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MEDICARE PLAN REVIEW FOR 2025

by | Nov 1, 2024 | Articles

As you may know, we are well into the Medicare Annual Enrollment Period (AEP).  This year it is very important for you to review your current Prescription Drug Plan or your Medicare Advantage Plan.  This time frame is when you can change plans for the upcoming year.  The formularies have changed a bit as well as the monthly premiums.  

Please send me your list of prescription medications so that I may process a review for you. Send to hilgerman.insurancesolutions@gmail.com.

 

Perhaps you’re finding that your current plan doesn’t cover all the medications you need, or maybe you’re simply looking for better pricing. Whatever your reason, a review of your Medicare drug plan doesn’t have to be a daunting task. At Hilgerman Insurance Solutions, we understand the importance of finding the right coverage for your healthcare needs. You can sit back and relax while we do the work for you.

You can make changes to your Medicare Part D (prescription drug) plan during specific periods:

  1. Annual Election Period (AEP): This period runs from October 15 to December 7 each year. During the AEP, you can change your drug plan or Medicare Advantage plan from one Medicare health plan to another. Any changes made during this period will take effect on January 1 of the following year.
  1. Special Enrollment Periods (SEPs): These are available based on specific circumstances, such as moving out of your plan’s service area, losing other drug coverage, or living in an institution like a nursing home. The availability and timing of an SEP depend on your particular situation.

This year it is extremely important due to the many changes that are taking place for 2025.  It’s a good idea to review your Medicare Part D coverage annually, especially during the AEP, to see if another plan could offer better coverage or lower costs based on your prescription drug needs. 

 

Assess Your Current Plan

We’ll take some time to review your current Medicare drug plan and make note of the medications you’re currently taking, the costs associated with your plan, and any limitations or restrictions.

 

Compare Plans

Once we receive your list of prescription medications and the Scope of Appointment, it’s time to explore your options. Hilgerman Insurance Solutions will compare different Medicare drug plans available in your area that cover your medications at a reasonable cost and offer the benefits you need.

 

Consider Your Budget

When switching your Medicare drug plan, it’s important to consider your budget. We can find plans that offer competitive premiums, deductibles, and copayments. Keep in mind that a lower premium may not always equate to the best overall value, so be sure to weigh the costs against the coverage offered.

 

Enroll in Your New Plan

Once we’ve found a Medicare drug plan that meets your needs, it’s time to enroll. I will walk you through the enrollment process.  You can typically enroll in a new plan during the Medicare Annual Enrollment Period, which runs from October 15th to December 7th each year.  

 

Review Your Coverage Annually

After switching your Medicare drug plan, we will review your coverage annually. Your healthcare needs may change over time, so it’s important to reassess your plan each year during AEP to ensure you’re still getting your medications covered at a reasonable price.

 

At Hilgerman Insurance Solutions, we’re committed to helping you navigate the complexities of Medicare and find the right coverage for your unique needs. If you have any questions or need assistance with switching your Medicare drug plan, don’t hesitate to reach out to our knowledgeable team of insurance experts. With your guidance, we make a seamless transition to a Medicare drug plan that offers the coverage and peace of mind you deserve.

Hilgerman Insurance Solutions of Camarillo is an independent insurance agency that specializes in the senior market, while offering health insurance solutions for small businesses and individuals. We are contracted with 11 of the top insurance providers to offer you 65 plans that will work for your needs, all with personal hands-on service and support. 

Our commitment is to provide expertise, friendly service along with a timely response. Please feel free to contact us today for a quote and/or no-cost consultation.   

 

 

Hilgerman Insurance Solutions
Your Health Insurance Advocate
(805) 279-5482
hilgerman.insurancesolutions@gmail.com   
www.hilgermanins.com

Understanding Medicare Enrollment

by | Oct 1, 2024 | Medicare

With Medicare Open Enrollment just around the corner on October 15th, now is the perfect time to familiarize yourself with the key aspects of enrolling in Medicare. Whether you’re new to Medicare or looking to make changes to your current plan, understanding the enrollment periods, requirements, and options available can help you make informed decisions and ensure you have the coverage you need for the upcoming year.

 

Know Your Initial Enrollment Period

 

Medicare enrollment is a crucial step that typically happens at two key times: around your 65th birthday and during the annual Open Enrollment Period from October 15th to December 7th. If you’re turning 65, you have a seven-month window to enroll in Medicare, which starts three months before your birthday month and ends three months after. This Initial Enrollment Period is your first opportunity to sign up for Medicare Part A and Part B, as well as other plans. If you’re already enrolled but want to make changes to your coverage, the Open Enrollment Period is your chance to switch plans, add or drop coverage, or move between Medicare Advantage and Original Medicare. Making the right choices during these periods ensures that your healthcare needs are met throughout the year.

 

Determine Your Eligibility

 

While many individuals automatically qualify for Medicare at age 65, eligibility can vary based on factors such as disability or specific medical conditions. It’s important to understand the eligibility criteria that apply to your situation. Hilgerman Insurance Solutions can help you determine if you meet the requirements for Medicare enrollment.

 

Understand the Different Parts of Medicare

 

Medicare consists of several parts, each covering different aspects of healthcare:

  • Medicare Part A: Hospital Insurance
  • Medicare Part B: Medical Insurance
  • Medicare Part C: Medicare Advantage Plans
  • Medicare Part D: Prescription Drug Coverage

 

Your choice of coverage depends on your specific healthcare needs, and you may opt for Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C) that often includes prescription drug coverage (Part D).

 

Consider Medigap Plans

 

Medigap plans, also known as Medicare Supplement Insurance, can help fill the gaps in your Original Medicare coverage. These plans are offered by private insurance companies and can provide additional benefits, such as reduced out-of-pocket costs.

