Medicare

Time to start thinking about Medicare?

Going on Medicare can be a stressful time in your life, but it doesn’t have to be.
Between receiving mounds of mail and receiving calls from insurance companies, enrolling in a Medicare plan can feel overwhelming. The experts at 5 Star Insurance Group, LLC assists you every step of the way by providing education as well as options.

What is Medicare?

Medicare is a Federal Health Insurance Program.
To be eligible for Medicare parts A & B you must be a US Citizen or Legal Resident and/or:

  • Age 65 or older
  • Be disabled for 24 months or more
  • Have End Stage Renal Disease or ALS

Patti-Jo Toellner explaining Medicare on WBAY’s “Ask the Expert” Show.

The Parts of Medicare

Part A includes inpatient hospitalizations, skilled nursing, home health care and hospice care. For many people there is no cost to Part A.

Part B covers Medical expenses including; doctor visits, lab work, x-rays, outpatient services, etc. The premium for Part B in 2018 is $134/month. If your income is greater than $85,000 as an individual or $170,000 as a couple your premium will be more than the standard premium.

If you do not enroll into Part B when you are first eligible, you may be assessed a Late Enrollment Penalty unless you have creditable coverage. Employer group coverage is an example of creditable coverage.

Part C, also known as Medicare Advantage plans, are offered through independent insurance companies. These plans cover Part A & Part B benefits, and may include coverage for Prescription Drugs. A Medicare Advantage plan offers extras such as; fitness memberships, dental & vision, and hearing aids.

To be eligible for a Medicare Advantage Plan you must:

  • Be enrolled in Original Medicare Part A & B
  • Reside in the plan’s service area
  • Cannot be diagnosed with End Stage Renal Disease.

Part D is Prescription Drug Coverage offered through independent insurance companies. Part D Prescription Drug plans differ between insurance companies and are required to be the same or better than Medicare Guidelines.

If you don’t enroll into a Part D Prescription Drug Plan or have another creditable drug coverage when first eligible, you may have a late enrollment penalty. Forms of other creditable drug coverage include: Wisconsin Senior Care, Employer or Union plans, Low Income Subsidy, or VA.

When can you Enroll?

The Medicare Annual Enrollment Period begins on October 15th and continues through December 7th for an effective date of January 1st of the following year.

There are also a number of Special Election Periods which will allow you to enroll in a plan outside of the Annual Enrollment Period such as; loss of coverage, residential move, or low income.

Medicare Supplement

Medicare Supplements also called “Medigap” plans are offered by independent insurance companies and cover the costs that Original Medicare does not. Medicare pays first with the Medicare Supplement paying secondary. You may go to any doctor that takes Medicare and there are no prior authorizations.

In Wisconsin, Medicare Supplements do not cover prescription drugs.  A Part D Prescription Drug Plan may be necessary unless you have creditable drug coverage.

Lastly, you can enroll in a Medicare Supplement plan at any time; depending on when you enroll will determine if you will need to complete medical questions.

With over 60 years of experience, putting together a personal insurance package is our specialty.  Let 5 Star Insurance Group, LLC take care of what we know best…Insurance.

Medicare Annual Enrollment Period

October 15th to December 7th

ACA/Individual Annual Enrollment Period

November 1st to December 15th

CUSTOMER TESTIMONIAL

Just wanted to let you know that I received my Network Health Medicare Advantage Card. I’ve written the coverage termination letter to Arise, and will mail it on Monday. Thank you for all of your help in making this transition so easy, and in a way that makes me feel confident that I’ve made the right choice; especially in choosing you as my health insurance advisor.

Susan Marjenka