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Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare and Medicaid Services (CMS)
CMS is a federal agency within the US Department of Health and Human Services. CMS runs Medicare, Medicaid, Children's Health Insurance Programs (CHIP), and the federally funded Marketplace.
Insurance Plans
Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare and Medicaid Services (CMS)
Insurance carriers are insurance companies that offer insurance plans in a specific state or specific state and county. Medicare and Marketplace insurance plans are under the format and rules dictated by CMS. Insurance carriers make decisions regarding the premium, copays, coinsurance, formulary, and have a network of providers.
Enrollment Periods
Centers for Medicare and Medicaid Services (CMS)
Enrollment Periods
There are specific times during the year or specific circumstances when someone can enroll into a Medicare or individual health insurance plan. Plan changes can also be done at specific times during the year or due to specific circumstances. Please contact me regarding your situation.
Medicare Insurance and Individual Health Insurance
Medicare Insurance Plans
I work with all three types of Medicare insurance plans: Medicare Advantage Plans, Medicare Supplement Plans and Medicare Prescription Drug Plans.
CMS requires agents/brokers of Medicare Advantage Plans to provide a disclaimer regarding the number of insurance carriers and plans we offer. Medicare Advantage Plans are offered per state and county. Depending on the county, I offer all of the Medicare Advantage Plans or almost all of the Medicare Advantage Plans. I contract with 14 insurance carriers providing 110 plans.
Medicare Advantage Plans
Medicare Advantage Plans are offered per state and county. The plans that are offered by an insurance carrier can change each year. Each individual plan can also change each year.
The insurance plan is required to send out the Annual Notice of Change letter to their members. This letter is sent at the end of September or early October describing the changes to the plan effective January 1st. It is important to review the plans changes every year!
I learn the plans changes as well and I can assist in reviewing your plan as well as check the doctor networks and prescriptions for the new year. We will discuss more and make sure you are on a plan that fits your needs.
Medicare Advantage Plans have a network of providers. The network options are HMO, HMO-POS, or PPO. It is important to check all of your providers (doctors, specialists, facilities) to make sure they are in network.
Most Medicare Advantage Plans include the Prescription Drug Plan. The Prescription Drug Plans are called Part D and Medicare formats how the drug plans work. Some Medicare Advantage Plans do not include drug coverage. It is important to understand which plan you have! It is also important to check your prescriptions to make sure they are included in the Formulary (list of covered drugs) every year.
Medicare Advantage Plans also offer benefits beyond what Medicare covers. Benefits such as dental, vision, hearing, fitness, over the counter, routine chiropractic, and more. Each plan is different so it is important to review your options!
Medicare Supplement Plans
Medicare Supplement Plans are called by letter and formatted by Medicare. The plans are A, B, C, D, F, G, K, L, M, and N. Each plan covers slightly different benefits. Since the plans are standardized by Medicare, they are the same in every state. The insurance carrier that offers a Medicare Supplement Plan may offer additional benefits. We can check the different plan offerings and insurance carriers to find a good fitting plan.
Medicare Prescription Drug Plans
Medicare Prescription Drug Plans are stand alone plans. The Prescription Drug Plans are called Part D and Medicare formats how the drug plans work. These plans are offered per state. It is important to check your prescriptions and pharmacies with the various plans to find a good fitting plan.
Individual Health Insurance
In Oregon, the Marketplace is the platform we use to enroll into an individual health plan. I work with all of the plans offered in the Marketplace throughout Oregon.
Support and Assistance All Year Long
Please contact me with your questions and when you need assistance anytime during the year. I explain costs and benefits, plan options, enrollment periods and rules, and provide enrollment into a Medicare or Marketplace plan. It is important to check your doctors, prescriptions, and pharmacies for coverage and the network.