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  • Quotes
    • Medicare Advantage Plan Quote
    • Medicare Supplement Coverage Quote
    • Prescription Drug Plans Quotes
    • Final Expense Insurance Quote
    • Life Insurance Quote
    • Annuity Quotes
    • Dental Insurance Quote
    • Vision Insurance Quote
  • Service
    • Update Contact Info
    • Policy Changes
    • Policy Review
    • Contact My Carrier
    • Resource Center
    • Medicare Glossary
    • Free Consultation
    • Insurance Education Workshops
  • Insurance
    • Medicare Advantage Plans
    • Medicare Supplement Coverage
    • Prescription Drug Plans
    • Final Expense Insurance
    • Life Insurance
    • Annuities
    • Dental Insurance
    • Vision Insurance
  • About
    • Medicare And Social Security Tips
    • Blog
    • Client Testimonials
    • Refer a Friend
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Paul Barrett Insurance Services Blog

What You Can Get From Final Expense Insurance

2/22/2021

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​When you are retired and don't have family members who are dependent on you, life insurance won't be the best choice for you. It may be difficult to accept, but death is inevitable, and it will entail a lot of payments for funeral arrangements. To ensure that you have the funds for your funeral, you can get final expense insurance. What is final expense insurance, you say? Well, continue reading and find out.

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Find Out Why People Are Getting Life Insurance

2/16/2021

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​Every dollar truly counts. People should come up with wise financial decisions, especially when they get to support their loved ones’ future. Some income earners opt themselves to be armed with life insurance as their strategic financial tool. In fact, its market penetration industry is relatively stable at 57% over the years, based on statistics. Below are some of the reasons why people buy life insurance:

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The Donut Hole Cost's Explained

2/4/2021

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2021 Medicare Part D Deductible, Costs & Copays. Donut Hole Discount Explained

Medicare Part D enrollees will receive a 75% Donut Hole discount on the total cost of their brand-name drugs purchased while in the Donut Hole. The discount includes a 70% discount paid by the brand-name drug manufacturer and a 5% discount paid by your Medicare Part D plan.
The 70% paid by the drug manufacturer; the 5% Part D plan discount together with the 25% you pay, count toward your TrOOP (True Out-of-Pocket) or Donut Hole exit point.
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Part D changes for 2021 are:
  • Initial Deductible: will be increased by $10 from $435 in 2020 to $445 in 2021.
  • Initial Coverage Limit: will increase by $120 from $4,020 in 2020 to $4130 in 2021 where the 2021 “Donut Hole” begins.
  • Out-of-Pocket  threshold cost: or (TrOOP true out of pocket) will increase from $6,350 in 2020 to $6,550 in 2021.
  • Coverage Gap (Donut Hole): begins once you reach your Medicare Part D plan’s initial coverage limit ($4,130 in 2021) and ends when you spend a total of $6,550 out-of-pocket in 2021.
  • Generic Drug when one reaches Medicare Part D Donut Hole: pay a maximum of 25% co-pay on generic drugs purchased while in the Coverage Gap (receiving a 75% discount).
  • For example: If you reach the 2021 Donut Hole, and your generic medication has a retail cost of $100, you will pay $25. The $25 that you spend will count toward your TrOOP or Donut Hole exit point.
  • Lower costs when one comes out of the Donut Hole and enter Catastrophic coverage until December 31 and then a new year begins. Then the Medicare Part D cycle begins again with a new deductible on January 1 of every year.
Does the Donut Hole really go away? No, the name changed. In 2020, the Donut Hole began being called Donut Hole Discount.
Paul’s Part D Tips      During Medicare’s Annual Enrollment Period from October 15th to December 7th be sure that all your prescriptions are covered by your standalone Medicare Part D plan or a Medicare Advantage plan with prescriptions and if your drugs are expensive make sure you compare options, which will begin January 1st.
Remember you will pay 100% of the cost if any prescriptions (generic or brand name) are not covered on your Medicare Part D plan.
Talk to your doctor or doctors about which brand name drugs can be changed to generics.
Be aware of available prescription assistance programs there are 12 State Pharmaceutical Assistance Programs for people on Medicare depending on what state you live in you may be eligible.
Remember most of us don’t see a doctor every month but we take our prescriptions daily and refill them every month, choosing the right Part D plan can be very important and you should choose wisely.
For help with your Medicare questions or choosing the right part D plan, call us 1-800-219- 0453 0r 631-358-5793  email questions to  medicare@paulbinsurance.com
 

