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Request An Affordable Care Act Quote!
Call today for quotes on health insurance for
Medicare beneficiaries
or any other type of health or life insurance!

Medicare Overview

Background on Medicare

Medicare is a federal health insurance program that pays for a variety of health care expenses. It's administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS). Medicare beneficiaries are typically citizens or legal residents age 65 and older. Those with certain medical conditions (such as Lou Gehrig's disease, end stage renal disease, or qualifying permanent disabilities) may also be eligible for Medicare benefits.

Like Social Security, Medicare is an entitlement program. Most citizens and legal residents earn the right to enroll in Medicare by working and paying their taxes for a minimum required period. Even if you didn't work long enough to be entitled to Medicare benefits, you may still be eligible to enroll, but you might have to pay more.

There are four different parts to the Medicare program. Parts A and B are often referred to as "Original" Medicare or "Fee for Service" Medicare. Both Medicare Part C (Medicare Advantage) and separate Medicare drug coverage (Part D) plans are offered through Medicare-approved private insurance carriers that must follow rules set by Medicare. Medicare Advantage plans can include Part D drug coverage, and, if so, they are referred to as Medicare Advantage Prescription Drug Plans.

You can learn more about Medicare at www.medicare.gov, which is the official site of CMS. Medicare & You 2025 is the official government handbook with information about Medicare. This handbook is mailed to all Medicare households each fall. It includes a summary of Medicare benefits, rights, and protections and answers to frequently asked questions about Medicare. The copy mailed to you contains an abbreviated list of available health and drug plans in your geographic area.

What You Need to Decide

Your biggest decision, and the one to make first, is whether you want Original Medicare (Part A and Part B) or Medicare Advantage (Part C). They cover the same basic services, but they work differently. Most Medicare Advantage Plans bundle together Part A, Part B and Part D (prescription drug coverage). And most Medicare Advantage Plans offer some extra benefits and lower out-of-pocket costs than Original Medicare. Your choice depends on what you need.

Once you decide, you'll have other choices to make:

If you choose Medicare Advantage, you'll have to pick a particular plan and decide whether or not you want a plan that includes coverage for outpatient drugs:

BUT

If you choose Original Medicare, you have more choices to make:

  • You can elect to stay in Part A and B ("Original" Medicare) only.
  • You can choose to supplement Original Medicare (Parts A and B) with a Medicare Supplement (also called "Medigap") plan. Medicare Supplements are standardized in all states except MA, MN, and WI. There are 10 basic standardized plans as well as the Hi Deductible F and HI Deductible G variations. Beginning January 1, 2020, if your birthdate is January 1, 1955 or later and you have not previously become eligible for Part A through disability, you won't be able to buy Medicare Supplement plans that offer no deductibles (i.e., Plan C or F). Plan Hi Deductible F won’t be available, as well. Depending on your state, zip code, and carrier, one or more of the standardized plans may be available in a Medicare Select version.

You'll also need to decide whether you want Medicare drug coverage (Part D) to cover your outpatient medications.

The following chart outlines your choices. You can obtain additional information by looking at the Medicare Supplement Plans, Medicare Advantage Plans, and Medicare Drug Coverage (Part D) pages.

 

medicare-choices

Schedule For 2024
Affordable Care Act Enrollment

Affordable Care Act open enrollment for 2024 plans began November 1, 2023 and ended January 16, 2024 on the Federal Facilitated Marketplace (https://www.healthcare.gov).

You’re eligible to enroll ONLY if you have a Qualifying Life Event.
There are no pre-existing condition limitations.

Call Us At 786-970-0740 (Cell)
to determine what kind of plan you may be eligible for.


2025 Annual Enrollment Period For Medicare Beneficiaries

Marketing for 2025 Medicare Advantage, Medicare Advantage Prescription Drug, and separate Medicare drug coverage (Part D) began October 1, 2024. Medicare beneficiaries can enroll in or change plans for 2025 by enrolling during the Annual Enrollment Period between October 15 and December 7 for a January 1, 2025 effective date. Individuals who want to keep their present plans, if they are available for 2025, do not need to submit enrollment applications. Individuals with terminating plans have until February 28 to enroll in a new plan but should enroll by December 31 to have a January 1, 2025 effective date. Except for individuals wishing to enroll in a Chronic Special Needs Plan, there are no health questions to qualify.

Medicare beneficiaries can enroll in a Medicare Supplement plan within 6 months of their Part A and B effective dates without answering health questions. Generally, individuals with Medicare Supplement plans can change plans at any time but in many cases will need to answer health questions to qualify. Individuals who have Medicare Advantage plans can enroll in Medicare Supplement plans during the Annual Enrollment Period but in most cases will have to answer health questions. There are special rules for individuals with “trial rights” or eligibility for guaranteed issue policies that don’t require answering health questions.

Call us at 561-734-3884 or 877-734-3884 (TTY: 711) for details.

family consulting

We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

We offer individual group health insurance plans

as an alternative to individual and family Affordable Care Act plans to those who can’t qualify
and/or who are looking for less expensive alternatives.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare-eligibles. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare-eligibles section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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561-734-3884 or 877-734-3884
(TTY 711)