Guiding You Down the Confusing Path of Health Insurance and Medicare
Information, Coverage Options and No-Cost Enrollment Assistance
With a specialized focus on Medicare and Individual Health Insurance, my expertise lies in guiding individuals through the complexities of healthcare
Guiding You Down the Confusing Path of Health Insurance and Medicare
Information, Coverage Options and No-Cost Enrollment Assistance
About Us
With a specialized focus on Medicare and Individual Health Insurance, my expertise lies in guiding individuals through the complexities of healthcare. Helping people navigate this intricate world is not just my profession; it’s my passion.
I am dedicated to assisting, educating, and supporting individuals in finding the perfect health benefits that cater to their unique needs. My area of specialization revolves around explaining the ins and outs of Individual and Medicare Health Insurance Plans, helping you enroll at the right time and into the right plan. I’m here to address all your questions, clarify your insurance options, and ensure you make the most informed choices while avoiding common misconceptions and late enrollment penalties.
Having served clients in Michigan and numerous other states, I possess an in-depth understanding of the insurance landscape nationwide. My career spans over 25 years, during which I worked with renowned health insurance companies like Blue Cross Blue Shield of Michigan, Aetna, and Health Alliance Plan. In these roles, I supported agents and brokers in comprehending Medicare and Individual Plans while providing extensive training and assistance. This experience made me realize the greater need to extend my expertise to a broader audience and make a direct impact on my clients’ decision-making process.
My mission is to empower my clients by helping them understand insurance and make informed decisions. Equipped with skills, knowledge, and years of experience, I strive to meet my clients’ goals effectively. I aim to be a lifetime resource for my clients, instilling confidence in their insurance choices for generations to come.
On a personal note, I reside in Troy, Michigan, with my wife and three wonderful children. When not serving my clients, I love exploring Lake St. Clair by boat, engaging in mountain biking, tennis, playing the piano, and creating cherished memories with my family during travels.
It’s a privilege to pursue my passion and calling every day, and I’m excited about the opportunity to assist you. Feel free to reach out for a no-cost, no-obligation, and no-pressure consultation!
Medicare Resources
What You Need to Know and How We Can Help You
Getting Started
Responses to often asked queries like: When should you enrol? When and how do you qualify for Medicare?
Defining the ABC’s
The four parts of Medicare are A, B, C, and D. Learn the "ABC's", how they function, and your options for each part as the first step.
Enrollment Periods
Medicare enables you to alter your coverage at particular periods each year after your initial enrollment.
Medicare’s “Donut Hole”
As a result of this circumstance, some beneficiaries have coverage gaps since they must pay extra out of pocket after exceeding their yearly coverage limits.
Advantage Plans
Private insurance providers provide Medicare Advantage Plans, which frequently result in cost savings for you.
Special Needs Plans
SNPs are Advantage Plans that have been specially designed to fulfil the needs of people with particular health problems or situations.
Medicare Part D
Private insurance companies offer Medicare Part D, which covers your prescription drug needs. We'll go into detail about how it operates.
Supplement Plans
To fill in the holes left by Medicare, private insurance companies sell insurance. Likewise known as "MediGap" plans.
Who is eligible for Medicare?
All US citizens become eligible for Medicare when they turn 65. Non-citizen permanent residents are eligible at 65 also, provided they have lived in the country for at least five years.
If you are under 65, you might qualify for Medicare if:
- You are permanently disabled and have received Social Security Disability benefits for at least 24 months
- You have been diagnosed with end-stage renal disease (kidney failure)
- You have been diagnosed with Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease) and are receiving Social Security Disability benefits
As with most large, complex government programs, Medicare can seem a bit overwhelming at first. That’s why we’ve created this guide to help you navigate the application procedure, annual enrollment, and more.
When you first enroll in Medicare during your Initial Enrollment Period, you will select Original Medicare (Parts A and B) or a Medicare Advantage plan (Part C) which combines the two types of coverage. Part D (prescription drug) coverage is also available with either of these options.
But once you make your selections, you aren’t stuck with those plans for life. In fact, Medicare offers you opportunities to change your plan(s), depending upon the situation.
Medicare is divided into several different programs, or parts.
You will choose to enroll in either Original Medicare, which encompasses Parts A and B, or Medicare Part C (also called Medicare Advantage).
For over 40 years, Medicare beneficiaries paid out of pocket for most of their prescription medications. In 2006, the federal government opened a new program called Medicare Part D to help beneficiaries manage their prescription drug costs.
Medicare Part D is offered via private insurance companies, and you have the ability to comparison shop and choose a plan that best suits your needs.
Medicare Part D is voluntary, meaning you can choose to opt into a plan or not. If you do enroll in Part D, you will be able to access retail prescription drugs at a more affordable rate, and enjoy protection against catastrophic costs in the event you need a very expensive medication.
