Navigating Medicare can be like solving a complex puzzle, with numerous pieces that must fit together just right. Whether you are already enrolled in Medicare and looking to make coverage changes or exploring your choices for the first time, the process may feel overwhelming. Knowing all your options enables you to make informed decisions, helping you manage your health and finances well into the future.
From identifying the critical windows of opportunity to choosing the right Medicare Supplement and Part D plans, our trusted TMA Insurance Trust advisors will work tirelessly to help you fit all the pieces of your Medicare puzzle together, ensuring your experience is as smooth and stress-free as possible.
The Importance of Supplementing Original Medicare
While Original Medicare provides a foundation of coverage, it often falls short of covering all medical expenses. Typically, it covers up to 80% of medical costs, leaving you responsible for the remaining 20%. Additionally, Original Medicare does not include prescription drug coverage. Many physicians opt for Medicare Supplement (Medigap) and Medicare Part D Prescription Drug plans to bridge these gaps.
Critical Enrollment Periods
Missing your initial enrollment deadline can lead to lifelong penalties and increased costs. Enrolling in the right plan at the correct time can secure optimal coverage and avoid unnecessary expenses. Timely initial enrollment allows you to use the guaranteed acceptance period for Medicare Supplement (Medigap) and Part D Prescription Drug plans. After this period, you may need to undergo medical underwriting, which can result in higher premiums or even denial of coverage based on your health status.
Below are key Medicare dates to keep in mind:
- January 1: The date all prescription plans (Medicare Part D) begin their annual calendar.
- January 1 - March 31: Medicare Open Enrollment Period (MOP) (not to be confused with Annual Enrollment). This period allows you to cancel a Medicare Advantage Plan and switch to Original Medicare. You can also add a Part D prescription plan during this time.
- October 1: If you are enrolled in a Medicare plan, your plan will send you a "Plan Annual Notice of Change" (ANOC) detailing any changes in coverage or costs effective in January.
- October 15 - December 7: Medicare Annual Enrollment Period (AEP). During this period, you can review your Original Medicare plan coverage and make changes to get better coverage or save money. This period is significant for those considering switching from Medicare Advantage to Original Medicare and/or from one Part D Prescription Drug plan to another.
- December 1: If your Medicare plan has high deductibles, it’s an excellent time to schedule any medical care you need before the end of the year, and a new year’s deductible threshold needs to be met.
- Your 65th Birthday: The seven-month window around your 65th birthday (three months before, your birthday month, and three months after) is your initial enrollment period for Medicare. This window is the best time to enroll in a Medicare Supplement plan (also known as a Medigap plan) and a Part D Prescription Drug plan because your acceptance is guaranteed. Once this enrollment period expires, you must apply and be approved for a Medicare Supplement plan. However, once enrolled in Original Medicare, you can apply for a Medicare Supplement plan at any time during the year.
How TMA Insurance Trust Advisors Assist You
For physicians already enrolled in Medicare but considering changes to their coverage, as well as those exploring Medicare choices for the first time, our knowledgeable advisors at TMA Insurance Trust provide invaluable support throughout the Medicare enrollment process. To help you avoid common pitfalls such as missed deadlines (which can lead to penalties), increased costs, and gaps in coverage, our advisors ensure you understand and adhere to all necessary timelines.
They assist you in comparing different plans, checking which plans cover your prescription drugs, and determining the costs involved. Additionally, our advisors stay updated on the latest Medicare changes, providing ongoing support to help you adjust your coverage as needed. This personalized service is free of cost, affirming our unwavering commitment to your well-being at every career stage. The same caring guidance available early in your career will continue into retirement.
Secure Your Medicare Coverage with Confidence
With TMA Insurance Trust by your side, you can confidently make informed decisions about your Medicare needs. Contact us at 800-880-8181, Monday through Friday, 8:00 AM to 5:00 PM CST. Whether you need assistance enrolling or making changes for better coverage, we are here to help with a no-cost, no-obligation consultation to ensure you have the best possible Medicare plan available.
For over 65 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of the highest-rated plans in the industry.
