Medicare Health Plan Advisor in Niantic
Medicare Health Plan Advisor in Niantic
  • Understanding MediCare
  • Applying for MediCare
  • Medicare Advantage Plans
  • Medicare Supplements
  • Professional Background
  • Questions? Send a note!
  • More
    • Understanding MediCare
    • Applying for MediCare
    • Medicare Advantage Plans
    • Medicare Supplements
    • Professional Background
    • Questions? Send a note!
  • Understanding MediCare
  • Applying for MediCare
  • Medicare Advantage Plans
  • Medicare Supplements
  • Professional Background
  • Questions? Send a note!
Medicare-Health-Plan-Advisor-helping-individuals-Southeastern-Connecticuit

Help individuals in SECT understand MediCare. + Tips on signing up at SS!

Help individuals in SECT understand MediCare. + Tips on signing up at SS! Help individuals in SECT understand MediCare. + Tips on signing up at SS! Help individuals in SECT understand MediCare. + Tips on signing up at SS!

Call today — to meet & discuss MediCare!   + Review all you gain buying a Medicare Advantage or Medicare Supplement plan.    

Your understanding of how Medicare Advantage and Prescription Drug plans in New London County work can increase plus you will gain gain special insights working with John. He is a Medicare Plans professional based in Niantic and helps you as an Advisor & as a Broker.

(860) 739-0005

Help individuals in SECT understand MediCare. + Tips on signing up at SS!

Help individuals in SECT understand MediCare. + Tips on signing up at SS! Help individuals in SECT understand MediCare. + Tips on signing up at SS! Help individuals in SECT understand MediCare. + Tips on signing up at SS!

Call today — to meet & discuss MediCare!   + Review all you gain buying a Medicare Advantage or Medicare Supplement plan.    

Your understanding of how Medicare Advantage and Prescription Drug plans in New London County work can increase plus you will gain gain special insights working with John. He is a Medicare Plans professional based in Niantic and helps you as an Advisor & as a Broker.

(860) 739-0005

Helping you — sign up for MediCare & enroll in Health Plan!

Want to sign up for MediCare? Social Security (SS) manages enrollment and there are two common times when individuals apply: <—> [First] The month turning 65, which is when SS & MediCare regulations say an individual becomes eligible! <—> [Second] Anytime an over 65 individual wants - if covered by their or spouse's employer medical plan.

 I call SS's how-to & when-to regulations on signing up — "rules"! They state: 

     ● You become what MediCare calls "eligible" for coverage if you want, the month when you are 65 and can sign up:

      + In the third, second, or month before 65, during the month when 65, or in the three months after.


     ● Individuals over 65 on an employer medical plan can decide when to sign up. They can apply for: 

       + Part A at any time.

       + Part B, on the date they want, by using the Special Enrollment Period (SEP) rules for leaving an employer medical plan.

   [This page has info on the steps to sign up !]  


There are two exceptions to the "you decide at 65 when to sign up" rule. A person will be automatically enrolled in Parts A & B:     

     ●  First - the month become eligible if had signed up for SS benefits and began to receive them four or more months before 65     

          Note:  When covered by an employer medical benefits plan and then start to receive SS benefits, individuals can opt out of Part B! Thus, they will not have to contribute to the employer plan plus pay Part B's monthly cost.


     ● Second - when under 65 and qualified for SS disability, individuals become "eligible" when they have received benefits for 24 months and thus enrolled!

 

Will you soon be — turning 65 ? — leaving an employer plan? — Call John's Google voice - (860) 451-9793 — We can have a no cost to you meeting to talk about the steps to sign up. I will also share insights on how to cover the part of treatment expenses MediCare does not pay! !
Steps to sign up for Medicare

● OK — The first step, when you decide to start MediCare at 65, is to call the Local New London Social Security (SS) office * — (866) 643-3401 — Suggest calling two months before 65!

 Talking to the Local SS office * * is usually better! Surveys report some individuals received incorrect information when calling SS's main 800 number! 

 

Tell the Local office you want to talk to a Retirement person! 

     Note: New London's SS office is not currently scheduling in-person appointments but will set a time for a telephone appointment.


A back-and-forth conversation with a local SS Retirement person about signing up at 65 has many advantages. Ask about: 

      ●  Completing your application for Part B and activating Part A.  