When you become eligible for Medicare, you face a series of choices. One of the first choices involves the type of coverage you prefer.
Medicare Parts A and B comprise what is known as Original Medicare. But if you would prefer to enroll in a plan managed by a private health insurance company, you can choose Medicare Part C, or Medicare Advantage.
Medicare Advantage plans combine Part A and Part B benefits, and often include Part D (prescription drug) benefits as well. Some beneficiaries prefer to have all of their coverage managed under one comprehensive plan.
You must be enrolled in both Medicare Part A and Part B in order to elect an Advantage plan, and you will continue to pay your Part B premiums. Medicare will then pay the Advantage plan administrator a set monthly amount to manage your care, and your Advantage plan will deliver all of your benefits. You also must live within the Advantage plan’s coverage area.
Medicare Part D was originally designed to cover the majority of a beneficiary’s prescription drug costs. Of course, each individual’s need for medication varies, so some people end up with prescription drug costs that exceed the limits of their Part D plan.
This situation creates a coverage gap for some beneficiaries, as they reach their annual coverage limits and then have to pay more out-of-pocket in the middle of the coverage year. This coverage gap is often called the “Part D Donut Hole”.
Special medical situations require specialized care. Medicare Special Needs Plans (or SNPs) were created with this principle in mind.
SNPs are Advantage Plans that are tailored to meet the needs of individuals with certain health conditions or circumstances.
The plan network, benefits, and drug formulary are all centered on the patient’s condition in order to provide the appropriate support. Many SNP plans also assign care coordinators to assist patients in managing their condition, following physician orders, accessing community resources, and obtaining timely prescriptions.
To qualify for a Special Needs Plan on the basis of chronic illness, the Medicare beneficiary must be diagnosed with one or more of the following conditions:
- Autoimmune disorders
- Alzheimer’s or dementia
- Cancer
- Cardiovascular disease, stroke, or chronic heart failure
- Diabetes
- End-stage renal disease, requiring dialysis
- Hematologic disorders
- HIV or AIDS
- Chronic lung disorders (such as COPD)
- Chronic or disabling mental illness
- Neurologic conditions
Medicare is available in several “parts” all of which are designed to fit together to offer comprehensive coverage.
Still, gaps between the plans mean that some people experience difficulty in gaining coverage in some situations, or end up with high out-of-pocket expenses. Medicare Supplement Plans were designed to help close these gaps. That’s why Supplement plans are often called “Medigap” plans.
A Medicare Supplement plan, paired with Original Medicare, will be accepted nationwide. Out-of-pocket costs are usually lowest with this combination, and flexibility is greatest. Of course, cost is based on your age, gender, geographic location, tobacco usage, and household eligibility for discounts. As a result premiums can vary greatly based on your specific situation and the insurance carrier you select.
Why Use Us?
Choosing a Medicare plan carries a high degree of importance for several reasons:
- You want the best healthcare coverage for your situation
- You want to keep your out-of-pocket expenses manageable
- You want a plan that you understand, so that you don’t experience unpleasant surprises
- You want to take advantage of the best opportunities available to you, during the appropriate time windows
- You don’t want to experience shocking gaps in coverage
- And probably a few more reasons, depending upon your circumstances
Frequently Asked Questions
Applying for Original Medicare online through the Social Security website is the simplest option. You can apply for Medicare quickly—it shouldn't take you more than ten minutes.
Yes! For as long as you have Medicare coverage, you may be charged premium penalties if you don't sign up for Part B coverage during your Initial Enrollment Period.
You have a 7-month window to apply for Original Medicare: the three months leading up to, the month of, and the three months after your 65th birthday.
You can, but you'll have to apply in person at a nearby Social Security office. Simply call our office and make an appointment if you want to apply for an Advantage or Supplement Plan in person. Please be aware that before enrolling in an Advantage or Supplement Plan, you must first apply for Original Medicare.
Normally, it takes 3 weeks for you to acquire your Medicare card after submitting an application.
Your next chance to sign up for Medicare Part A and Part B will be during the General Enrollment Period, which runs from January 1 to January 31. Since you missed your seven-month window, you will have to wait until then. Following your registration date, coverage will start on the first of the following month. If you enrol, for instance, on February 10th, your coverage will start on January 1st.
What We Do
Here are some key points about me and my business:
- 100% family-owned and operated.
- Over 25 years of experience in the health insurance industry.
- Fully licensed and insured.
- Impeccable ethical and legal track record.
- Representing all major insurance carriers.
- Patient and attentive to your individualized needs.
- Caring for my customers as if they were my own family.
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Get in Touch
Our licensed agents offer Medicare enrollment assistance at no cost and no obligation!
- Review your current benefits
- Explore additional benefits
- Explain your coverage options
