• 918-841-2694
  • Info@yourchoicehealthplans.com
  • 125 W Blue Starr Dr.

Claremore, OK 74017

Medicare Made Simple

Are you getting ready to turn 65? Newly eligible for Medicare? Are you already a Medicare beneficiary but are looking to change your plan? Are you trying to navigate the Medicare space? Confused by your options and the decisions you need to make?

Call to speak with a licensed agent

Call us today!
918-841-2694

TTW 711

or

No obligation to enroll

We are Shane and Tammy Carpenter

We are licensed health and life insurance agents here in Oklahoma. Our goal is to simplify the Medicare enrollment process for our neighbors here in Oklahoma and help out in any way we can.

We have made every endeavor to simplify the realm that is Medicare to make this process stress free. Take a moment to check out our FAQ. While you are at it, download a turning 65 checklist so you can tackle the steps easily. It is our hope to assist you to understand your options and make the right choice for your personal situation. When we say “make the right choice for your personal situation” we mean it! No two situations are the same. However, understanding the system, what your choices are and how they impact you is the foundation of making the right decision. So let’s get started.

Frequently Asked Questions

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What is Medicare?

Medicare is made available to US citizens and others that may qualify based on certain medical conditions, disability or age. It consists of Medicare Part A (inpatient coverage) and Part B (outpatient coverage) and is provided by the federal government. This is considered “Original Medicare.” Part A is premium free if you have worked 40 plus quarters. With Medicare Part B, the premium is currently (2023) $164.90 a month if your income doesn’t exceed $97,000 as an individual or $194,000 married over the past two years. If it exceeds these limits, the monthly premium will be higher.

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Can I be penalized for not enrolling in Medicare Part B?

Yes, if you want to join later after your initial qualifying event, and did not have qualifying insurance, Medicare will increase the amount that you will have to pay for your monthly premium indefinitely. This penalty will continue to increase over time making it increasingly difficult to enroll in, as it may become unaffordable.

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Does Original Medicare cover all of my health needs?

No, Medicare leaves limitless gaps in coverage when there are any medical treatments or testing, whether inpatient or outpatient. For example, if you only have Medicare Part A, without additional coverage, you will have to pay $1600 for each hospital stay before Medicare will begin to pay. This resets every 60 days. This is only one of six gaps in Original Medicare.

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How can I ensure that I don’t have excessive medical bills after enrolling in Medicare?

There are several ways that this can be approached. The first approach is to stay with Original Medicare and enroll in a Medigap/Supplement plan with or without Part D Prescription Drug Coverage (PDC). These plans have a monthly premium in addition to your Part B monthly premium. You can enroll in a Medigap/Supplement plan without medical underwriting once you initially become eligible for Medicare. These plans come in a variety of packages. They are, however, standardized and the most basic ones will cover your Part A and Part B gaps. Supplement plans allow you to go to any provider that accepts Medicare across the United States. On the other hand, others choose to enroll in a Part C plan. Part C plans are not original Medicare, and cannot be used in combination with a Medigap and standalone PDP plan. They are also known as Medicare Advantage plans. You must be enrolled in Medicare Part A and B and pay your part B premium continuously to qualify for a Medicare Advantage plan. Medicare Advantage plans are essentially managed care and you will be in a network. In this case, the federal government provides funding to insurance companies to manage the care of Medicare recipients. These plans generally have co-pays and a maximum out-of-pocket. However, they often have low or zero dollar premiums and include extra benefits like dental, vision and hearing.

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How do I know if a Supplement or a Medicare Advantage plan is right for me?

While there may be a lot of opinions out there on this, the truth is that each situation is unique. It’s important to evaluate all of the aspects of your personal circumstances to determine which system is right for you. Speaking to an expert is a great resource, and does not incur any cost to you. They can help you to enroll and continue to assist you with the transition into your plan.

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When can I enroll in Medicare?

You can enroll in Medicare during a seven month window surrounding the month that you will turn 65. This period includes the 3 months before, your birth month, and the three months after your birth month. This is not black-and-white though. In fact, there are other factors such as: Will you continue to work after turning 65? Will you have qualifying healthcare coverage from another source? Are you entitled to benefits from other healthcare systems?

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What if I am already enrolled in a Medigap or Medicare Advantage plan? Can I change my plan?

While supplement plans can be enrolled in year-round, Medicare Advantage plans must be enrolled in during enrollment periods. The Annual Enrollment Period (AEP) for Medicare Advantage plans is between October 15 and December 7 each year. You can enroll in, switch or return to Original Medicare during this time. There are several other Special Enrollment Periods (SEP) throughout the year that allow you to make changes as well. Some of these might include moving, qualifying for “Extra Help” or Medicaid and other circumstances as well. You can always ask your Medicare agent if you qualify for any special enrollment periods.

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What is a Scope of Appointment? Do I have to sign one?

With the new regulations surrounding Medicare, you will be hearing more about signing a Scope of Appointment (SOA). So just what is a SOA? It is essentially a form that allows an agent to talk to you about the available plans for you and the details surrounding them. Without the SOA, an agent may not be able to discuss these points with you. It never means that you are signing up for a plan. It also explains that you, the beneficiary, incurs no charges for using an agent. The insurance company that has contracted with the agent will pay the agent a commission and this does not change your premiums or costs. In addition, depending on those circumstances, an agent and beneficiary may need to wait 2 days to set up an enrollment appoint after signing a SOA. Not to worry, your agent will know when it is necessary to follow these guidelines. In the end, these new rules are for your benefit. If you have additional questions, we are happy to answer them for you.

Contact us

We have endeavored to simplify these answers and have not covered everything in these frequently asked questions. However, we would be happy to answer your questions. Plans and options are unique by state and even zip codes. Be sure to reach out to us and we can help walk you through what plans are available here in Oklahoma including the Tulsa metro and surrounding areas such as Owasso, Jenks, Broken Arrow, Muskogee and more. Reach out now!

Call to speak with a licensed agent

Call us today! 918-841-2694

TTY 711