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What To Know Before You Turn 65

Posted on by United Integrity

About to Turn 65 in Pennsylvania or New Jersey?

Start Planning Now — Missing Medicare Deadlines Can Cost You Money for Life

Medicare enrollment has strict deadlines and missing them can result in permanent penalties that follow you for life. United Integrity Group, Inc. has helped more than 30,000 clients across Pennsylvania and New Jersey navigate the Medicare enrollment process over the past 20 years. Here is everything you need to know before your 65th birthday.

WHEN SHOULD I SIGN UP FOR MEDICARE IF I AM TURNING 65?

Your Initial Enrollment Period begins three months before the month you turn 65 and ends three months after, giving you a seven-month window to enroll. This is your single most important Medicare deadline.

During this window you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance). Once enrolled in Original Medicare, you can also explore Medicare Supplement (Medigap) plans to cover the costs Original Medicare does not pay.

In Pennsylvania and New Jersey, your Medicare Supplement enrollment rights during this period are especially strong. You cannot be denied coverage based on your age or health history during your Initial Enrollment Period. That protection disappears once your window closes, which is why timing matters so much.

Our licensed Medicare experts at United Integrity Group, Inc. recommend scheduling a consultation at least 90 days before your 65th birthday so you have time to compare plans, understand your options, and enroll with confidence.

WHAT HAPPENS IF I MISS MY MEDICARE ENROLLMENT DEADLINE?

Missing your Initial Enrollment Period can result in a permanent late enrollment penalty on your Part B premium of 10% for every 12-month period you were eligible but did not enroll. That penalty stays with you for as long as you have Medicare, adding up to hundreds or thousands of dollars over time.

There are exceptions. If you or your spouse is still actively working and you have creditable employer coverage with no gaps, you may qualify for a Special Enrollment Period that allows you to delay Medicare without penalty. The key word is creditable. Not all employer plans qualify, and the rules are specific.

If you have already missed a deadline or are unsure whether your current coverage qualifies, United Integrity Group, Inc. can review your situation and help you understand your options across Pennsylvania and New Jersey. Our licensed Medicare experts have over 20 years of experience navigating enrollment exceptions and late enrollment situations.

DOES IT MAKE SENSE FOR ME TO SIGN UP FOR MEDICARE AT 65?

Not always, and the answer depends on your specific situation. Here are the key questions to consider:

Are you or your spouse still working and covered by an employer health plan? If that plan is considered creditable coverage under Medicare rules, you may be able to delay enrollment without penalty.

Is your employer coverage truly better than what Medicare plus a Supplement plan would provide? Many people assume their employer plan is the better deal without ever comparing the two side by side. In many cases a Medicare Supplement plan delivers equal or better coverage at a lower total cost.

How long do you plan to keep working? If retirement is within one to two years, starting the Medicare planning process now puts you ahead of the deadline and gives you the most options.

United Integrity Group, Inc. can walk you through this comparison with a simple phone call. With over 20 years of experience guiding clients through this exact decision across Pennsylvania and New Jersey, our team knows how to find the answer that fits your life and your budget.

CAN I CHANGE MY MEDICARE PLAN AFTER I ENROLL?

Yes, in most cases. You can switch Medicare Advantage plans or change your Part D prescription drug plan during the Annual Enrollment Period, which runs October 15 through December 7 each year. Changes take effect January 1 of the following year.

Switching from Medicare Advantage back to Original Medicare with a Supplement plan is also possible but may require medical underwriting in most states. Pennsylvania and New Jersey both have stronger consumer protections than most other states in this area, which can make switching easier for residents of both states.

United Integrity Group, Inc. reviews every client’s coverage annually before the Annual Enrollment Period at no additional cost. If there is a better plan available for your situation, we will find it and let you know.

WHAT IS THE MEDICARE ANNUAL ENROLLMENT PERIOD AND WHEN IS IT?

The Medicare Annual Enrollment Period (AEP) runs every year from October 15 through December 7. During this window Medicare beneficiaries can switch Medicare Advantage plans, change their Part D prescription drug plan, or move between Original Medicare and Medicare Advantage. All changes made during AEP take effect January 1 of the following year.

This is also the time of year when United Integrity Group, Inc. proactively contacts every client to review their current coverage and compare all available options in Pennsylvania and New Jersey. If your plan has changed or a better option exists, we will find it for you at no additional cost. You never have to wonder if you are still on the best plan available.

