Medicare Gals: Turning 65 and Annual Election Period

www.MedicareGals.com

ABOUT THE MEDICARE GALS

Mary DornVP of Agent Support

•Originally from Ohio, moved to Texas in 1990.•Insurance Agent, licensed in many states.•Has been helping our community since 2008.•Has been with Trusted Senior Specialists since 2002.•Is a Grandmother of 4, 3 girls and 1 boy.

Sondra FordCompliance Officer

•Native Houstonian.•Has been in the Insurance Industry since 2007.•Field agent with Trusted Senior Specialists since 2009.•Experienced in call center and now compliance.•Has a 2-week University child, and one that just turned 2.

ABOUT TRUSTED SENIOR SPECIALISTS

We began in Texas over 13 years ago and are now in 40-plus states across the country.

As members of the Better Business Bureau, we have an A+ rating and have been honored

as a Winner of Distinction at the 2011, 2012, 2013 Awards for Excellence.

For the past decade, we have established a name and reputation based on reliable service,

honesty, integrity and have built an Insurance Marketing Organization of over

3,000 agents in 42 states.

We are dedicated to assisting families, groups and individuals with their different insurance

needs such as: Life Insurance, Health Insurance, Final Expense, Long Term Care and Cancer.

We specialize in Medicare Supplements and Medicare Advantage Plans.

www.TrustedSeniorSpecialists.comwww.MedicareGals.com

TOPICS FOR TODAY

1. Enrollment Periods: Parts A and B2. Enrollment Periods Part C3. Enrollment Periods Part D4. Penalties5. Assistance Programs (State and Federal)6. Questions7. Presentation Review

ENROLLMENT PERIODS:PARTS A AND B

Initial Enrollment Period is a 7 month period allowing you to join Medicare when you first become eligible. Your initial enrollment period will begin 3 months before your 65th birthday, your birth month, and the three months following your 65th birthday.

General Enrollment Period: If you didn’t sign up for Part A and/or Part B (for which you must pay premiums) when you were first eligible, you can sign up between January 1–March 31 each year. Your coverage will begin July 1 of that year. You may have to pay a higher Part A and/or Part B premium for late enrollment.

ENROLLMENT PERIODS:PARTS A AND B

Special Enrollment Period: For those who delay enrolling into Part B because they have an Employer Group Health Plan (GHP)

In this scenario, you can enroll in Part B anytime before your employer coverage ends. Your SEP will also extend to an 8 month period beginning the 1st day of the 1st month your employment or group health plan coverage ends.

ENROLLMENT PERIODS:PARTS A AND B

NOTE: This is the time for you to decide how you will receive your benefits. You will have several choices:

A. Medicare Part A OnlyB. Original Medicare Parts A and BC.Original Medicare Parts A and B with a Medicare

Supplement and Part D planD.Parts A and DE. Part C

YOUR MEDICARE CARD

ENROLLMENT PERIODS:PART C

• Initial Enrollment Period (IEP):• Annual Election Period (AEP): Every year between October

15th and December 7th

• Special Election Period (SEP): You have to qualify for these enrollment periods. There are many different situations which may occur making you eligible for an SEP.

A. You qualify for both Medicare and MedicaidB. Your current plan terminates or leaves the area C. You are misled and as a result enroll in a plan not

suited to youD. You have a chronic condition that qualifies you for a

Special Needs Plan (SNP)

ENROLLMENT PERIODS:PART D

• Initial Election Period (IEP)• Annual Election Period (AEP): Every year between October

15th and December 7th

• Special Election Periods (SEP)

NOTE: You will notice that Part D enrollment periods mirror those of Part C

PENALTIES(PARTS A,B, AND D)

1. Part A: If you are not eligible for premium free Part A and do not buy it when you are fist eligible your premium may go up 10%. You will have to pay the higher premium for twice the number of years that you could have had Part A.

Example: If you are eligible for Part A for 2 years before enrolling, you will have to pay the higher premium for 4 years.

PENALTIES(PARTS A,B, AND D)

2. Part B: If you do not sign up for Part B when first eligible your late enrollment penalty will be 10% for each 12 month period that you could have had Part B. This penalty will last for as long as you have Medicare.

Example: Your IEP ended September 30, 2009 and you wait until General Enrollment 2012, your Part B penalty will be 20%. ( This is because you waited 2 full 12 month periods)

PENALTIES(PARTS A,B, AND D)

3. Part D: If you did not sign up for Part D during your IEP a penalty will be added to your Medicare Part D premium. This penalty equals 1% per month of the National average premium for a Part D plan.

Example: The National base premium for 2014 is $32.42. The penalty for 2014 will therefore be .32 cents for each month you delayed enrollment beginning when your IEP ended. You will pay this penalty for as long as you have Medicare.

ASSISTANCE PROGRAM(FEDERAL)

Low Income Subsidy (aka Extra Help) is a Federal program administered by the Social Security Administration. This program provides assistance in paying the Part D premium and lowering prescription drug costs. To qualify you must:

A.Be entitled to Part A or enrolled in Part BB.Reside in one of the 50 States or The District of ColumbiaC.Have an annual income of less than 150% of the Federal Poverty Level. This is based on household size.D.Have resources that fall within the established limits.E.File a low income subsidy application or be deemed eligible.

ASSISTANCE PROGRAM(FEDERAL)

NOTE: LIS will not only lower the cost of your prescriptions and pay your Part D premium, it will also protect you from falling into the doughnut hole. If you have a Part D penalty you will not pay this penalty for as long as you qualify and continue to receive this assistance.

ASSISTANCE PROGRAM(STATE)

• Medicare Saving Programs (MSP) are jointly funded through State and Federal funds. These programs are based on much lower means and resources than LIS.

• MSP’s will help pay part or all of your Part B premium AND lower your co-insurance when visiting a hospital, doctor or specialist. Another advantage is that it may help further reduce your prescription drug costs.

NOTE: When you apply for LIS and Social Security believes you may qualify for a MSP, they will forward your information to the state. When you have QMB or SLMB, LIS is paying for your prescriptions.

ASSISTANCE PROGRAM(STATE)

NOTE: When you apply for LIS and Social Security believes you may qualify for a MSP, they will forward your information to the state. When you have QMB or SLMB, LIS is paying for your prescriptions.

You must apply for these programs through your local State Health and Human Service office. This can be done in person or online. The process generally takes 45 days and will include a telephone interview regarding the information submitted on the application.

REVIEW

Review

Q&APLEASE ASK QUESTIONS

DO YOU NEED HELP?

If you’d like to speak with a specialist one on one, please call us at:

(281) 879-7711Monday – Friday

9:00 a.m. to 7:00 p.m.

On behalf of Trusted Senior Specialists and The Medicare Gals, we would like to thank you for joining us today.

We look forward to our next presentation in this series and hope you will join us once again.

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