Medicare

Medicare Advantage (MAPD), Medicare Supplement (Medigap), and Prescription Drug Plans (PDP)

There are several types of Medicare health insurance plans, including:

• Medicare Advantage Prescription Drug Plans (MAPD)

• Medicare Supplement (Medigap) Plans

• Medicare Prescription Drug Plans (PDP)

Before an agent can discuss Medicare Advantage or Prescription Drug Plan details, Medicare requires completion of a Scope of Appointment (SOA) form. This form gives the agent permission to review plan options with you. The Scope of Appointment must be signed before plan-specific details are discussed. We offer both paper and electronic Scope of Appointment forms. Please complete and return the signed form for your agent, and we will contact you with detailed information about available Medicare Advantage Prescription Drug Plans.

• 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 

What Is Medicare?

Medicare is the federal health insurance program for:

• Eligible people age 65 or older

• Certain younger individuals with disabilities

• Individuals with End-Stage Renal Disease (ESRD)

Medicare Publications

• Medicare & You: The official U.S. Government Medicare Handbook
• Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare – Centers For Medicare & Medicaid Services
• Your Guide to Who Pays First: Centers For Medicare & Medicaid Services Medicare & Other Health Benefits

The Different Parts of Medicare

Medicare is divided into different parts that help cover specific services:

• Part A – Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care

• Part B – Covers certain doctors’ services, outpatient care, medical supplies, and preventive services

• Part C (Medicare Advantage) – Combines Parts A and B, and often Part D. Offered by private insurance companies as an “all-in-one” alternative to Original Medicare

• Part D – Adds prescription drug coverage to Original Medicare and certain other Medicare plan types. Offered by private insurance companies

Medicare Rates & IRMAA (Income-Related Monthly Adjustment Amount)

Most beneficiaries pay the standard premium for Medicare Parts B and D. If your modified adjusted gross income exceeds certain thresholds, you may pay an Income-Related Monthly Adjustment Amount (IRMAA).
Medicare determines IRMAA using the modified adjusted gross income reported on your IRS tax return from two years prior.

• Medicare Part B Rates
• Medicare Part D Rates

What Medicare Plans Are Available?

Original Medicare covers medically necessary services and supplies, such as doctor visits, lab tests, and durable medical equipment.

Additional coverage options include:

Medicare Advantage (Part C)

• Also known as Part C, Medicare Advantage replaces Original Medicare and typically includes Part A, Part B, and often Part D coverage in one bundled plan. We offer Medicare Advantage plans in Oregon and Southwest Washington from a variety of carriers.

Medicare Supplement Insurance (Medigap)

• Medigap policies are purchased from private insurance companies to help pay out-of-pocket costs not covered by Original Medicare. You must be enrolled in Medicare Part A and Part B to purchase a Medigap policy. We offer multiple Medigap plan options in Oregon and Southwest Washington.

Medicare Prescription Drug Plans (PDP)

• Prescription Drug Plans provide Part D coverage and may be paired with Original Medicare or certain Medicare plan types. Medicare requires a completed Scope of Appointment form before discussing PDP options.

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?

Setting Up 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

Selecting and Enrolling in Your Medicare Plan

Once enrolled in Medicare Parts A and B, and after deciding whether to begin Social Security benefits, you may:

• Enroll in a Medicare Advantage Prescription Drug Plan (MAPD), or

• Enroll in a Medicare Supplement (Medigap) plan and a separate Prescription Drug Plan (PDP)

We represent numerous leading Medicare Advantage, Medicare Supplement, and Medicare Prescription Drug plans in Oregon and Southwest Washington. Some plans allow online enrollment after consultation with an agent.

If you would like assistance reviewing your Medicare options, please complete a Scope of Appointment form and call our office to schedule an appointment.

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.