      ● The options SS has to pay your share of Part B monthly cost? 


Background on paying your share of Part B costs: 

     ● The base monthly cost for Part B is $164.90 in 2023. This amount is 25% of MediCare Part B's overall costs across the US divided by the number of individuals covered by Part B. 

 

     ● The $164.90 will, however, be higher if the AGI on a Single filer's IRS 1040 from two years ago was above 97k or 194k for a Joint. 

       Note: The regulations, that established charging higher income individuals more of Part B's overall cost, call it an "income-related monthly adjustment amount." Page two on this link shows the five income-based levels above the 97k base for 2023. Each level adds an additional amount to $164.90 each month!


* * FYI: You can sign up for MediCare using this SS online option.  — This SS page; is:

       ● Somewhat complicated, so I recommend being careful.  

       ● Not recommended when leaving an employer plan after 65! 

         Call John [ Google voice (860) 451-9793]  if any questions. 


A key point: When an individual's application is complete, MediCare calls them "entitled" [not enrolled ]  Their coverage * will start the first day of their eligible month and include:

       ●   Part A — covers inpatient care in a hospital. 

       ●   Part B —  covers the many kinds of outpatient services.

       Note: * Medicare only covers treatment or services they deem medically necessary. 


When approved for Part A & B, individuals are mailed an ID card with Entitled above the date their Part A & B medical coverage started! 


The card also has what is called a Medicare Beneficiary Identifier. It's a unique number for each individual with:

       ● 11 upper-case letters & numbers.  There are four characters  —  then three more —  then four more.   

       ● To avoid confusion between certain numbers and letters such as "0" and "O," the MBI does not use letters S,  L,  O,  I,  B, and  Z.


The ID card format is explained, and there is a picture of the card on this page. 



When people reach 65, they may start to think about  —   when to begin receiving Social Security benefits. This link has details on when individuals become fully eligible!


Social Security has additional information about the value of waiting to sign up on this page, which may be helpful. 


Misleading — Buy a Medicare Health Plan — TV ads continue to run on Local TV.

Most Medicare ads on Southeastern CT TV channels are from a Medicare Marketing organization. A specific Medicare Health Plan company does not sponsor them. However, based on MediCare's advertising rules, I believe many of these ads are close to being deceptive. Why?  


Marketing rules say MediCare ads:

● Can not, but do, ask individuals with  Medicare to Call! Why? Only individuals with MedicAid & MediCare can change their coverage during the year! 

       [See  * *  at the bottom ]


● Are to ask individuals turning 65 or leaving an employer medical plan to call. Most ads do not!


● Are only to mention benefits available to all Individuals in the area with MediCare. However, most benefits mentioned, such as in ads with celebrity spokesmen   - >  " are not available" to all individuals with MediCare.! 


● Are to include the name of the company offering the benefits mentioned. Most ads do not!


Another ongoing TV ad on planning for retirement mentions the company also helps individuals with Medicare and says -  Buy their Medigap plan! 

    [It's a Medicare Supplement plan]  But: 

    + Their plan is not approved in CT! 


Call if you have any questions about these ads! 

   Note: A call means you are committing to talk, not to enroll.


      * * The only times individuals can enroll in a Medicare Advantage (MA) plan or a Prescription Drug Plan (PDP) are set by CMS and highlighted on this red link  —  enrollment periods.


In the months before turning 65, Individuals receive lots of Medicare Health Plan brochures: ● Call John's Google Voice # (860) 451-9793 today —>>> To meet, discuss the words in brochures or on online, which are confusing.

A survey found ― 55% of people report being confused about MediCare!


Another survey of individuals over 65 found:

    - > 29% do not understand Medicare Advantage Plans

    - > 23% do not understand Medicare Supplements 

    - > Only 48% said enrollment was easy. 


Tip:  Call John C Parker's  [Google Voice #] at (860) 451-9793 — If you have questions about how:  

   ● MediCare works & interacts with a Medicare Health Plan 

   ● The when to and how to sign up!      

         Note: Calling John is just a commitment to talk ― not to enroll! 


   Note:  Meeting and talking in person is more effective and avoids the.Medicare marketing regulations do not talk about Medicare Health plan details during a phone call unless the call is recorded. 


