Fill in the significant coverage gaps in traditional Medicare
The Dealer Benefits Program’s private health insurance exchange gives you access to the top Medicare Supplement (“MediGap”) Insurance and Part D Drug plans, or Medicare Advantage Insurance plans in your area — needed to fill in the significant coverage gaps that exist in traditional Medicare alone.
“Whether its during Medicare’s annual General open enrollment period (October 15 – December 7), your Initial enrollment on becoming eligible for Medicare, or a qualified Special enrollment, you can use our private exchange to review Medicare coverage options to help you make the best choice for your health,” said Al Benson, Dealer Benefits program manager.
“Our licensed and professional staff is available by phone or online to help you address questions about your Medicare coverage. We provide this free and confidential resource through our trusted affiliate eHealth so you can confidently review your health coverage and make the best choice for your health care needs.”
You should have a good understanding of the enrollment periods of Medicare to be sure you get the health coverage you need without unnecessary delays or penalties. This is especially important as more or more people are working well past their 65th birthdays.
Initial Enrollment Period
If you are just becoming age 65 and newly enrolling in Medicare,
You will have a 7-month window to decide to use traditional Medicare along with private supplemental insurance and drug plans to help cover the sizable deductibles and copays for services under traditional Medicare. The 7-month period begins 3 months before your 65th birthday month, your birthday month, and the 3 months following.
The Medicare.gov website provides a useful guide to these Medigap plans. They are standardized plan designs, labeled A through N, and cover some or even almost all of the gaps in what traditional Medicare alone covers.
You must have both Medicare Part A and Part B to sign up for Medicare Supplement or Medicare Advantage plans. We can help you select a Medigap plan with a Part D Prescription Drug plan or a Medicare Advantage plan from a top insurance companies with a combination of coverage and monthly premium that works for you.
Medigap plans allow you to see any physician or health provider who accepts Medicare patients. The range of standardized Medigap plans let you select a level of coverage and cost to fit your health condition and budget.
Medicare Advantage plans, while often having subsidized low or even $0 monthly premiums, still have high co-pays, deductibles and out-of-pocket maximum requirements, as well as limited access to providers in-network. To help cover these higher costs, especially when even short hospital stays happen, consider adding our Hospital Recovery benefit that pays a cash benefit directly to you for each day of a hospitalization, up to $900 per day. See: Supplemental Insurance Benefits – Dealer Benefits Network
Consider that the average length of a hospital stay for adults ages 65 to 84 is 5.2 days at an average cost of $14,500.* Even if you have a Medicare Advantage plan, it’s easy to see how a short hospital stay can quickly add up to big unexpected cost and financial stress when the focus should be on healing.
CAUTION: Medigap is a one-time decision, only available to new Medicare beneficiaries. These Medigap plans are generally not available during the annual fall enrollment if you are already enrolled in a Medicare Advantage plan. If you start out with a Medicare Advantage plan and decide later to move to traditional Medicare, getting a Medigap policy may be extremely difficult or inadvisable. Only four states — CT, MA, ME and NY — require Medigap insurers to accept any applicant regardless of age or health history outside the initial 6-month enrollment window.
General “Open Enrollment” Period
Existing Medicare Advantage insureds
Each fall, Medicare provides a national Open Enrollment for Medicare Advantage plan beneficiaries to review, compare and change their existing coverage effective on January 1 of the upcoming year. The enrollment window for these plans runs October 15 through December 7. If you’re satisfied with what you currently have, you don’t need to do anything. The coverage you have will continue.
If your current Medicare Advantage plan doesn’t meet your healthcare needs or fit your budget, you can make changes. But if you decide to switch plans, you should confirm your preferred doctors are in the new company’s network of providers.
During the annual Open Enrollment, you can:
- Make changes to your plan, including shifting from Original Medicare to a Medicare Advantage Plan or from Medicare Advantage to Original Medicare;
- Switch from one Medicare Advantage Plan to another; and
- Adjust your current Medicare Part D Prescription plans.
Any changes made during Open Enrollment are effective as of January 1.
People Who Initially Waived Medicare
People who missed their initial enrollment for Medicare can sign up for Parts A and/or B during the General Enrollment period that runs from January 1 – March 31. In most cases, however, people who delayed signing up for Part B will be subject to a late enrollment penalty of 10% for each 12-month period they missed after their initial enrollment opportunity. Part D Drug penalties may also be imposed.
Special Enrollment Period
Individuals must meet specific requirements to qualify for a Special enrollment period. Younger disabled people qualify after 24 months on Social Security benefits. Individuals who stayed on COBRA, group or individual health plan and initially waived Medicare to save money may need help with enrollment delays, penalties and costs. Answers can be found in the “Medicare and You” and the “Enrolling in Medicare Part A and B” booklets online at www.medicare.gov and www.socialsecurity.gov
You can compare private plans for yourself online at our national private exchange powered by our technology partner eHealth. You can talk with an eHealth licensed representative in your area help with your questions before enrolling online. To get covered, you will need the Medicare number issued to you by your local Social Security office when you started traditional Medicare Part A and Part B.
Notice on Availability of Plan Options
Our goal is to give you easy access to the top-value health plans insured by highly-rated carriers that we can find.
This program does not offer every Medicare plan and option that may be available in your area. Any information we provide is limited to those plans and options we offer in your area. To get information on all of your options, please contact Medicare.gov or 1-800-MEDICARE.
Each year hundreds of health insurers file thousands of health plans for regulatory approval in the states. This means rates are not negotiable on these plans. But with the help of our technology partner eHealth, we identify and show you the plans and options we believe are the best value in each area through our annual national due diligence process.
*Source: Agency for Healthcare Research and Quality, H-CUP Statistical Brief #246, December 2018.