.
Medicare Supplement Insurance Plans. (Medigap)
Medicare Medical Savings Account (MSA).
Medicare Cost Plans, Pilot Programs, PACE.
Medicare Contact Information

Social Security – ssa.gov
Create Your Social Security Account 
“Retirement Benefits – Ready To Retire?” 

Centers for Medicare & Medicaid Services

cms.gov – Centers for Medicare and Medicaid Services.