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Retiree Insurance & Medicare

2/3/2021

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Retiree insurance & MedicareIf you're retired and have Medicare and group health plan (retiree) coverage from a former employer, generally Medicare pays first for your health care bills, and your group health plan coverage pays second.
4 things to find out about your retiree coverage
  1. Can you continue your employer coverage after you retire? Generally, when you have retiree coverage from an employer or union, they control this coverage. Employers aren't required to provide retiree coverage, and they can change benefits, premiums, or even cancel coverage.
  2. What's the cost and coverage? Your employer or union may offer retiree coverage for you and/or your spouse that limits how much it will pay. It might only provide "stop loss" coverage, which starts paying your  out-of-pocket costs only when they reach a maximum amount.
  3. What happens to your retiree coverage when you're eligible for Medicare? Retiree coverage might not pay your medical costs during any period in which you were eligible for Medicare but didn't sign up for it. When you become eligible for Medicare, you will need to enroll in both Medicare Part A and Part B to get full benefits from your retiree coverage.
  4. How does your retiree coverage work with Medicare? Get a copy of your plan's benefit booklet, look at the summary plan description provided by your employer or union, or call your employer's benefits administrator.
If your former employer goes bankrupt or out of business, Federal COBRA rules may protect you if any other company within the same corporate organization still offers a group health plan to its employees. That plan is required to offer you COBRA continuation coverage. If you can't get COBRA continuation coverage, you may have the right to buy a Medigap policy even if you're no longer in your Medigap open enrollment period.
You may want to talk to a knowledgeable insurance broker for advice about whether to buy a Medicare Supplement Insurance (Medigap) policy or enroll in a Medicare Advantage Plan.  Since Medicare pays first after you retire, your retiree coverage is likely to be similar to coverage under Medicare Supplement Insurance (Medigap). Retiree coverage isn't the same thing as a Medigap policy but, like a Medigap policy, it usually offers benefits that fill in some of Medicare's gaps in coverage—like coinsurance and deductibles. Sometimes retiree coverage includes extra benefits, like coverage for extra days in the hospital and often covers part D prescription coverage.
Everyone’s situation is different if you have questions about Medicare & retirement coverage contact my office and we would be happy to walk you through the steps you need to take.
Call                        email
631-358-5793      medicare@paulbeinsurnace.com


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Which Medicare Insurance is Best?

2/1/2021

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Which Medicare Insurance is Best? 
Medigap Vs. Medicare Advantage

Almost every day someone will ask me some version of this question:  “What is the difference between Medicare Advantage vs Medigap and how do I choose?” I’ve answered versions of this question thousands of times in my career.
As you may know by now, Medicare alone doesn’t cover everything. Most people buy additional insurance to bridge the gaps.  After all, who wants to come up with a $1400+ deductible each time you enter the hospital? Or shell out 20% of the cost of an expensive test like a MRI? 
When considering Medicare Advantage vs Medigap plans, it’s important to understand that both types of plans will help to reduce your out of pocket spending, understanding the differences will help you select the right plan for your needs.
 
Medigap, commonly referred to as Medicare Supplement
Medicare supplements will pay secondary to original Medicare, that means there is no provider network and patients with this coverage can go to any provider that accepts original Medicare.  If you enroll in a comprehensive plan like Plan G, you will have very little out of pocket.  Not even doctor copays!

