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 to sign up at SS!

Help individuals in SECT understand MediCare. + Tips to sign up at SS! Help individuals in SECT understand MediCare. + Tips to sign up at SS! Help individuals in SECT understand MediCare. + Tips to sign up at SS!

Call today: — Let's meet to discuss MediCare — Plus how a Medicare Advantage or a Medicare Supplement plan can help you!    

You can increase understanding of the Medicare Advantage and Prescription Drug plans in New London County working with John! He is a Niantic based Medicare Plans Professional & Broker who will share special insights !

(860) 739-0005

Help individuals in SECT understand MediCare. + Tips to sign up at SS!

Help individuals in SECT understand MediCare. + Tips to sign up at SS! Help individuals in SECT understand MediCare. + Tips to sign up at SS! Help individuals in SECT understand MediCare. + Tips to sign up at SS!

Call today: — Let's meet to discuss MediCare — Plus how a Medicare Advantage or a Medicare Supplement plan can help you!    

You can increase understanding of the Medicare Advantage and Prescription Drug plans in New London County working with John! He is a Niantic based Medicare Plans Professional & Broker who will share special insights !

(860) 739-0005

Making — MediCare & Health Plans easy for you!

The common times individuals apply for MediCare: <—> [First] The month turning 65 when "eligible"! <—> [Second] Any time an individual wants — if actively working after 65 and covered by their employer or a spouses's medical plan. <—> Signing up is done through Social Security (SS)!

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

     ● You become "eligible" for coverage the first of the month when 65. If decide to sign up at 65 an application is completed:

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


     ● Individuals over 65, covered by an employer medical plan can apply for: 

       + Medicare's Part B whenever they want, and select a date 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 when to sign up" rule. A person will be automatically enrolled in Parts A & B:     

     ●  First - the month eligible if they applied and were receiving SS benefits for four or more months before 65     

          Note:  An individual receiving SS benefits, who is covered by an employer medical plan, can opt out 

of Part B! Thus, they will not have to contribute to their employer plan plus pay Part B's monthly cost.


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

 

Soon be 65 ? — about to leave an employer plan? — Call John's Google voice - (860) 451-9793 — To meet for a no cost to you talk about steps to sign up. Will share insights on how to cover the part of treatment expenses MediCare does not pay ! !
Steps to sign up for Medicare

● OK — Want to start MediCare at 65? First step — 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: Local SS offices, including New London's in the Shaws Cove complex, are open. They may be closed some days and often want to set up a telephone appointment.  


I suggest asking for a face-to-face appointment. Talking to 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 offers to pay your share of Part B monthly cost? 


What do you have to pay for Part B ? 

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

     (Part B's cost will be $174.70 in 2024) 

 

I heard I might have to pay more for Part B ! 

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

      (Will be 103k or 206k in 2024} 

       Note: The legislation that established charging higher-income individuals more of Part B's overall cost called the extra cost 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 each month to the Base amount! 


* * FYI: You can also sign up for MediCare online using  — This SS page :

       ● Somewhat complicated, so I recommend being careful.  

       ● Not recommended when over 65 and leaving an employer plan! 

         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 ]  to coverage *  *  that starts the first day of their eligible month. It includes:

       ●   Part A — covers inpatient care in a hospital. 

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

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


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


The ID card also shows each individual's unique number called a Medicare Beneficiary Identifier. It's made up of:

       ● 11 upper-case letters and numbers with a format of four characters  —  then three more —  then four more.   

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


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



When an individual reaches 65, they may also start to think about  —  when to begin receiving Social Security benefits. 


This information from SS may be helpful:

      ● Details on when individuals become fully eligible!


      ● Information about the value of waiting past full retirement age to sign up may be helpful. 


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

Many of the Medicare ads on Southeastern CT TV channels have been from what is called  Medicare Marketing organizations, not a specific Medicare Advantage Plan company. People have reported these ads are confusing and they did not trust "free" benefits.


As a Medicare professional I believe some of these ads are  close to being deceptive. MediCare implemented new advertising rules, starting October with the Annual Election Period, that say ads:

● Can not ask , other than during the AEP each Fall, anyone with  Medicare to Call! Why? Only individuals with MedicAid & MediCare can change their coverage during the year! 

