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 and compare your options and choose a plan that fits your doctors, prescriptions, and budget.

What Is Medicare?

Medicare is a federal health insurance program available to individuals who meet certain eligibility requirements, including:

• Individuals age 65 or older who meet Medicare eligibility requirements
• Certain individuals under age 65 with qualifying disabilities
• Individuals with End-Stage Renal Disease (ESRD)
• Individuals with Amyotrophic Lateral Sclerosis (ALS)

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) before we can discuss specific Medicare plan options with you. The SOA documents your permission for us to discuss the Medicare products you select.

The intake form also allows you to provide your prescription medications, preferred pharmacy, doctors, and other healthcare providers. If you provide this information, we can use it to review prescription drug coverage and costs and check which carriers and plan networks your providers participate with.

Please select your agent below to complete the Scope of Appointment and, if desired, provide your prescription and provider information:

• Intake form for Paris Laughlin
• Intake form for Stuart Ouellette
• Intake form for Rachel Laughlin
• Intake 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 36 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 Medicare Intake Form and contact our office to schedule a time to meet.