Medicare-sign-up-after-65-answers-assistance

● OK — you worked after 65, then decided its time "to slow down" and sign up for MediCare! SS rules say — an individual covered by their or spouse's employer's medical plan can qualify for a Special Enrollment Period. (SEP) The SEP has steps to follow and a specific time frame to apply to avoid Part B's late enrollment penalty:

● First — Call the Local SS office — ask to talk to a Retirement person. Only telephone appointments are being used. When talking tell them the date you will be leaving employer coverage and thus want to:

    + Start Part B. 

        -> FYI. Signing up for Part B also activates Part A but it will be backdated six months from your Part B date.


    + Understand your options to pay your share of Part B's monthly cost which is $164.90 in 2023 :

     ->  it's deducted from SS when receiving benefits.


The steps to avoid Part B's late enrollment penalty are:  

● Bring your employer the CMS-L564 form to complete. It confirms you had employer medical coverage.  

      -> The CMS-L564 can be found on this link.   

     ->  The application for Part B, CMS-40B can also be found on this link. 


● Return the CMS-L564 to SS when it's signed. Submitting this form:

     ->  approves your SEP to sign-up for Part B.

     ->  shows you have medical coverage and thus will avoid B's late enrollment penalty 

 

BTW — If someone was not actively on a employer medical coverage they can't just sign up for Part B whenever they want! <—> Federal regulations limit sign up times when past 65 to these periods.   

OK! When the application, submitted through SS, is complete MediCare calls an individual "entitled" and then covered under ● Part A — for hospitalization ● Part B — for outpatient services.

Let's look at: 

● What you would pay if treatment or services were received just using Part A & Part B 

         [Called original Medicare]  


● How the Medicare system works:

    - > MDs or other outpatient providers are not paid what might be called their "office rate" for the treatment or service provided, nor are they paid 100% of the amount MediCare approved for the specific treatment!  


 - > All medical treatments and services are reviewed to determine if they are medically necessary. Then, an amount is "assigned" ** for each. 


   - >  MDs and other outpatient providers who signed up to participate agreed to accept just 80% of the approved amount. This is called the — accept "assignment."

       **  Discounted, often directly from retail! 


 - > When a Medicare beneficiary has  —  any:

         + Outpatient treatment or service: They will be charged by MediCare's claim, paying the contractor 20% of the approved amount for all the treatment they receive!   

     - > At the beginning of each year, Individuals also pay Part B' deductible — $226 in 2023. 


          Note: A large and growing amount of medical treatments and services are provided outpatient — so paying 20% could quickly be a Big Risk to your income & savings! 


       + Hospital-based treatment   — Part A's coverage is extensive when an individual is in an admitted, not observation status! MediCare pays for everything "medically necessary" —  Each person, however, is responsible for paying Part A's deductible each time admitted. It's $1,600 in 2023.


Call (860) 451-9793 to talk to John - - Calling means you would like to meet to talk! You are not committing to select and enroll in a plan!

OK! Paying 20% for complex outpatient treatment, especially if it's an ongoing situation would be very expensive! — How TO COVER this Big Risk?

Buying either of the unique insurance plans, to pay medical-related treatment/services, called — Medicare Health Plans, is like —  putting an umbrella up over your income & savings! 

    Note: Buying what may be best called a "financial protection from medical expenses" plan means — providers bill the plan, and you will not receive a rainstorm of bills from them for your 20% share!


These red links take you to information developed to describe how each type of plan works with the MediCare system and thus protects your finances:

● Medicare Advantage Plan in New London, CT or a  

● Medicare Supplement in CT 


Each plan has options for different levels of coverage to meet an individual's situation/interest/budget.

 

Medicare-Health-Plans-control-treatment-expenses-give-peace-mind

OK — many people say I'm fine and work to stay healthy! Thus, wonder — do I really need a "Medicare Health Plan"?

It would be nice if someone could say a change of health will not happen in the future —  BUT in every life we know: 

    ● No one can say an accident won't happen!

 

    ● We also know the possibility of an illness, with complex and ongoing treatment, is high! 


Thus, if only using original MediCare (A & B), you would have to pay 20% for a lot of outpatient treatment   = high costs!   


