The purpose of Medicare ABC is to make your experience with Medicare as enjoyable as possible, free of the complexities of health insurance and Medicare. Our objective as a leader in the Health Insurance Marketplace is to assist you in achieving maximum health and financial wellness, beginning with providing you with a health insurance plan that meets your needs at an affordable price.
It doesn’t end there; when you’ve enrolled, we’ll help you get the most out of your plan by guiding you through your healthcare experience, from verifying benefits to explaining claims to selecting doctors/specialists and scheduling appointments.
We’re here to make the process of enrolling in a Medicare Plan as simple as possible for you.
When completing your health insurance enrollment, we can assist you in applying for several programmes such as SLMB, also known as Specified Low-Income Medicare Beneficiary, LIS (Low Income Subsidy), or Medicaid, which help with the part b premium. However, we may only consider you for these programmes if your monthly income qualifies you.
- If you have worked for ten years or 40 quarters and filed taxes, you may be eligible for a free part a premium, but you will have to pay 148.50 for part b.
- You can get a part a for 279 plus the 148.50 monthly if you have worked 30 to 39 quarters.
- If you worked less than 30 quarters, you will be required to pay 471 plus 148.50.
- SLMB: Specified Low Income Medicare Beneficiary: Assists in the Payment of the $148.50 Part B Premium
- SPAP: State Pharmaceutical Assistance Programs: Helps Pay for Prescriptions. Generics are $5.00 and brand names are $7.00.
LIS: Low-Income Subsidy: Aids in the payment of medications, with generics costing $3.70 and brand names costing $9.20.
Medicare is a federal programme for persons 65 and older, disabled people, people with renal failure, and people with Lou Gehrig’s disease. Medicaid is for low-income or resource-poor families or individuals. If you are a senior with a modest income, you may be eligible for Medicaid.
In order to have more benefits in addition to Medicare, you may enroll in a Medicare Advantage which is a combination of part a, part b, part c, and d. Depending on the insurance plan you choose, you may be eligible for dental and vision benefits as well as other benefits with a Medicare advantage plan.
Apart from asking questions about your doctors and medicines so that we can recommend the best Medicare Advantage plan, Supplemental Plan, or Prescription Drug Plan for you, our representatives at Medicare ABC can also help you pre-qualify for any state or federal programmes that help pay for Medicare. In addition, we will assist you in enrolling in the most appropriate plan for which you qualify, as well as applying for any additional programmes that may be available to help you pay for Medicare expenditures.
You will need the following documents if your appointment is by phone, in person, or at your home:
- Social Security Card
- Medicare Card with Part A and B
- Drivers License or ID
The advantage of having a Medicare Advantage plan is that Original Medicare covers only 80% of your medical costs. The other 20% has to be covered by you. However, if you enroll in a Medicare Advantage plan, it helps cover the 20% that Original Medicare does not cover.
You may enroll in a medicare advantage plan during the following Inscription Periods:
- Initial Enrollment Period (IEP): This is when you first enroll in Medicare you may enroll in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MAOEP): Runs from January 1st-March 31st. During this time you may change to another Medicare Advantage plan once.
- Special Election Period (SEP): If you qualify for LIS you may be able to enroll in a Medicare Advantage plan. If you qualify for Medicaid, you may enroll in a Dual Special Need Plan which comes with additional benefits.
- Annual Enrollment Period (AEP): during this time, you may change your health insurance plan. This program runs from October 15th to December 7th
In order to get a plan with us, you may do any of the following options:
- Call any of our Medicare Advisor’s agents.
- Visit any of your 10 Locations where an agent could help you to the local office closest to you.
- If you have a smartphone we can also enroll you using our Medicare Advisors enrollment system
If any of these options do not seem to work for you, no need to panic. In addition to these options, we have agents that can visit your house in order to complete your enrollment process at no cost to you.
When it comes to Medicare Advantage plans, you may only have one active plan. You are not allowed to have more than one medicare advantage plan.
Depending on the enrollment period you may be able to replace your plan, here are the following options that allow you to replace:
- Medicare Advantage Open Enrollment Period: This allows you to change to another Medicare Advantage Plan once from January 1st to March 31st.
- Annual Enrollment Period: This allows you to change your medicare advantage plan from October 15th to December 7th.
Special Election Period: If you qualify for Medicaid or LIS you may be able to change your plan to Dual Special Need Plan or another Medicare Advantage plan.
If you are currently working and are receiving health insurance through your workplace, you may delay enrolling on Medicare. However, if your employer has less than 20 employees then you have to join Medicare Part A and B since it will be your primary insurance.
If you are disabled, you may enroll on Medicare Health Insurance after you have been in disability for at least 2 years.
In order to change my personal information such as an address change, phone number or any additional changes, you may change this information using the following methods:
- By Creating a My Social Security Account
- Calling Social Security 1 (800) 772-1213
Medicare comes with part a and be in its default card. However, you may acquire additional parts such as part c and part D
Here is a full description of what every part offers:
Part A: Hospital Insurance – which covers hospital stays and skilled nursing facilities.
Part B: Medical Insurance- Covers doctor visits, labs and outpatient services.
Part C: Medicare Advantage – This is provided by private companies and they are responsible for providing additional benefits such as dental, vision among others
Part D: Prescription Drug Plan: It provides for the Medicines
Medigap, also known as Medicare Suplemental Insurance, which are known to cover the 20% that Medicare does not cover.
Here is a comparison chart between Medicare Advantage Plans and Medicare Supplemental Plans
Medicare Advantage Plan
Medicare Supplemental Plan
May Qualify for $0 Premium
Has a monthly Premium
Part D Coverage
Not covered with a supplemental plan
Routine dental, hearing, vision
Does not Cover
Part B Premium
Has to pay unless you qualify for extra help
Has to pay
Can Switch Plan
Two Times Per Year
One Period Change Allowed unless