Ready to simplify Medicare?
At Eagle Insurance, we specialize in guiding you through the Medicare process, helping you find the right plan that fits your healthcare needs and budget. With so many options and changes each year, understanding Medicare can be overwhelming. Our team of experts is here to simplify the process and provide you with personalized advice and support
Understanding Medicare
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Who is eligible for Medicare?
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Individuals aged 65 or older.
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Those under age 65 who have qualified for Social Security Disability for longer than 24 months
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People of any age who have been diagnosed with either End Stage Renal Disease (ESRD) or Amyotrophic lateral sclerosis (ALS)
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What is Medicare?
Medicare is a federal health insurance program that provides eligible people coverage in several parts:
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Part A: typically covers hospital stays, inpatient care and skilled nursing.
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Part B: generally covers outpatient care, such as doctor visits, preventive services and certain medical supplies.
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Part D: is designed to help cover the cost of prescription drugs. It's an optional plan offered by private insurance companies approved by Medicare. You can add Part D to Original Medicare or get it as a part of a Medicare Advantage plan that includes drug coverage.
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Part C: also known as "Medicare Advantage" - these plans combine Parts A and B, and often include prescription drug coverage (Medicare Part D) as well as additional services like dental, vision, and wellness programs.
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How to decide what Medicare plan is right for You ?
With so many options available, choosing the right Medicare plan can feel overwhelming, but it doesn't have to be.
Here's why working with an Eagle Insurance Agent is invaluable:
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Personalized Assistance: An independent agent can help you review your healthcare needs, including your current doctors, prescriptions, and budget. They’ll guide you through the various Medicare Advantage plans available and help you understand which plans align with your needs.
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Plan Comparison: Medicare Advantage plans differ in terms of costs, provider networks, and additional benefits. An agent can help you compare these options to find a plan that suits your individual situation.
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Ongoing Support: Medicare plans can change from year to year. An independent agent can provide ongoing assistance to ensure your coverage continues to meet your needs, helping you make adjustments if necessary.
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When can you enroll in Medicare?
There are specific periods throughout the year when you’re allowed to sign up for Medicare or make changes to your existing plan. Knowing the details of these enrollment periods can help you avoid penalties and ensure that you’re taking full advantage of your Medicare benefits. Here’s a breakdown of the key enrollment periods you should know about.
1. Initial Enrollment Period (IEP)
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When: Your Initial Enrollment Period begins three months before the month you turn 65, includes your birthday month, and ends three months after.
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What It’s For: This is the time when you can first sign up for Medicare Part A (hospital insurance) and Part B (medical insurance). You can also enroll in a Medicare Advantage (Part C) plan or a Medicare Part D prescription drug plan if you choose to.
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Why It’s Important: Enrolling during your IEP helps ensure you have coverage when you become eligible for Medicare at age 65 and may help you avoid any late enrollment penalties..
2. General Enrollment Period (GEP)
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When: January 1 to March 31 every year.
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What It’s For: If you didn’t sign up for Medicare Part A and/or Part B during your Initial Enrollment Period and you don’t qualify for a Special Enrollment Period, you can enroll during the General Enrollment Period. Your coverage will start on July 1 of that year.
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Why It’s Important: While the GEP provides an opportunity to enroll if you missed your IEP, there may be late enrollment penalties for Part B.
3. Special Enrollment Period (SEP)
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When: Timing depends on your specific circumstances.
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What It’s For: You may be eligible for a Special Enrollment Period if you delayed enrolling in Medicare Part B because you had other creditable health coverage, such as through an employer. SEPs can also be available for other situations, like moving out of your plan’s service area or losing your current health coverage.
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Why It’s Important: SEPs allow you to enroll in Medicare outside of the regular enrollment periods without facing a late enrollment penalty, provided you meet the criteria.
4. Medicare Advantage Open Enrollment Period
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When: January 1 to March 31 every year.
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What It’s For: If you’re already enrolled in a Medicare Advantage plan, this period allows you to switch to a different Medicare Advantage plan or return to Original Medicare. You can also join a Part D plan if you switch back to Original Medicare.
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Why It’s Important: This period provides an opportunity to make changes to your Medicare Advantage plan if your healthcare needs have changed.
5. Annual Enrollment Period (AEP)
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When: October 15 to December 7 every year.
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What It’s For: During the Annual Enrollment Period, you can make changes to your Medicare coverage. This includes switching between Original Medicare and Medicare Advantage, changing Medicare Advantage plans, or joining, dropping, or changing a Medicare Part D prescription drug plan.
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Why It’s Important: The AEP is an important time to review your Medicare coverage and make any necessary adjustments for the upcoming year.
Medicare vs. Medicare Supplement: Which is right for you?
Choosing between Medicare Advantage and Medicare Supplement (Medigap) plans depends on your unique healthcare needs and preferences. Below is a summary to help you start thinking about which option might be right for you
Medicare Advantage (Part C)
All-in-One Coverage: Combines Part A, Part B, and often Part D (prescription drugs) in a single plan. Many plans also include extra benefits such as dental, vision, wellness, over the counter allowances and hearing benefits.
Cost-Effective: Often lower premiums, with some plans offering $0 premiums. Includes an annual out-of-pocket maximum for financial protection.
Convenient: One plan covers all your healthcare needs, plus extra benefits like wellness programs
Network-Based: Many plans now offer access to broader network options such as regional or even National.
Medicare Supplement (Medigap)
Supplemental Coverage: Works with Original Medicare to cover out-of-pocket costs like copayments and deductibles. Does not include drug coverage.
Flexibility: Allows you to see any doctor or hospital that accepts Medicare, making it great for frequent travelers.
Higher Premiums: Typically higher monthly costs, with no annual out-of-pocket limit.
No Extra Benefits: Focuses solely on covering gaps in Original Medicare, without additional perks.
Is Medicare Advantage right for you?
Medicare Advantage offers comprehensive, cost-effective coverage with added benefits and an out-of-pocket cap, making it a strong choice for those who want an all-in-one solution. At Eagle Insurance, our team can help you understand your options, so you can choose a Medicare Advantage plan that fits your needs.
Meet Your Medicare Specialist
My name is Michelle Rahme
Falo Português / Hablo Español
With over 18 years of experience, including 14 years at Blue Cross and Blue Shield of Rhode Island, Michelle is your go-to resource for all things Medicare. She’s dedicated to helping retirees and those planning for retirement fully understand their Medicare options, making the process simple and stress-free. Michelle’s passion for helping others shines through in her personalized approach, offering support in English, Portuguese, and Spanish. Her extensive knowledge and commitment ensure that every client is empowered to make informed decisions about their healthcare.
Schedule your individual consultation?
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Are you turning age 65 and have questions about Medicare?
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Are you over age 65 and thinking about retiring?
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Do you already have Medicare and want to review your coverage options?
Fill out the form below to schedule a no cost, no obligation individual consultation