       [Times * *  to enroll in a Medicare Health Plans are on a   red ink at the bottom of this section.]


● Are only 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:

+  Many benefits mentioned in ads with celebrity spokesmen   - >  " are not available" to all individuals with MediCare.! 


+ One frequent ad asking individuals with MediCare & MedicAid to call is sponsored by a company that is not available in New London County!


● That mention specific benefits are to include the name of the company offering them. Many ads do not!


Another ongoing TV ad about planning for retirement mentions they also help individuals with Medicare and says -  Buy their Medigap plan! [A Medicare Supplement plan]  But: 

    + This company's plan is not approved in CT! 


Call if you have any questions about these ads! There is much more to a Medicare Advantage plan than the benefits provided! 

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


      * * Individuals can only enroll in a Medicare Advantage (MA) plan or a Prescription Drug Plan (PDP) during times set by CMS. They are 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 confusing words in brochures or on online.

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 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 discuss Medicare Health plan details during a phone call unless the call is recorded. 


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

● OK — you worked past 65, then decided it's time "to slow down" and to sign up for MediCare! SS rules say — individuals covered by their or a spouses employer medical plan can sign up for Part B whenever they want. Leaving an employer plan qualifies an individual for a Special Enrollment Period (SEP) that has a specific time frame and steps to follow to avoid Part B's late enrollment penalty:

● First — Call the Local SS office — ask to talk to a Retirement person. (They may suggest a telephone appointment)  


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 : [Will be $174.70 in 2024]

     ->  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! 

When an application to sign up, submitted through SS, is complete MediCare calls the individual "entitled" [not "enrolled"] They are then covered by ● Part A — for hospitalization ● Part B — for outpatient services.

When signed up and entitled 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 they provide, 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 admitted, not observed, status! MediCare pays for everything "medically necessary" —  Each individual, 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! Just using "original Medicare" and paying 20% for complex outpatient treatment, especially if it's an ongoing, 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!


The pages on the two 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 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! 


Because of the Big uncertainty of a health change 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 an extensive 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 is a Professional MediCare insurance Advisor based in Niantic. He helps individuals in New London County increase understanding of MediCare and Medicare Health Plans.

Working with John means you will be helped by:       

  ● An Advisor to — better understand MediCare's Part A & Part B coverage — how its treatment system works — simplify the two types of Medicare Health Plans — and how they interact with physicians & providers. 


  ● A  Broker to — highlight effective options to fit the individual's situation/budget/interest. When an enrollment period is available — a plan can be selected — and steps taken to enroll.   

 

Meeting face-to-face with a Certified MediCare Insurance Professional, vs. talking to a who knows where they are individual on an 800 #, means < - - > you gain:

● Face-to-face discussions — the most effective way to receive accurate, helpful, and understandable information. 


● Insights about how New London County plans work that are unavailable when talking on an 800 #.  


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


The Center for Medicare and Medicaid Services (CMS) implemented new marketing regulations for Medicare Advantage and Prescription Drug Plans on Oct 1, 2023. They require John when providing any information about Medicare Plans such as on this website, to disclose (inform) to Medicare beneficiaries that:

  ● He is appointed and certified by all eight Medicare Advantage (MA) companies that offer plans in New London County during 2024  —  the only area where he helps individuals. These companies have 33  regular MA plans for John to offer beneficiaries. He usually does not offer special needs plans.  


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

     Note: The other two PDP companies do not offer plans through MediCare insurance professionals. However, John can share insights with clients about all the PDP plans in CT using Medicare.gov. He can not, however, process an enrollment for plans from the two PDP companies!         


  ● They can also find help with plan choices in New London County by contacting:

+  Medicare.gov or

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

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


The new CMS rules also require recording any discussion over the telephone about plan coverage details or enrolling in a Medicare Advantage or Prescription Drug Plan. However, more effective face-to-face conversations do not have to be recorded. 


      Note: CMS regulations also state that information created to describe Medicare Plans, such as the content on this website that does not mention a company name, specific plan benefit details, or plan costs, is considered communication material, not marketing material.

 

Have questions on MediCare or Health Plans:

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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Content on MedicarePlansSECT.com is © 2018 to 2023 by John C Parker, RHU, LTCP - All Rights Reserved.

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