Important Information About Medicare Benefits

Assisting others – the right plan at the right price

Steering through the Medicare maze can be challenging for even seasoned professionals. For many, the confusion of choosing a Medicare benefit package is a next-to-impossible cumbersome chore. That is why millions of Americans miss out on special benefits that can help them pay for health care.

Our team works hard to improve the Medicare benefit choice for each person, even individuals with fixed incomes. We believe we help Medicare beneficiaries better understand their coverage, so they can make informed choices about cost and enjoy all the benefits they are entitled to. We believe we can help our clients live happier, healthier lives.

For Medicare Beneficiaries, timing is everything!

If you are 65 and not yet receiving Social Security or Railroad Retirement Board (RRB) benefits (because you’re still working), you will not get Part A and Part B automatically. Instead, you will need to sign up for them.

Sign up for Part A and/or Part B during the following times:

• Initial Enrollment Period — When a person is first eligible for Medicare during their lifetime, they have a seven (7) month period to sign up. This seven-month period begins three months before the month of their 65th birthday, the month he/she turns 65, and ends the three months after turning 65.
• General Enrollment Period — If a person misses his/her Initial Enrollment Period, he/she can sign up (for Part B) between January 1 through March 31 each year. The coverage will begin July 1 of the same year. These individuals may have to pay a higher premium for late enrollment.

You are also entitled to Medicare benefits.

• Annual Enrollment Period — The Annual Enrollment Period (AEP), is when beneficiaries can change his/her Medicare health or prescription drug coverage. AEP is from October 15 through December 7 each year. Your new coverage will begin January 1 of the following year, as long as the plan you choose gets a completed enrollment request by December 7.

  In most cases, enrollees must stay enrolled for the full calendar year. If a beneficiary makes no change his/her coverage the plan you have chosen will automatically renew.

  Look out for the Annual Notification Change from your health plan to ensure that your plan co-payments or benefits are changing significantly or if premium costs are going up.

• Special Enrollment Period — If a person or his/her spouse (or family member if you are disabled) is currently working and you are covered by a health insurance through an employer or union, you will have a Special Enrollment Period when your coverage ends. Special Enrollment Period also applies for international volunteers, if you move out of your plan’s service territory and for individuals who are re-entering society, are 65 or better and are ending incarceration.

There is a Medicare Advantage Disenrollment Period (MADP), that begins January 1st and goes through February 14th. Disenrollment is an opportunity for beneficiaries to switch from a Medicare Advantage plan and return to Original Medicare. It is not an extra enrollment period nor is it an opportunity for Medicare Advantage Members to switch from one MA Plan to another MA Plan.


The date of a dis-enrollment request will become effective when using the Medicare Advantage Dis-enrollment Period (MADP), on the first of the month following receipt of the dis-enrollment request by CMS. A request made any time in January will be effective February 1, likewise a request made in February (by the 14th) will be effective March 1.

For Example

If your 65th birthday is April 12, your Medicare effective date would be April 1. If your birthday is on the first day of the month, Medicare Part A and Part B will be effective on the first day of the prior month. So then, if your 65th birthday is April 1, your Medicare effective date would be March 1.

If you are under the age of 65 and disabled, you automatically get Part A “after” you get DISABILITY BENEFITS from Social Security or certain benefits from the Railroad Retirement Board (RRB), for more than 24 months. You will get your Medicare card in the mail three months before your 65th birthday or your 25th month of disability.

If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s Disease), you automatically get Part A the month your disability benefits begin.