Doctors’ affiliations with plan networks are subject to change without notice. Your physician might be an in-network provider under your plan now and opt out shortly thereafter, or vice versa. The decision to accept Medicare assignment and join a plan network (becoming in-network) is ultimately at a doctor’s discretion. You’re able to retain all your doctors as long as they are within your plan’s network. At Senior Healthcare Advisors, our commitment to a meticulous and compliant Medicare Advantage enrollment process involves ensuring your preferred doctors are in-network for your chosen plan. We undertake this step not just for quality assurance purposes but also because it’s a mandated component of the Medicare Advantage enrollment procedure.

Many Medicare Advantage plans provide a $0 copay home-delivered meal service after an inpatient hospital or skilled nursing facility stay. These home-delivered meals are freshly prepared and nutritionally balanced and are usually delivered in increments of 3 meals per day for 14 days. Some plans offer less, while some plans offer more. It all depends on the Medicare Advantage plans that are available in your area. Our responsibility at Senior Healthcare Advisors is to assist you in navigating the benefits that are available to you and to help you find a Medicare Advantage plan that fits your needs.

No, It’s mandatory to have both Medicare Parts A and B in active status when you’re approved for a Medicare Advantage plan. To retain your Medicare Advantage plan, you need to continuously maintain Parts A and B. If you ever lose your Part A or Part B coverage, your eligibility for the Medicare Advantage plan ceases, potentially resulting in your disenrollment from the plan.  LEARN MORE

The Low-Income Subsidy, also known as Extra Help, is a program designed to assist Medicare beneficiaries with limited income in covering prescription drug costs. Extra Help aids in paying for premiums, deductibles, or coinsurance related to Medicare prescription drug coverage. Eligibility for this assistance is determined based on an individual’s low-income status.   LEARN MORE 

First and foremost, our team of Senior Healthcare Advisors wishes to extend our heartfelt gratitude for your service. If you or your spouse have retired from military service and are below 65, TRICARE coverage is available to you and your family. Upon reaching 65, eligibility extends to Medicare and TRICARE for Life. Holding TRICARE for Life requires you to also sign up for Medicare Parts A and B. With enrollment in Medicare Parts A and B, you qualify to join a Medicare Advantage plan, granting you access to an array of additional benefits contingent on your residential area. Opting for a Medicare Advantage plan allows your TRICARE for Life to synchronize benefits with your chosen plan. In this arrangement, Medicare takes precedence in settling payments for services covered under Medicare, while TRICARE for Life handles your Medicare deductibles and coinsurance, plus any services covered by TRICARE for Life but not by Medicare. More on TRICARE FOR LIFE 

Call Procedure:

• Confirmation of Medicare Parts A and B Effective Dates:
  • Within the initial 3 minutes, we confirm your effective dates for Medicare Parts A and B to establish your eligibility for a Medicare Advantage plan. Unlike supplements, enrollment in a Medicare Advantage plan necessitates active status in both Parts A and B. This step streamlines our procedure, facilitating a more efficient search for the optimal plan in your vicinity, all while respecting your time.
• Zip Code Verification:
  • Regrettably, the scope and quality of benefits vary across different U.S. regions. Your residential area might offer a diverse range of Medicare Advantage plans, or perhaps very few or none at all. By confirming your zip code early in the call, we maintain time efficiency.
• Conducting a Needs Analysis:
  • This analysis is crucial for understanding the current benefits you possess, lack, and require, including dental, vision, hearing, gym memberships, home-delivered meals, monthly allowances for healthy foods, home health care, over-the-counter spending allowances, transportation services, Medicare Part B givebacks, and more. We meticulously document this to match you with the plan that best addresses your unique requirements, comparing benefit availability in your region.
• Validation of Doctors & Hospitals:
  • This step is essential and mandatory. Senior Healthcare Advisors is committed to compliance, ensuring each enrollment is legitimate. Therefore, we request a list of your healthcare providers in every interaction, verifying their inclusion in a plan’s network before proceeding with enrollment.
• Prescription Drug Verification:
  • Depending on the number of prescriptions you have, this stage might take longer. We will outline the prescription cost-sharing aspects of your Medicare Advantage plan and offer to cross-reference your medications with the plan’s formulary, a comprehensive list of covered drugs. By sharing your prescriptions with our agent, you’ll learn about any applicable cost shares (copays) and the categories your medications belong to.
• Information Verification:
  • Accuracy is critical for your Medicare Advantage enrollment. Any discrepancies or inaccuracies can lead to non-approval by Medicare. Please ensure the information you provide is as accurate as possible to avoid forfeiture of the plan.
• Disclosure Review:
  • Each enrollment involves crucial disclosures that you need to be aware of. If you’re already enrolled in an Advantage plan, much of this may be familiar.
• Addressing Queries:
  • After going through the disclosures, feel free to ask any questions you may have about the process. You will also be asked to confirm whether you agree to the discussed benefits and wish to finalize the enrollment.
• Enrollment Submission for Medicare Approval:
  • We finalize your enrollment with your voice signature, after which it’s forwarded to Medicare for approval. Your enrollment status is now pending Medicare’s review. 

Joining, switching, or dropping your Medicare Advantage plan requires a qualifying enrollment period or a Special Enrollment Period. The three primary enrollment periods are:

1. Initial Enrollment Period (IEP) – Upon first becoming eligible for Medicare, you’re granted a 7-month timeframe to sign up for a Medicare Advantage plan. This period encompasses the 3 months before, the month of, and the 3 months following your Part A and B effective date.
2. Annual Enrollment Period (AEP) – Occurring annually from October 15th to December 7th, this window allows all Medicare beneficiaries to enroll in, exit, or change their Medicare Advantage plan.
3. Medicare Advantage Open Enrollment Period (MA-OEP) – Following the AEP, this interval extends from January 1st to March 31st each year, offering you an additional opportunity to alter your plan if your current Medicare Advantage plan’s benefits don’t meet your satisfaction.

Besides these specified times, numerous Special Enrollment Periods (SEPs) might permit you to modify your plan under certain circumstances. While the roster of these periods is extensive, there’s no need for concern over recalling or comprehending this array of enrollment options. At Senior Healthcare Advisors, our role is to leverage any available avenues to assist you in acquiring the benefits you necessitate.  LEARN MORE