Medicare Plans from PlanWell Insurance Partners

Medicare plans aren’t one size fits all. Our team at PlanWell hopes to help you find the right coverage that fits your needs. We can assist you with any questions regarding Medicare plans, but if you would like more information beforehand, you can read up on some of the things we find most important when looking into Medicare options below.

 

Who's eligible for Medicare?

A United States citizen or legal resident who is one of the following is eligible for Medicare coverage:​

• 65 or older​

• Younger than 65 with a qualifying disability

• Any age with a diagnosis of end-stage renal disease or ALS

 

Medicare Coverage Options

Original Medicare

• Part A

  • Hospital insurance​

  • Inpatient hospital and mental health care, skilled nursing services, hospice, and some blood transfusions are included

• Part B​

  • Doctor and outpatient visits

    • Physician and outpatient hospital services, ambulance, outpatient mental health, lab services, durable medical equipment, outpatient physical, occupational and speech-language therapy, and some preventative care are included​

• Part A and Part B deductibles, co-insurance, and premiums are not covered. Part B excess charges are not covered. Prescription drug coverage, additional benefits (Ex: hearing, vision, dental), and long term custodial care are not covered. However, those who opt into Original Medicare can invest in a Medicare Supplement plan to cover these gaps in coverage. See this example for more information.

 

Medicare Advantage Plans

• Part C​

  • Combine Part A and B in most cases, includes prescription drug coverage​, offered by private insurance companies, usually include extra benefits

  • You must be enrolled in Part A and Part B to be eligible for Part C and live in the plan service area and must not have end-stage renal disease

• Part D

  • Prescription drug plans, only offered through private insurance companies, must continue to pay Part B Premium ​

  • Dual Special Needs Plans (DSNP)

 

Medicare Supplement Plans

Medicare supplement insurance plans help pay some out of pocket costs not paid by Original Medicare, like deductibles and coinsurance. The plans are the same nationwide, except in Minnesota, Wisconsin and Massachusetts. Plans are sold by private insurance companies. See this example for more information.

 

Medicare Enrollment Periods

 

Initial Enrollment Period (IEP)

Your Initial Enrollment Period (IEP) is your first chance to enroll in Medicare and choose the coverage you want. Your IEP is 7 months long. It includes your birthday month or the 25th month of getting disability benefits plus the 3 months before and 3 months after. Medicare A, Part B and Part D may charge penalties if you sign up after your IEP ends unless you qualify for a Special Enrollment Period.

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Special Enrollment (SEP)

Some individuals may qualify for a Special Enrollment Period. You may be able to enroll in a Medicare plan outside of the Initial Enrollment Period (IEP) or open enrollment time frames, you may qualify for a Special Enrollment Period if you:

• Retire and lose your employer coverage

• Move out of the plan’s service area

• Receive assistance from the state-ex.Medicaid

• Have been diagnosed with certain qualifying disabilities or chronic health conditions

• Qualify for low-income subsidy/extra help for prescription drug coverage

 

Annual Enrollment

Annual Enrollment is from October 15-December 7.

During this time you can add, drop, or switch your Medicare Advantage plan or Medicare Part D. Your new plan will start the following January.

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Medicare Advantage Open Enrollment Period (OEP)

Medicare Advantage Open Enrollment Period (OEP) is from January 1-March 31.

 

If you are already a Medicare Advantage plan member, you may disenroll from your current plan and switch to a different Medicare Advantage plan one time only during this period.

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