When you enroll, you're Medicare supplement insurance company notifies Medicare that you have purchased a policy. Thereafter, as we described earlier, when Medicare pays its portion of your bills, it will automatically send the remainder of your bill to your Medicare supplement company.
Freedom of Access & No Referrals NecessaryMedicare supplements also offer you the most freedom of access to providers. You have freedom to choose your own doctors and hospitals from among the 900,000+ Medicare providers in the nation. No referrals are necessary to see a specialist on this type of coverage. Because these plans offer you the most freedom and flexibility, they have higher premiums than Medicare Advantage plans. In the New York area, for example, a female, non-tobacco user turning 65 might pay around $200 – $270/month for Plan G in 2020.
Rates in other states depend on which Medigap plan is chosen and whether that individual uses tobacco. Plans and rates also vary by region, age and sometimes gender. 
Your Retail Drug Coverage is SeparateMedicare supplement  plans cover medications administered in a hospital setting, such as injectables or chemotherapy drugs. They do not cover retail medications though, so most beneficiaries will enroll in a separate Part D drug card. There are plans available in every state starting around $10/month up to $100.
If you enroll into a Medicare supplement plan during your one-time open enrollment window (within 6 months of your Part B effective date), there are no health questions. The insurance company will approve your application.
There are also no waiting periods or pre-existing condition exclusions when you apply during this window. If you miss this window and apply later on, then you will usually be required to answer medical questions and be underwritten. The underwriter at the insurance company can accept or decline you based on your medical history.
Medicare Advantage About 36% of beneficiaries choose to enroll into Medicare Advantage policies, which are private insurance plans. They usually have lower premiums than Medigap plans….Many even a $0 premium on some plans in some areas.
When a plan has a $0 premium, it means that you will pay no additional premiums for the plan itself. You will still pay for your Part B premiums monthly though.  You must be enrolled in both Medicare Parts A and B to be eligible for a Medicare Advantage plan.
 Check Your DoctorsMedicare Advantage plans have networks which vary greatly in size, making it even more important to choose a plan with a good network that fits your needs.  
Your Medicare Advantage insurance company will pay your healthcare bills instead of Medicare paying them.  You will pay copays for the services you obtain from providers in the plan’s network as you go along. Generally the copays are reasonable, but you’ll want to review them before you enroll to make sure. Often Medicare advantage plans will offer benefits that are not covered by original Medicare like dental, vision, hearing, free gym memberships and more.
Bottom Line
There are many variables to consider when choosing a plan This is not a one size fits all, so take your time and do your homework here are a few things to consider,
  • Monthly premiums
  • Deductibles, if any
  • Expected costs of healthcare services on each plan
  • How often you use healthcare services
  • Areas where you will need access to care
  • Expected copays for your medications
  • Potential out of pocket spending for you on each plan type
  • Remember, you get what you pay for
Checking the provider networks and drug formularies for each plan can take many hours.  You can simplify your search by having Paul Barrett Insurance licensed agents  to do this for you. We’ve helped thousands of people like you with their options. We can search Medicare Advantage vs Medigap plans in your area.
We’ll be able to quickly tell you which plans your doctors take and whether your medications are covered. Working with an agent also gives you policy support when dealing with providers and year round customer service if needed.
 Call 1-800-219-0453 for help today!

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Medicare Advantage Plans Are the BEST?

1/29/2021

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Medicare Advantage Plans ARE the BEST?
So let's first talk about what is a Medicare advantage plan also known as part C of Medicare. Medicare advantage plans are another way to receive your Medicare health insurance, these plans are run by private health insurance carriers. Companies like BCBS or Humana and many others offer these plans as an alternative to straight Medicare parts A & B. These plans will  cover everything Medicare covers plus many times include prescription drug coverage also known as part D. All Medicare advantage plans have a contract with the federal government and are subsidized by Medicare taxes , this is why you will see many plans offered for $0 per month. If you watch Television at all I am sure you have seen some of the commercials with famous athletes promoting all of the fantastic benefits like, Dental Vision Hearing Transportation Gym Memberships Free Meals $144.00 part B giveback  Ect….. Who wouldn't want all of these benefits right? However the bottom line is these television commercials are not run by agents or agencies most of the time but rather third party marketing firms who are looking to sell your phone calls to agents/agencies. So on the other end of the phone you have someone who has paid to speak with you and probably has sales quotas and no other agenda then enrolling you in a plan. With Medicare advantage plans the benefits vary greatly from area to are zip code to zip code. So the burning question is can you get these great benefits for $0 per month? The answer is yes if you are lucky enough to live in the very limited zip codes and states that offer these benefits or if you happen to be dual eligible for both Medicare & Medicaid. As a licensed agent in multiple states for many years I have seen these benefits offered, but in very few counties in only a couple of states, which they certainly do not say on the television commercials.
It’s the old bait and switch, the commercials are designed to generate excitement and a phone call giving a sales agent the opportunity to enroll a customer in a plan, with or without all the benefits you were hoping for. The bottom line Medicare advantage plans can be great and they serve a lot of people well across the country, but they do not all offer all of those amazing benefits. So buyer beware, Medicare has become big business and if you are turning 65 or are already on Medicare someone wants to sell you. If you would like FREE advice or help understanding Medicare options I would be honored to assist you in anyway your comfortable, call me at 631-358-5793  email medicare@paulbinsurance.com  schedule a free consultation 

