Medicare ABC has the goal to make your experience with Medicare a pleasant one without the confusion of health insurance and Medicare. As a leader in the Health Insurance Marketplace, our goal is to help you achieve optimal health and financial wellness, starting with offering you a health insurance plan that meets your needs at a reasonable cost.
It doesn’t stop here, After enrollment, we help people make the most out of their plan to guide you through your healthcare journey from verifying benefits, explaining claims, finding doctors/specialists, and in addition to this, we can help to set up appointments.
We’re here to make sure that your experience with enrolling on a Medicare Plan is as smooth as it can be
In order to receive the 148.50 dollars from social security that you’re being deducted, when completing your health insurance enrollment, we can help you apply to different programs such as SLMB known also as Specified Low-Income Medicare Beneficiary, LIS (Low Income Subsidy), or Medicaid which help with the part b premium. However, we may only apply you for these programs if you qualify in terms of monthly income.
- If you have worked 10 years or completed 40 quarters and reported taxes, you may obtain part a premium free but will have to pay 148.50 for part b.
- If you have worked 30 – 39 quarters, you may acquire a part a for 279 plus the 148.50 monthly.
- If you have worked less than 30 quarters, then you will have to pay 471 plus 148.50
If you have low income or resources, and you qualify for Medicare, you may apply for the following programs which help pay for Medicare:
- SLMB: Specified Low Income Medicare Beneficiary: Helps Pay for $148.50 Part B Premium.
- SPAP: State Pharmaceutical Assistance Programs: Helps Pay for Prescriptions $5.00 for Generic and $7.00 for the brand name.
LIS: Low-Income Subsidy: Helps pay for prescriptions making Generic $3.70 and $9.20 brand name.
Medicare is a federal program for people ages 65 and older, people who are disabled, people who have kidney failure, or Lou Gehrig’s disease. Medicaid is for families or individuals who have low income or resources. However, if you are a senior who has a low income you may apply 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. With a medicare advantage plan, you may have dental and vision benefits among additional benefits depending on the insurance plan that you choose.
Here in Medicare ABC, apart from asking questions about your doctors and prescriptions, in order to give you the most appropriate Medicare Advantage plan, Supplemental Plan, or Prescription Drug Plan, our agents can help pre-qualify you for any state or federal programs that help pay for Medicare. In addition to this we will help you enroll you in the most appropriate plan you qualify and help you apply for any additional programs that help pay for Medicare costs.
If the appointment is by phone, in person, or home appointment you need the following documents:
- 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.