DO I NEED A MEDICARE SUPPLEMENT PLAN IF I HAVE A RETIREE HEALTH PLAN FROM MY FORMER EMPLOYER?

It depends on what your retiree plan covers and what it costs. This is one of the most common questions our licensed Medicare experts hear from clients approaching 65 in Pennsylvania and New Jersey.

Some employer retiree plans provide strong coverage that coordinates well with Medicare and may be worth keeping. Others have high premiums, shrinking benefits, or provider networks that become more restrictive over time.

Before assuming your retiree plan is the better choice, it is worth doing a side by side comparison against Medicare Supplement options. In many cases clients are surprised to find that a Medicare Supplement plan provides equal or better coverage at a lower total monthly cost.

United Integrity Group, Inc. can review your retiree plan details and provide a full no-cost comparison. Our licensed Medicare experts have guided thousands of clients through this exact decision across Pennsylvania and New Jersey over the past 20 years.

READY TO START PLANNING FOR MEDICARE IN PENNSYLVANIA OR NEW JERSEY?

United Integrity Group, Inc. is an industry-leading independent Medicare brokerage serving clients throughout Pennsylvania and New Jersey for over 20 years, with more than 30,000 clients served by our team of licensed Medicare experts. We work for you, not the insurance companies.

Our consultations are available by phone, video, or in person at our Quakertown, Pennsylvania office. There is no pressure and no obligation. Call us today at (215) 536-4455 or visit Medicare.gov to learn more about Medicare eligibility and enrollment.

United Integrity Group, Inc. is not affiliated with, endorsed by, or connected to the federal government, the Centers for Medicare and Medicaid Services (CMS), or the Medicare program. We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

What is Medicare Supplement Insurance?

Posted on by United Integrity

WHAT IS MEDICARE SUPPLEMENT INSURANCE?

Medicare Supplement insurance, also known as Medigap, offers plans meant to cover the costs Medicare does not.

Consequently, it covers a wide array of payments:

  • Deductibles
  • Copayments
  • Coinsurance
  • International care

Medicare Supplement plans are offered by private insurance companies, and the benefits of the standardized plans are always the same. The only differences that occur are in the required premiums, as rates differ from insurance company to insurance company. Some states may have additional regulations concerning coverage.

Prices vary by location, age, sex and possibly current health conditions except for those turning 65, going on Medicare Part B for the first time, losing credible coverage, or qualifying for Medicare disability.

HOW DOES IT WORK?

Medicare pays for most medically necessary expenses. The remaining 20% is sent to Medicare who then forwards to your Medicare Supplement insurance company.

Like other insurance plans, Medicare Supplement plan policyholders must pay a monthly premium to receive services. This premium is paid in addition to premiums for Medicare Part B. (Most individuals do not pay for Medicare Part A, as it has previously been paid in payroll taxes during their working career.)

WHO SHOULD CONSIDER A MEDICARE SUPPLEMENT PLAN

To be eligible for a Medicare Supplement plan, individuals must meet the following criteria:

  • An individual must be at least 65 years old, unless on Medicare Disability or has ESRD
  • The applicant must have Medicare Part A and Part B.

ADVANTAGES

Medicare Supplement plans offer several benefits.

LESS PAPERWORK

Your Medicare Supplement plan sets up an automatic crossover with Medicare, so you do not have to file any claim paperwork. Your doctor simply sends the entire bill to Medicare, and Medicare forwards the remaining portion to your Medicare Supplement insurance company.

FREEDOM TO CHOOSE HOSPITALS AND DOCTORS

Insured individuals can go to any facility that accepts Original Medicare. Instead of being forced to pick from a list an insurance company provides, you’ll have more flexibility to choose the hospitals and doctors of your choice.

TRAVEL

If you travel between states or internationally, Original Medicare may not cover you in the event you would need care away from home. However, Medicare Supplement plans do provide additional coverage. As a result, vacations or business trips can be enjoyed fully.

COST

Medicare Supplement plans provide peace of mind knowing that most of your expenses will be paid by Medicare and the insurance company.

GUARANTEED RENEWABLE

Your Medicare Supplement plan cannot be canceled for any reason unless you do not pay premiums on time. Regardless of health or newly diagnosed conditions, your policy is guaranteed renewable.