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Medicare Part D Insulin Savings Program

1/29/2021

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Insulin savings through the Part D Senior Savings Model Starting January 1, 2021, you may be able to get Medicare drug coverage that offers broad access to many types of insulin for no more than $35 for a 30-day supply. You can get this savings on insulin if you join a Medicare drug plan or Medicare Advantage Plan with drug coverage that participates in the insulin savings model. This model lets you choose among drug plans that offer insulin at a predictable and affordable cost.
Things to know Part D covers these: Injectable insulin that's not used with an insulin pump Certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs However, if you use an external insulin pump, Part B may cover insulin used with the pump and the pump itself as durable medical equipment (DME). If you live in certain areas of the country, you may have to use specific pump suppliers for Medicare to pay for an insulin pump. Ok so what does this mean to you if you are on insulin? Not all insurance carriers are participating or have plans nationwide offering these benefits, so you will need to research your plan options to see who indeed is offering these benefits.  Select insulins include all Tier 2 and Tier 3 insulins found on the list of covered drugs for each participating MAPD plan or prescription drug plan. They include at least 1 each of rapid-acting, short-acting, intermediate-acting, and long-acting insulin vials and pens. If you have questions about the insulin savings program or how you may be able to reduced you out of pocket drug cost, email medicare@paulbinsurance.com or call my office 631-358-5793
www.paulbinsurance.com/

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How to pick a Medicare Part D plan

