Medicare Benefits

Are You New To Medicare?

When it comes to Medicare, knowledge is power, and we are here to help you get started the right way so you can continue enjoying your best life. We invite you to begin your medicare journey by registering for our Medicare 101 webinar.

on Medicare Wanting to Switch plans?

Sorting through the details to choose the right plan can feel confusing and stressful, but we are here to help. Simply complete an information request form and we will reach out to you directly.

Information Request Form

Medicare Enrollment periods

Initial Enrollment Period (IEP)

This is your very first chance to sign up for Medicare.
It lasts 7 months: the 3 months before your 65th birthday, your birthday month, and the 3 months after.
There are penalty fees for late enrollment.

Annual Enrollment Period (AEP)

Runs every year from October 15 to December 7.
During this time, you can:
- Switch from Original Medicare to a Medicare Advantage plan.
- Switch from Medicare Advantage back to Original Medicare.
- Join, drop, or change a Part D prescription drug plan.
Any changes take effect January 1 of the following year.

Medicare Advantage Open Enrollment Period (OEP)

Runs January 1 to March 31 each year.
If you already have a Medicare Advantage plan, you can:
- Switch to a different Medicare Advantage plan.
- Drop your Advantage plan and return to Original Medicare (with the option to add Part D).
You cannot switch from Original Medicare into Advantage during this period.

Special Enrollment Periods (SEPs)

Certain life events allow you to make changes outside the standard windows. Examples include:
- Moving out of your plan’s service area.
- Losing employer or union coverage.
- Qualifying for Medicaid or Extra Help.
The timing and rules depend on your specific situation.

Frequently Asked Questions

Please reach us at info@spbbusinesssolutions.com if you cannot find an answer to your question.

Q: WHAT IS MEDICARE?

A: Medicare is a federal health insurance program designed for people age 65 and older that have worked a minimum of 10 years, and individuals of any age with disabilities. Medicare helps to cover costs such as hospital stays, doctor visits, and prescription drugs.

Q: WHEN SHOULD I APPLY?

A: You should enroll during your Initial Enrollment Period (IEP) 3-months before the month you turn 65, the month you turn 65, or the 3-months after. If you delay enrollment without having qualifying employer coverage or other creditable coverage, you could incur late enrollment penalties for Part B and/or Part D and potentially face gaps in coverage. If you have employer group health coverage through either you or a spouse and meet certain conditions, you may delay enrollment in Part B (and Part D) without penalty.

Q: WHAT ARE THE FOUR PARTS OF MEDICARE?

Part A – Hospital Insurance: Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care.
Part B – Medical Insurance: Covers doctor visits, outpatient care, preventive services, and durable medical equipment.
Part C – Medicare Advantage: Private plans that bundle Part A and Part B, often with Part D and extra benefits.
Part D – Prescription Drug Coverage: Helps pay for prescription medications through private plans approved by Medicare.

Q: WHAT IS MEDICARE ORIGINAL, ADVANTAGE, & MEDIGAP?

A: Original Medicare is the traditional federal Medicare program run by the U.S. government. It includes:

Part A (Hospital Insurance) – covers inpatient hospital stays, skilled nursing facility care (under certain conditions), hospice, and some home health care.
Part B (Medical Insurance) – covers outpatient services such as doctor visits, preventive care, lab tests, imaging, durable medical equipment, and more.

A: Medicare Advantage is an all-in-one alternative to Original Medicare offered by private insurance companies approved by Medicare.

These plans must cover everything Original Medicare covers, and many offer extra benefits. Medicare Advantage plans often include:

Part A + Part B
Part D (prescription drug coverage)
Extra benefits such as dental, vision, hearing, transportation, fitness programs, and over-the-counter allowances

A: Medicare Supplement, also known as Medigap, is private insurance you can buy to work with Original Medicare only (NOT Medicare Advantage).

Medigap helps pay for costs that Original Medicare doesn’t fully cover, such as:

Part A and Part B deductibles
Copayments
Coinsurance
Emergency coverage during foreign travel (in some plans)

Q: WHAT IS MEDI-MEDI?

Medi-Medi is an informal term used to describe people who qualify for both Medicare and Medicaid at the same time. The official term is “dual eligible.”

To qualify for Medi-Medi, you must be eligible for Medicare (due to age or disability), and meet their state's income and asset requirements for medicaid.

Dual-eligible individuals may get:

Help paying Medicare premiums (Part A and/or Part B)
Help paying deductibles, copays, and coinsurance
Low or $0 Part D prescription drug costs
Access to Dual Eligible Special Needs Plans (D-SNPs), a type of Medicare Advantage plan designed specifically for people with both Medicare and Medicaid

Q: HOW CAN I ENROLLMENT?

A: As Licensed Senior Benefits Consultants, we help you navigate your options, not only during your initial enrollment or when switching plans, but also with year round support. We make sure that your primary doctor and specialists are in-network and enroll you in plans with perks such as otc allowance and more... We also stay in contact with you to make sure your coverage continues to meet your needs and that you feel confident every step of the way.