Because the uncertainty of a health change is BIG and the Big Costs that could come — it's very important —  to buy   —  either a:  

        ->  Medicare Advantage (MA) Plan approved for New London County 

        ->  Medicare Supplement approved in Connecticut 


Owning either means this special kind of financial protection plan: 

+ +  will provide protection from significant expenses 

+ +  puts you in control 

+ + provides peace of mind, knowing you are protected! Bottom line: Owning is priceless! 

     Note: A Medicare Health Plan can only be changed once a year, but a "Med. Supp." can be changed anytime! 


Whether you'll soon be 65  — or are over 65 and have decided to leave your or a spouse's employer plan, call/text John C Parker's Google Voice today at (860) 451-9793) 


Meeting in person is most effective! We can: 

    ● Review your situation/interest/budget! 

    ● Increase understanding of how the plans in our area work with MediCare and discuss which type will be the most effective for you! 

          Note: Whatever time you need will be available.

             - > I am told this is a big Help!

    BTW: It's also OK to say  — now is not the right time!     


   ● Avoid MediCare's requirement that any discussion about benefits or enrollment details over the phone has to be recorded. 


Then, after thinking about what will be best for your situation and an enrollment period is available, we can meet to sign up!


You can also send questions about signing up for a Medicare Advantage Plan or a Medicare Supplement: 

    ● Using the form below or

    ● To   — John@MedicarePlansSECT.com  


John C Parker, a Professional MediCare insurance Advisor, focuses on helping individuals in New London County increase understanding of MediCare and Medicare Health Plans. He is based in Niantic.

When working with John:       

  ● You gain his help as an Advisor —  discussing MediCare Part A & Part B coverage, how it's treatment system works, simplifies the two types of Medicare Health Plans that work with MediCare's system, and how plans interact with physicians & providers. 


  ● You gain his help as a  Broker —  when an enrollment period is available, the most effective plan for their situation/budget/interest, is selected and steps are taken to enroll.   

 

What you gain by  < - - > meeting face-to-face with < - - >  working with < - - >  a Certified MediCare Insurance Professional based in Niantic:

● Personal discussion — the most effective way to receive accurate, helpful, and understandable information. 


● Insights unavailable when talking to a, who knows where they are, individual on an 800 #.  


● Not having to have your discussion on coverage and enrolling in a Medicare Advantage or Prescription Drug Plan recorded. 


John is licensed in CT (# 2276378 ) and does not solicit or sell in other states.


The Center for Medicare and Medicaid Services (CMS) created regulations for marketing Medicare Advantage and Prescription Drug plans that include a requirement for John to disclosure (inform) to Medicare beneficiaries :


  ● He is appointed and certified by the seven Medicare Advantage (MA) companies offering plans in New London County in 2023, the only area where he helps individuals. They have 30 regular MA plans, not special needs plans, available to beneficiaries.  


 ● He is also appointed and certified by six of nine Prescription Drug Plan (PDP) companies with plans available in CT and New London County. 

     Note: The other three companies do not make their plans available through MediCare insurance professionals. John can, however, using Medicare.gov, share insights with clients on the 24 plans available from all nine companies. He can not however process an enrollment for plans from the three PDP companies!         


  ● Help with the plan choices in New London County is also available by contacting:

+  Medicare.gov and 

+ CT's State Health Insurance Program (SHIP). 

       < - - >  However, this help will not be from a licensed or certified professional.


    Note: The CMS regulations state information published or created about Medicare, such as the content on this website, that does not state a company name, or benefit details, or costs is considered Communications.

 

Questions about MediCare or Health Plans?

Questions such as: < - - > how to sign up for MediCare < - - > how a Medicare Health plan works. Sending the form means you consent to meet John just to talk, not enroll! < - - > John is an independent professional Medicare plan broker, not connected with nor endorsed by the U.S. government or the federal Medicare program. < - - > He created MedicarePlansSECT.com to help individuals in New London County better understand Medicare and how the Medicare Health Plans work with MediCare's system. < - - > If individuals in Southeastern CT find this information useful they are encouraged (solicited) to contact John to meet, talk, and hopefully enroll.

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Medicare Health Plan Advisor in Niantic

38 Hope St, Unit 1312, Niantic, CT 06357-2454, US

(860) 739-0005

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  • Understanding MediCare
  • Applying for MediCare
  • Medicare Advantage Plans
  • Medicare Supplements
  • Professional Background
  • Questions? Send a note!