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Medicare Resources: Medicare Eligibility Information & Enrollment Options

Understanding Medicare is essential whether you are approaching retirement age or navigating the complex world of healthcare options. With various Medicare plan choices and enrollment processes, making informed decisions about medicare coverage can significantly impact your health and financial well-being.


Get help with Medicare Plan 2024 Coverage Options

Choosing the right Medicare coverage is crucial to ensuring comprehensive care coverage. Part A covers hospital stays and skilled nursing, while Part B focuses on medical services and preventive care.

  • Part A: Hospital care, skilled nursing, hospice, and home health care.
  • Part B: Doctors' services, outpatient care, medical supplies, and preventive services.
  • Part C (Medicare Advantage): Combines Parts A, B, and often D with extra benefits.
  • Part D: Prescription drug coverage.

Medigap (Medicare Supplement Insurance) policies, sold by private companies, can help cover costs like copayments, coinsurance, and deductibles that Original Medicare doesn't cover.


Enrollment Periods

Understanding the enrollment timeline is essential to avoid costly penalties for late enrollment in this health insurance program. The initial enrollment period for Medicare typically starts three months before you turn 65 and ends three months after. This period allows you to sign up for Medicare Part A and Part B without incurring penalties.

If you miss the initial enrollment period, you may face penalties for late enrollment if you sign up later. It is crucial to stay informed about Medicare changes that may affect your enrollment eligibility.

The Medicare 2024 enrollment schedule is as follows:

Enrollment PeriodDescriptionStart DateEnd Date
Initial Enrollment Period (IEP)If you're turning 65 in 2024, your IEP begins 3 months before your birthday month and ends 3 months after.March 1, 2024September 30, 2024
General Enrollment Period (GEP)If you didn't sign up for Medicare Part B during your IEP, you can enroll during the GEP.January 1, 2024March 31, 2024
Open Enrollment Period (OEP)During this period, you can join, switch, or drop a Medicare Advantage Plan or a Medicare prescription drug plan.October 15, 2024December 7, 2024
Medicare Advantage Open Enrollment PeriodIf you're enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time.January 1, 2024March 31, 2024

Defining the ABCs of Medicare

Medicare consists of different parts, each serving a specific purpose in providing health coverage. It includes Medicare Part A and Medicare Part B, which offer hospital and medical insurance, respectively. Additionally, Medicare Part D offers prescription drug coverage to help manage medication costs.

Determining your Medicare eligibility is crucial for accessing this federal health insurance program. Involves various factors such as age, disability status, and citizenship. It is crucial to assess your coverage options under Medicare to choose the plan that best fits your healthcare needs.

Medicare Coverage Components:

Medicare Part AHospital insurance, a key component of the U.S Medicare health insurance program.
Medicare Part BMedical insurance
Medicare Part DPrescription drug coverage
Medicare Advantage (Part C)Bundled plans offered by private insurers, combining Parts A, B, and often D

Medicare Eligibility:

Eligibility CriteriaDescription
Age 65 or olderAt this age, you'll need to consider obtaining a Medicare card.
Under 65 with a disabilityYou may qualify for Medicare, a U.S. health insurance program.
Any age with ESRD or ALSQualification for Medicare due to End-Stage Renal Disease or Amyotrophic Lateral Sclerosis.

Medicare Part D - Prescription Drug Plans & Drug Costs

Medicare Part D helps cover prescription drug costs, and if you are eligible, you can save more by using generic drugs and exploring extra help programs.

When choosing a Medicare drug plan, consider the plan's network and formulary to ensure your medications are covered. Medicare.gov helps find the right plan and understand Medicare savings programs.

In 2024, Medicare Part D will have the following changes:

  • $505 deductible and 25% coinsurance up to $4,660 in drug costs.
  • After $4,660, you'll pay no more than 25% for covered drugs until your out-of-pocket spending reaches $7,400 (donut hole).
  • Broader supplemental benefits are available for chronically ill enrollees.
  • After $7,400, you'll pay a small coinsurance or copayment for covered drugs (catastrophic coverage).
  • High-income earners may pay an additional premium (IRMAA), with 2024 thresholds to be announced.

Remember to review your Part D coverage annually during Open Enrollment (October 15 to December 7) to ensure your plan still fits your needs and budget.


Medicare Advantage Plan

Medicare Advantage Plans, offered by private insurers, bundle Original Medicare (Part A and B) with additional benefits like prescription drug coverage, dental, vision, and hearing. In 2024:

  • The maximum out-of-pocket limit for in-network services increases to $8,300.
  • Expanded telehealth benefits continue.
  • Broader supplemental benefits are available for chronically ill enrollees.
  • Plans rated on additional quality measures, including patient experience and access to care.

Open Enrollment Period runs from January 1 to March 31, 2024.

