Medicare

Medicare can feel complicated—but it doesn’t have to be. Whether you’re turning 65 or reviewing your current coverage, we’re here to help you understand your options and choose a plan that fits your doctors, prescriptions, and budget.

What Is Medicare?

Medicare is a federal health insurance program for:

• Individuals age 65 or older
• Certain younger individuals with disabilities
• Individuals diagnosed with End-Stage Renal Disease (ESRD)

The Different Parts of Medicare

Medicare is made up of several parts, each covering different types of care:

• Part A – Hospital coverage (inpatient stays, skilled nursing, hospice, some home health care)
• Part B – Medical coverage (doctor visits, outpatient care, preventive services, medical equipment)
• Part C (Medicare Advantage) – An all-in-one alternative to Original Medicare offered by private insurance companies
• Part D – Prescription drug coverage offered through private insurance companies

Your Coverage Options

Once you’re enrolled in Medicare Parts A and B, there are two main ways to structure your coverage:

Option 1: Medicare Advantage (MAPD)
Medicare Advantage plans combine Part A, Part B, and usually Part D into one plan.

• All-in-one coverage
• Often lower monthly premiums
• May include additional benefits
• Uses provider networks (HMO/PPO)

Option 2: Medicare Supplement (Medigap) + Part D (PDP)
This option pairs Original Medicare with additional coverage.

• Helps cover out-of-pocket costs not paid by Medicare
• Greater flexibility to see providers nationwide
• Requires a separate Prescription Drug Plan (PDP)

Prescription Drug Plans (PDP)
Standalone plans that provide Part D prescription drug coverage when paired with Original Medicare or a Medicare Supplement plan.

Before We Review Plan Options

Medicare requires a completed Scope of Appointment (SOA) form before we can discuss plan-specific details. This form simply gives us permission to review your options with you.

We offer both paper and electronic options. You can complete your form here:

• Scope of Appointment for Paris Laughlin
• Scope of Appointment Form Stuart Ouellette
• Scope of Appointment Form for Rachel Laughlin
• Scope of Appointment Form for Katie Hernandez 

Medicare Costs & IRMAA

Most individuals pay a standard premium for Medicare Part B and Part D. However, higher-income individuals may pay an additional amount called IRMAA (Income-Related Monthly Adjustment Amount).

IRMAA is based on your income from two years prior, as reported on your tax return.

• Medicare Part B and D Rates

How to Prepare for Medicare

We recommend beginning Medicare planning 6 to 12 months in advance of eligibility. Take time to evaluate your needs and preferences. Consider the following questions:

• Will you continue working past age 65?
• Will you begin taking Social Security at age 65?
• Do you plan to travel?
• Do you have ongoing health conditions or expensive prescriptions?
• Do your preferred providers accept the plan you’re considering?
• Do your providers accept Original Medicare?

How to Enroll in Medicare (Parts A & B) 

The typical enrollment process includes:

• Apply for Medicare Parts A & B online through the Social Security Administration website
• Save your enrollment confirmation or confirmation number
• If unable to enroll online, contact Social Security at (800) 772-1213
• Review health plan options with an agent 2–3 months before your Initial Enrollment Period
• Complete your Medicare plan application approximately one month before your effective date
• Pay your first premium to activate coverage
• If receiving Social Security benefits, you may choose to have your Medicare Advantage premium deducted from your Social Security check

After enrolling in Medicare Parts A and B, you can:

• Enroll in a Medicare Advantage Prescription Drug Plan (MAPD), or
• Enroll in a Medicare Supplement (Medigap) plan along with a Prescription Drug Plan (PDP)

We represent a variety of Medicare Advantage, Medicare Supplement, and Prescription Drug plans in Oregon and Southwest Washington. Some plans allow for online enrollment after consultation.

If you’d like help reviewing your options, please complete a Scope of Appointment form and contact our office to schedule a time to meet.

We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.