1/12/2021

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See tips to help you select a prescription drug plan—and learn what to avoid.
Key takeaways
  • Never pick a Medicare Part D prescription drug plan just because it has a low monthly premium. Instead, pick a plan based on how the prescription drugs you're taking are covered.
  • Pay attention to Medicare Part D plans with special rules that may limit prescription usage or force you to satisfy requirements before you can have a prescription drug.
  • Typically, you can switch Medicare Part D plans each year during open enrollment (October 15–December 7), but some states may have more switching options available.
For most retirees, health care—especially prescription drugs—can be a significant expense. The average annual cost of therapy for widely used generic drug products was $365 in 2019 and $6,798 for widely used brand name drug products.1
Whether or not you need coverage when you first sign up for Medicare, it's critical to plan ahead. Most people will need coverage at some point in retirement. If you're uncovered and need prescription drugs, the costs can be crippling. And if you wait to sign up for drug coverage until you need it, you will likely need to pay a much higher insurance premium.
Those eligible for Medicare have 2 options: A stand-alone Medicare Part D prescription drug plan or an "all-in-one" approach with a Medicare Advantage plan. Here we will focus on Medicare Part D. 
Either way, it's crucial to consider Medicare drug coverage options carefully.
Your Medicare Part D checklistNot all Part D plans are created equal. Each plan varies in terms of cost, the drugs covered, special rules, and so on. Just because a friend or family member's Part D plan works for their needs doesn't mean it will work for yours. Instead, do some homework. Here are 5 simple steps to get started.
  1. Make a list of your current prescription drugs, including the dosage, quantity (30-day supply, 60-day supply, etc.) and frequency (how often you take them).
  2. Take your list to the Medicare Plan Finder at Medicare.gov. It can show you which Part D drug plans are available in your area and which of those plans cover your drugs. (You can also use the Plan Finder each year to check your current Part D plan and see if better options are available.)
  3. Once you find plans that cover your prescriptions, see how much they will cost you. Costs are typically your monthly premium (what you pay to have the Part D plan) and any out-of-pocket amount you pay for a drug. While a Part D plan may cover your prescriptions, you may wind up paying more compared to other plans, depending on which pricing tier the plan places your prescriptions (referred to as a drug formulary).
  4. Your share of the prescription drug costs can fluctuate based on your drug's category (generic or brand). Part D plans usually spell out this information in their plan details. If you want to choose a plan with a low monthly premium, make sure to consider the plan's total cost (premium plus out-of-pocket costs) per year.
  5. Check out the Part D plan's ratings. Medicare gives Part D plans a rating of 1 start (poor) to 5 star (excellent) based on customer service, customer experience and complaints, performance, drug safety, and pricing accuracy. These ratings can help you know how good a job the plan is doing in providing coverage. Keep in mind new plans might not have a rating.
What if I'm not taking prescription drugs?No one can predict the future. Even if you're a super fit 65-year-old and you're not taking any prescription drugs, you could need a prescription because of a sudden illness or accident. Without prescription drug coverage, you could wind up paying the full cost, which could be hundreds or thousands of dollars.
Even if you don't take prescription drugs currently, if you need them later and you try signing up for a Part D plan late, you could face a penalty of 1% for each month you went without coverage. Not having Part D coverage could be a costly—and long-term—mistake.
You should consider enrolling in a Part D prescription drug plan as soon as you become eligible for Medicare (unless you have creditable drug coverage such as from an employer health plan), regardless of your current prescription drug needs.
Navigating Part D restrictions
A Part D plan may also feature restrictions around certain prescriptions. These restrictions are intended to address drug safety and manage prescription drug costs. You'll usually see these drug restrictions on the higher pricing tiers in a drug plan. Here are some common ones:
  • Prior authorization: A plan can require you to get physician authorization and/or insurance company approval before your prescription is covered.
  • Quantity/dosage limits: If your doctor prescribes a prescription drug at a certain dosage or for a certain period that a plan considers outside the range necessary to treat your condition, the plan may not cover the drug. Or, the plan may ask that it be prescribed at a lower dosage or for a shorter period.
  • Step therapy: If your doctor prescribes an expensive drug, the plan may require you to try a similar but lower-priced drug first.
While not every Part D prescription drug plan includes these restrictions, there are steps you can take to avoid them in plans that do. The 2 biggest actions you can take are:
  1. Try a different drug. Ask your doctor if there's a more affordable alternative to a restricted drug or a generic version of the drug. Try a different Part D plan. You can switch Part D plans during open enrollment.
Yes, you can switch plans as your needs changeIf your Part D plan isn't working for you, there's hope. Each September, plans send out an Annual Notice of Change letter. This letter lets you know about plan changes for the upcoming year, such as cost increases or drugs being added or removed from the plan (or switched to a different pricing tier). Read the Annual Notice of Change letter carefully to see if it makes sense to keep or switch your plan. You can change plans during open enrollment.
Get readyBefore you enroll in a Part D prescription drug plan, find out which plans are available in your area and whether they cover your prescriptions. Compare their overall cost and look for a plan that:
  1. Features the lowest overall cost
  2. Has either no restrictions or minimal restrictions
  3. Best meets your health and financial needs
If the costs to cover your drugs are too high for your budget, contact your local State Health Insurance Assistance Program (SHIP) office about programs available in your state that help with costs. These services are provided at no extra charge to you. (You can also check with your state's SHIP representatives to see when you are allowed to change Part D plans.)
Choosing Medicare prescription drug coverage is a decision you'll have to make throughout your retirement.
If you have questions we are here to help 631-358-5793 or email medicare@paulbinsurnace.com 





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Before You Choose a Medicare Plan Read This

