Medicare

If you are age 65 or older or are deemed to have a disability, you may be eligible for the federal government insurance program. Understanding your insurance benefits can be tricky. It costs you nothing to use our service and there is never an obligation. The average insurance agent writes with 3 insurance companies. Our only objective is to help you make an educated decision based on your medical needs. Therefore we offer 8-10 quality companies that offer some of the strongest medicare plans. Each has their own niche in the market. That’s where we come in. Having the knowledge of multiple carriers and all their plan options to assist you.

It costs you $0 to work with me because I am paid by the insurance companies. I represent 8-10 insurance carriers and their many plans. My only objective is to help you make an educated decision based on your medical needs. You’re getting unbiased advice. I am not incentivized by any carrier for you to purchase from one company over another. Each has their own niche in the market. That’s where I come in. Having the knowledge of multiple carriers and all their plan options and assisting you in finding the right fit for your needs.

When you choose to work with Bayside Medicare, we’ll compare your employer benefits or simply educate you on Original Medicare and the different types of supplements—Medigap and Medicare Advantage.

1) Must be US citizen or legal resident living in the United States for at least 5 consecutive years.

2)Must be 65 years old or on Social Security Disability for 24 months or have End-stage Renal (at any age) or ALS known as Lou Gerig’s Disease.

Once Medicare Eligible:

• Automatic enrollment in Parts A and B for those receiving Social Security or Railroad Retirement Income at 65 or for those eligible based on Social Security Disability
• Self-enrollment in Parts A and B if you’re not receiving Social Security Income at your IEP
• This only applies to Original Medicare Parts A and B. Enrollment in a Part D Prescription Drug Plan or MAPD is necessary to avoid Part D penalties starting at your IEP.

Part B Enrollment Effective Dates:

• Accepting automatic enrollment in the 3 months before you reach 65 – coverage starts the 1st day of your birth month.
• Enrolling in Part B during your 65th birth month and the 3 months after — coverage is delayed by 1 to 3 months!

Traditional Medicare—that is, Parts A and B only—does NOT cover:

• deductibles, co-payment requirements when you see a doctor, hospital, RX ( these can be significant)
• monthly premiums for Parts B, C or D
• routine or yearly physical exams
• custodial care (help with bathing, dressing, toileting, and eating) at home or in a nursing home
• dental care and dentures
• deductibles, co-payment requirements when you see a doctor, hospital, RX ( these can be significant)
• hearing aids
• routine foot care and/or orthopedic shoes
• routine eye care and/or glasses
• health care you get while traveling outside of the United States (except under limited circumstances)
• Original Medicare does not have an out-of-pocket limit!

Medicare Penalties

Parts B and D have lifetime penalties when coverage is not taken timely. Contact us to help you navigate this important decision.

Working Past age 65?

Depending on your situation, you may or may not be able to delay Medicare enrollment. Your (IEP) Initial Enrollment Period happens in the month you turn 65 regardless if you are working.

• Employers may require you to enroll in Original Medicare (both Parts A and B)
• You have the option to enroll in Original Medicare Part A only during your IEP, then enroll in Original Part B and/or Part D later during a Special Enrollment Period.

Original Medicare—that is, Parts A and B only—does NOT cover:

• deductibles, co-payment requirements when you see a doctor, hospital, RX ( these can be significant)
• monthly premiums for Parts B, C or D
• routine or yearly physical exams
• custodial care (help with bathing, dressing, toileting, and eating) at home or in a nursing home
• dental care and dentures
• hearing aids
• routine foot care and/or orthopedic shoes
• routine eye care and/or glasses
• health care you get while traveling outside of the United States (except under limited circumstances)
• Original Medicare does not have an out-of-pocket limit!

Option I – Medigap (known as Supplements or Plan F, G)

Policies that are in addition to and pick up where Original Medicare leaves off.

• NO networks — simply any certified Medicare doctor, anywhere
• No medical underwriting up to 6 months after enrolling in Part B
• Monthly premiums vary by county, state
• RX not included. Must obtain RX in a stand-alone Part D Prescription Drug Plan

Option II – Medicare Advantage (known as Part C)

Policies through private insurance companies that include Parts A, B, C, and D.

• HMO, PPO
• Never any underwriting not even ESRD starting 2021
• Low monthly premiums
• Plans with and without Part D (RX)

Are Medicare Advantage plans that include prescription drug coverage and are designed for those with a chronic illness like diabetes, heart disease, coronary artery disease, COPD, and a blood-clotting disorder. You may also qualify based on your income. We will educate and guide you through the State and Federal programs—that’s where we really simply the processes. Once qualified, programs offer full and partial “dual eligibility” from the State-Federal Medicaid program. You may get help paying for Part B, deductibles, copays depending on the level of assistance you are qualified to received.

ICEP – Initial Coverage Enrollment Period

3 months before 65th birth month, 65th birth month, 3 months after (7 months total) IE – January, February, March, April’s birth month, May, June, and July

SEP – Special Election Period

Medicare Advantage or Part D Prescription Drug Plan changes based on special events
(Move, Medicaid, Lose Employer Coverage) All Year

AEP – Annual Election Period

Medicare Advantage and Part D Prescription Drug Plan changes
October 15th through December 7th

OEP – Open Enrollment Period

Only Medicare Advantage plan-to-plan changes or return to Original Medicare with a Part D Prescription Drug Plan
January 1st through March 31st