Review your plan options during the Annual Enrollment Period (October 15 to December 7) to ensure your needs and budget are met.

Medicare Advantage Plan Feature

May be good choice if you:can get all the services you need within the networkwant choices outside the care networkwant to see specialists without referralshave qualifying health or financial needs
Has a contracted network of doctors and hospitalsYesYesNoYes
Must choose primary care provider from plan networkYesNoNoYes
Must use doctors and providers within the plan network for covered servicesHMO - Yes, HMO-POS - No, but costs more out-of-networkNo, but costs more out-of-networkNoYes
Referral required to see a specialistVaries by planNoNoYes
May include drug coverageYesYesYesAll include drug coverage

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Special Needs Plans

SNPs are Advantage Plans tailored to meet the needs of individuals with certain health conditions or circumstances. They offer targeted care and benefits to serve their members better.

Types of SNPs: These are specialized Medicare plans designed to meet beneficiaries' unique needs, ensuring they get help tailored to their specific health situations.

  • Chronic Condition SNP (C-SNP): For those with chronic conditions like diabetes, ESRD, HIV/AIDS, chronic heart failure, or dementia.
  • Dual Eligible SNP (D-SNP): For those eligible for both Medicare and Medicaid.
  • Institutional SNP (I-SNP): For those who live in a nursing home or require nursing care at home.

2024 SNP Updates: Changes will take effect for Special Needs Plans, which are part of Medicare's efforts to provide targeted care coverage.

  • D-SNPs must establish enrollee advisory committees to improve health equity.
  • D-SNPs must have a unified grievance and appeals system for Medicare and Medicaid services.
  • C-SNPs and I-SNPs can offer additional supplemental benefits tailored to their target populations.

Enrollment: Individuals must meet the specific requirements of the SNP.

Enrollment periods are the same as other Medicare Advantage Plans.


Supplemental Plans

Also known as "Medigap," these plans are sold by private insurance companies to cover gaps in Original Medicare (Parts A and B). They help pay for out-of-pocket expenses like copayments, coinsurance, and deductibles.

Types of Medigap Plans:

  • Plans A, B, C, D, F, G, K, L, M, and N
  • Each plan offers a different level of coverage
  • Plans C and F are not available to new Medicare beneficiaries who became eligible on or after January 1, 2020

Medicare Changes & Updates

2024 Medicare Changes:

Part A:

  • Deductible: $1,696 per benefit period
  • Coinsurance: $424 per day for days 61-90 and $848 per "lifetime reserve day."

Part B:

  • Deductible: $226 annually
  • Premiums: $164.90 to $560.50 per month, based on income

Part D:

  • Deductible: $505
  • Coverage gap (donut hole) begins after $4,660 in total drug costs
  • Catastrophic coverage begins after $7,400 in out-of-pocket costs

Assessing your coverage options is crucial to choosing the plan that best fits your healthcare needs and budget. Consider factors like out-of-pocket costs, provider networks, and additional benefits when making your decision.

Start Comparing Plans Today!

Fill out the form below to discover your eligibility and explore your options for Medicare Parts A, B, C, and D.

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7800 University Pointe Drive
Fort Myers, Florida 33907

Harly Sushil: (239) 201-4289

Harly Sushil SMS: (239) 265-8713


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7800 University Pointe Drive
Fort Myers, Florida 33907

Harly Sushil: (239) 201-4289

Harly Sushil SMS: (239) 265-8713


We do not offer every plan available in your area. To get information on all of your options, please visit Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day, 7 days a week, or your local State Health Insurance Program (SHIP). Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Harly Sushil is a licensed and certified representative of Medicare Advantage [HMO, PPO, and PFFS] organizations [and stand-alone prescription drug plans]. Each of the organizations they represent has a Medicare contract. Enrollment in any plan depends on contract renewal. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan's contract renewal with Medicare. Medicare Advantage organizations and/or Medicare Part D plan sponsors comply with applicable Federal civil rights laws and do not discriminate based on race, color, national origin, age, disability, or sex. Out-of-network/non-contacted providers are not obligated to treat Plan/Part D Sponsor members except in emergencies. Please call the Plan's customer service number or see your Evidence of Coverage for more information, including cost-sharing that applies to out-of-network services. Certain Plan/Part D Sponsors pharmacy networks may include limited lower-cost, preferred pharmacies in some areas. The lower costs advertised for these pharmacies may not be available at your pharmacy. For up-to-date information about network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call the Plan's customer service number or consult the Plan's online pharmacy directory. Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or are in your Medicare Initial Enrollment Period. The standard Part B premium for 2024 is $174.70. Monthly savings vary, may be subject to processing delays, and may not be immediate. They are not available with all plans. Availability varies by carrier and location.

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