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Prairie Grove Insurance Resource Library

Medicare Fall Open Enrollment

9/30/2020

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The Fall Medicare Open Enrollment lets you change your current Medicare Coverage.  You are able to return to Original Medicare, switch to a Medicare Advantage, switch to a different Medicare Advantage and lastly switch to a different Medicare Part D plan ( drug plan).  This happens annually from October 15th to December 7th.   The new plans take effect January 1st.

If you are satisfied with your current Medicare Plan, you DON'T need to do anything.  Your current plan will rollover to the next year.   However, plans can change annually so you may want to at least compare options to make sure your plan is still the best fit for your needs.  This can be very important for your drug plans (Medicare Part D) because medications change often and drug prices vary year to year.   

Changes that can be made during Open Enrollment
  • Switch from a Medicare Advantage plan back to Original Medicare
  • Switch from on Medicare Advantage plan to another
  • Switch from one Medicare Part D plan to another
  • Drop your Medicare Part D coverage completely
    • Be aware if you go without Part D coverage for more than 63 days in a row you will be subject to a penalty.

If you would like a review of your current Medicare Plan, contact me and we can go over your options!

Rob Davies
​800-254-5200



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Welcome to Medicare Visit

9/21/2020

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When you first enroll in Medicare you get a one-time only Welcome To Medicare physical exam.     This is covered by Medicare the first 12 months after you have enrolled in Medicare Part B.  The exam will include a thorough review of your health, education about preventive services you need and referrals for other care.  I highly recommend everyone take advantage of this.  

This is an easy way to get up to date on crucial screenings, shots and a chance to talk with your doctor about family history.  At the Welcome to Medicare appointment your doctor will record your medical history, check your vision, blood pressure, and make sure you are up to date with all your preventative screenings like cancer and immunizations.  If needed they will also order further tests.  When you leave you will get a written plan letting you know which screenings and other preventative services you should have done.

How Much does the Welcome To Medicare Visit Cost?

It is free the first 12 months after you have enrolled in Medicare Part B.   After the 12 months has come and gone you can get a yearly wellness visit which is also covered under Medicare.  If you have any additional tests or services during these visits you may have to pay coinsurance and the Medicare Part B deductible.  

What do I need to bring with me?

  • Your medical records
  • Prescription drug lists and other the counter medications you take
  • Family history
  • Immunization records
  • Any other information you can give your doctor to help determine if your at risk for certain diseases. 




If you have any questions or comments please reach out to me

Thank You 
Rob Davies
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What Is Medicare - Facts You Need To Know

9/16/2020

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When starting Medicare it's important to know the difference between all the parts of Medicare.  Part A, B, C, and D.  You want to make sure you get the most out of Medicare and you find a plan that fits your needs as well.

The Basics of Medicare

​Medicare is a federal health program, administered by CMS (Centers for Medicare and Medicaid) which is a division of the U.S. Health and Human Services (HHS).  Most Medicare beneficiaries are senior citizens 65 and older.   However, adults with permanent disabilities and some approved medical conditions such as ALS may also be eligible for Medicare Benefits.

U.S. citizens are eligible to enroll by working and paying taxes for 40 quarters.  If you don't have the required amount of quarters you may still be eligible, but you will have to pay more.  

4 Parts of Medicare A,B,C and D

Medicare Part A
covers inpatient hospital Care, limited time in a skilled nursing facility, limited home health services, and hospice care.  Think of this as your Hospital insurance.  Most beneficiaries don't have to pay a premium for this part.  If you worked your 40 quarters (10 years) and paid taxes Part A is free.   If you didn't you can still receive benefits for  Medicare Part A but you will have a premium.  

Be aware that Part A doesn't cover the full amount of your hospital bill, and you will be responsible for the difference.  There is also a deductible you have to pay before your benefits begin.   

Medicare Part B covers the non-hospital medical expenses.   Doctor visits, blood tests, X-rays, diabetic screening and supplies, and outpatient hospital care.   For Medicare Part B you have a monthly premium.  This premium for Original Medicare varies by income.  The fee is much higher for people in high income brackets.  For people in low income brackets who need help with coverage Medicaid is also available.  

Medicare Part B also has a deductible before your benefits kick in.  After that you are responsible for 20% of the bill.  

Medicare Part C commonly know as Advantage Plans.   These plans are offered by private insurance companies and are contracted through CMS.  The benefit package are an alternative to Original Medicare but to qualify for Medicare Part C you must still be enrolled in Original Medicare.  You still have to pay your Part B premium .

Medicare Advantage plans have to provide all the benefits of Original Medicare (except hospice) they can include additional benefits such as eye exams, hearing aids, and dental care.  Many Medicare Advantage plans also include prescription drug coverage.  These are called Medicare Advantage Prescription Drug plans.  

Medicare Part D is prescription drug coverage.  This is a stand alone plan through private insurance companies and the monthly fees vary between companies.   Open enrollment for Part D is October 15th through December 7th and these plans may change every year.  

Have questions or just need help Give Me a Call. 
Rob Davies
​800-254-5200


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5231 Voges Rd
Madison, WI 53718
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Medicare has neither reviewed nor endorsed this information. Not connected with or endorsed by the Unites States government or the Federal Medicare program.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.