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How it Works & Your Options

A plan that suits your specific needs

We understand that trying to find a Medicare plan that suits your specific needs can be confusing. That is why when it is time for you to enroll in Medicare, we will take the time to educate you on how Medicare works, your options for getting coverage and how the plan will work with or supplement original Medicare.

There is a lot to learn about Medicare, which is why we are here to help.

We do not offer every plan available in your area. Currently, we represent eight organizations, which offer fifty-six products in your area. Please contact, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Did you know?

Some individuals with disabilities and end stage renal disease also qualify for Medicare?

You don’t have to wait until you retire to enroll in and start using original Medicare?

Besides your Initial Enrollment Period and the Annual Enrollment Period (October 15th – December 7th) there are sometimes Special Enrollment Periods that may apply to you depending on your circumstances, which will allow you to enroll in a Medicare Advantage Plan or Prescription Drug Plan?

Medicare Advantage Plans

Medicare Advantage plans are plans offered by individual insurance carriers to encompass Medicare Parts A, Part B and often Part D. These plans use provider networks, usually have copays, require coinsurance for some services and have a max out of pocket for each calendar year.

Prescription Drug Plans

Medicare Prescription Drug Plans can be purchased as a stand-alone product to complement Medicare Parts A and B, alongside a Medicare Supplement or may be incorporated into a Medicare Advantage Plan. You are not required to share your prescription information with a broker when looking for a plan. However, this will allow the broker to make sure that a PDP plan suits your needs. You can also review the insurance carrier’s prescription drug formulary for information on which drugs will be covered during the plan year.

Medicare Supplement

Medicare supplement (Medigap) insurance can help pay some of the health care costs that original Medicare does not cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medicare supplement insurance policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Medicare Advantage Plans offer another way to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

About Medicare Supplement Coverage

Important Things to Know

  • If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
  • You pay the private insurance carrier a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
  • A Medigap policy covers one person. If you and your spouse both want Medigap coverage, we’ll work with you to setup two separate policies.
  • Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.

As Medicare evolves to meet the needs of today, navigating through the coverage plans has become more complex. Understanding the various parts and supplemental options can help you choose a coverage plan to suit your needs. We’ll help you evaluate your needs so you can make an informed decision. Call (210) 277-7871 or (636) 732-1122 to get a quote.

The Insurance Solution Experts (TiSE) is not connected to the Federal Medicare program. This is a solicitation of insurance.