12/22/2020

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Before you choose a Medicare plan, think about your options carefully and read through the information that is available on all the plans. Attend a seminar or online Medicare 101 webinar.  Speak with an insurance broker who represents many carriers to get unbiased advice. It is wise to get a good education on Medicare and what it has to offer before making decisions.
Medicare has many different parts. The original Medicare Part A & B leaves a lot of needs uncovered as well as a high out-of-pocket risk for many medical situations. 
To help with the cost of prescription drugs, Medicare uses private companies to offer what is called part D.  Many people would probably consider this the most complex part of Medicare, and for many of us prescription coverage is very important.  Most states offer over 20 different options for part D with each one having variations of the Medicare coverage model.  Which means they have different deductibles, copays, coinsurance,  formularies and rules.
Medicare supplement plans, AKA(medigap), are offered to help alleviate costs such as Medicare Part A & B deductibles and coinsurance.  Some of these supplement plans  cover all out-of-pocket Medical costs, with the exception of prescription drugs. There are 10 standardized Medicare supplement plans offered by many companies in most states with the exception of MA, WI and MN. These states offer a different model of supplement coverage.
Medicare advantage plans, also known as part C, is another option to help control Medicare costs. With a Medicare Advantage plan you receive traditional style health insurance through a private insurer contracted with Medicare. These plans are generally HMO or PPO plans which cover costs associated with hospital stays, medical coverage and part D prescription coverage, all under one plan. These plans are subsidized by the government and coverage varies greatly from plan to plan as well as by zip code. Some areas have as many as 50 plus choices while others may have just a few.
There is no one plan that is best for all, everyone has different medical needs and budgets. One thing we all want is the best coverage to meet our personal needs and budget, when getting ready to choose a coverage option here are some questions you should ask. 
 
Ask yourself the following questions:
  • What is most important to you in a Medicare plan — cost, coverage or convenience?
  • Will you have your choice of health care providers?
  • Will the plan you choose meet your needs? How does the plan’s quality ratings compare with others in your area? With those nationally?
  • How much will you have to pay for your health care and prescription drugs?
  • Will you have coverage if you travel frequently or leave your hometown for long periods of time?
 
Don’t let Medicare overwhelm you, start early and do your homework so you can make an educated decision.
To compare Medicare plans, use the Medicare Plan Finder at www.medicare.gov/find-a-plan, on the official U.S. government site for people with Medicare.  This site allows you to compare plans by cost, quality and other features that may be of importance to you. If you have specific questions about Medicare, or Medicare plans Paul Barrett Insurance Agency offers free guidance,  you can schedule a call or zoom meeting at http://www.paulbinsurance.com/ 

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Medicare Open Enrollment What is it?

12/14/2020

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Medicare Open Enrollment what is it?

Medicare is a super confusing topic for most individuals and Medicare open enrollment does not make things and easier. Most clients and even insurance agents will confuse this enrollment period with when it is, who it’s for and what exactly can be done.
Medicare has a few enrollment periods the most well known is the Annual enrollment period which occurs from October 15th and runs until December 7th, during that time anyone on Medicare can make as many changes as they like to there Medicare advantage plans or prescription drug plans also known as part D. The last change made will go  into effect for January 1st in the new year. Ok so what is the Medicare open enrollment?  The Medicare open enrollment happens from January 1st - March 31st during this enrollment period anyone on a Medicare advantage plan can make one change, this change will go into effect the 1st of the following month the change was made. So what changes can be made? Members of a Medicare advantage plan can change to a new Medicare advantage plan or go back to original Medicare and a drug plan. Members may apply for Medicare supplemental coverage as well depending on the individual's residence medical underwriting may be required.
This is not a well known enrollment period unlike the Medicare annual enrollment period, insurance carriers, brokers and agents are not allowed to advertise and promote changing plans during this time. This is a great opportunity for many people on Medicare who missed out on the annual election period, or did not realize plan changes that were made to their current coverage until after the new year . The Medicare open enrollment period is essentially Medicare trying to give people one last opportunity to improve their coverage situation without all the sales pressure that comes with the annual enrollment period which has really gotten out of control. So if you are on a Medicare advantage plan and have not really examined how well it will fit your current health and budgetary needs for the new year, you really should do yourself a favor and take a look at your current plan and any changes it has made for the new year.  Stay safe, and as always if you have any questions regarding,
Medicare or your coverage please feel free to message me or give me a call directly at 631-358-5793 email medicare@paulbinsurance.com      http://www.paulbinsurance.com/



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