PEACE OF MIND

If you’re retired or have low income, you have the freedom to choose your own hospitals and doctors without referrals and with limited out of pocket expenses.

Call today to speak with a licensed representative to find a plan to fit your financial goals and needs.

Medicare Supplement vs. Medicare Advantage

Posted on by United Integrity

WHICH IS THE BETTER OPTION?

Are you trying to choose between a Medicare Supplement plan and Medicare Advantage plan? Here’s a side-by-side comparison so you can make the right choice when it comes to your insurance plan.

Around 44 million people, or 15 percent of the population of the United States, rely on Medicare. This government-run program, which has been operating since 1966, provides medical coverage for those 65 and older, in addition to individuals with disabilities.

The program helps seniors (and those on disability) pay for their medical needs. As the population ages, their need for healthcare increases. Without full-time jobs that provide full coverage, they need a program they can rely on.

While Medicare is a fantastic program, it doesn’t cover everything. Medicare Supplement plans and Medicare Advantage plans both exist to help you ensure that you have all accrued medical expenses paid.

There are pros and cons to Medicare Supplement plans and Medicare Advantage plans. The main difference between health plans include the associated costs, freedom to choose doctors and hospitals, specialist referrals versus no referrals, copays and deductibles. Contact us to answer your questions and determine which coverage is right for you, your health, and your lifestyle.

You have options, and they can be confusing. It is important to know which the best option for you is. Read on for more information.

WHAT DOES A MEDICARE SUPPLEMENT PLAN COVER?

The out-of-pocket costs of a Medicare Supplement plan are typically lower in the long run because they offer more flexibility, more stability, and more coverage than most other plans.

A Medicare Supplement plan has no networks – that means that you can continue to see your own doctors and use your own hospitals of choice. A medical provider can not turn you away based on your Medicare Supplement insurer as long as they accept Original Medicare. Medicare Supplement plans offer low to no copays and low to no deductibles, thus you don’t have to come up with a large sum of money if you were to become sick or injured. Medicare Supplement plans give you the freedom to choose between 30 different drug plans (depending on your state), which makes it more likely that you can get the particular prescriptions you need at a price you can afford. Call today to find out which drug plan will save you the most money based on your current medications.

You have the ability to sign up for a Medicare Supplement plan 6 months before you turn 65 and 6 months after. You cannot be denied due to health or age. To discuss your options, call today to find the ideal plan for you.

WHAT DOES A MEDICARE ADVANTAGE PLAN COVER?

Many people don’t realize that a Medicare Advantage plan is not Original Medicare–by choosing a Medicare Advantage plan, you are opting out of Original Medicare and purchasing a private plan. The main draw for a Medicare Advantage plan is that it may save you some money in the short term because they typically offer lower monthly premiums than a Medicare Supplement plan, but they tend to cost more in the long run due to many more out-of-pocket costs. Our licensed representatives can help you determine what those costs might be and which plans are most appropriate for you.

A Medicare Advantage plan has networks, which means you may only see doctors that are covered under their plan, and you may have to find new doctors and hospitals when you sign up. Medicare Advantage plans also typically carry copays and deductibles that must be paid for out-of-pocket. Medicare Advantage plans often offer drug coverage but may not cover the particular medications that you take. The costs for a Medicare Advantage plan can go up as high as $6,700 maximum out-of-pocket but could be higher if you get treatment or services outside of your network. It’s important to call to determine what type of drug coverage will suit you best.

It’s important to know if you choose a Medicare Advantage plan and become sick, you may not easily switch to a Medicare Supplement or Medigap plan. At this point, you will have forfeited your Initial Election Period and must now go through the medical underwriting process. During medical underwriting, your age, health history and pre-existing conditions will be taken into consideration for your eligibility. Your illness or injury will now be considered a pre-existing condition, and your new carrier may deny coverage.

Under a Medicare Advantage plan, your copays, in-network doctors, and drug coverage can change from year to year, so it’s important to review the terms of your plan often. Medicare Advantage plans are typically catered to those with lower income, even though they can have higher costs in the long run.

WHICH PLAN SHOULD I CHOOSE?

Deciding whether to go with a Medicare Supplement plan or Medicare Advantage plan isn’t something you should do on your own. As experts in the industry, our licensed agents are able to help educate and assist in making the best decision for your specific needs.

Contact us for more information and assistance in finding the right insurance plan during your golden years.

United Insurance

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.