 

Be Aware of Late Enrollment Penalties

 

Failing to enroll in Medicare during your initial enrollment period may result in late enrollment penalties. These penalties can increase your premiums for Part B and Part D coverage. To avoid these extra costs, it’s essential to enroll during your initial enrollment period or during a Special Enrollment Period, which you may be eligible for under certain circumstances.

 

Consult an Expert Like Deborah Hilgerman

 

Medicare can be complex, and the choices you make can have a significant impact on your healthcare and financial well-being. Consulting with a Medicare specialist at Hilgerman Insurance Solutions is a wise decision. They can help you navigate the enrollment process, understand your options, and choose the coverage that best suits your needs.

 

Stay Informed About Enrollment Periods

 

In addition to the initial enrollment period, there are other enrollment periods that you should be aware of, such as the Annual Enrollment Period (AEP) and Special Enrollment Periods. Staying informed about these dates is crucial for making changes to your Medicare coverage.

 

Understanding Medicare enrollment is essential for securing the healthcare coverage you need as you age. With the guidance of experts at Hilgerman Insurance Solutions, you can make informed decisions about your Medicare coverage, ensuring that you receive the healthcare services that are right for you. Don’t hesitate to reach out to us for assistance and make the most of your Medicare benefits.

 

Navigating the complexities of Medicare eligibility and coverage can be challenging, which is why it can be helpful to work with a knowledgeable insurance professional like Hilgerman Insurance Solutions. Our team can help you understand your options and make informed decisions about your Medicare coverage. Contact us today to learn more about our services and how we can help you get the most out of your Medicare benefits.

 

Hilgerman Insurance Solutions
(805) 279-5482
deb@hilgermanins.com  
www.hilgermanins.com

Do You Qualify for Social Security Spouse’s Benefits?

by | Aug 1, 2024 | Social Security

Social Security benefits are a crucial part of the retirement income for millions of Americans. If you don’t have enough Social Security credits to receive benefits on your own work record or if your own benefit is small, you may be able to receive benefits as a spouse. For you to get benefits on your spouse’s work record, your spouse must be receiving their benefits. If your spouse is not yet receiving retirement or disability benefits, you’ll have to wait to apply on their record.

Eligibility for Spouse’s Benefits

To be eligible for spouse’s benefits, you must meet one of the following criteria:

  • Be 62 years of age or older.
  • Be any age if you have a child who is younger than 16 or has a disability and is entitled to benefits on your spouse’s record.

How the Spouse’s Benefit is Determined

Your full spouse’s benefit could be up to one-half of the amount your spouse is eligible to receive at their full retirement age. If you choose to receive your spouse’s benefits before you reach full retirement age, your payment will be permanently reduced.

If your spouse has postponed or plans to postpone their retirement to increase their monthly benefit amount by earning delayed retirement credits, your maximum spouse’s benefit remains 50% of their full retirement age benefit, not the higher amount including delayed retirement credits. However, your benefit as a surviving spouse would be based on the higher amount.

If you wait until you reach full retirement age to receive benefits, you’ll receive your full spouse’s benefit amount, which is one-half the amount your spouse receives. You may also get your full spouse’s benefit if you are under full retirement age but care for a child and one of the following applies:

  • The child is younger than age 16.
  • The child has a disability and is entitled to benefits on your spouse’s record.

Receiving Retirement and Spouse’s Benefits

If you’re eligible for both retirement and spouse’s benefits, you must apply for both. This requirement is called “deemed filing” because when you apply for one benefit, you are “deemed” to have applied for the other benefit as well. If you receive retirement benefits on your own record, that amount will be paid first. If your benefits as a spouse are higher than your own benefit, you will receive a combination of benefits that equals the higher spouse’s benefit.

Consider this example: Sandy is eligible for a monthly retirement benefit of $1,000 and a spouse’s benefit of $1,250. If she waits until her full retirement age to receive Social Security, she will receive her own $1,000 retirement benefit. Additionally, she will receive $250 from her spouse’s benefit, totaling $1,250 a month. Sandy only gets an additional spouse’s benefit because her own benefit is less than half her spouse’s full retirement age benefit.

Divorced Spouses Can Get Benefits, Too

If you are divorced from a marriage that lasted at least 10 years, you may be able to get benefits on your former spouse’s record. The rules for divorced spouse’s benefits are slightly different. You can find out more by visiting the Benefits For Your Family page on ssa.gov.

How Hilgerman Insurance Solutions Can Help

Navigating Social Security benefits can be complex and overwhelming. Hilgerman Insurance Solutions is here to help you understand your options and maximize your benefits. Whether you need assistance with determining your eligibility, understanding the application process, or managing your benefits, our team of experts is ready to provide the guidance and support you need. We specialize in helping individuals and families in Ventura County with their Social Security benefits, ensuring you get the most out of your entitlements.

Contact Hilgerman Insurance Solutions today to learn how we can assist you with your Social Security benefits and other insurance needs. Let us help you secure a stable financial future.

 

Hilgerman Insurance Solutions
(805) 279-5482
deb@hilgermanins.com  
www.hilgermanins.com

Prescription Drug Coverage (Part D): What You Need to Know

by | Jul 1, 2024 | Medicare

Navigating Medicare can be complex, especially when it comes to Prescription Drug Coverage (Part D). This part of the Medicare program changes frequently, almost every year, so it’s crucial to have your plan reviewed to determine coverage and costs for the upcoming year.

What is Medicare Part D?

Medicare Part D is prescription drug coverage that helps cover the cost of your medications. It’s available to anyone with Medicare and is provided through private insurance companies approved by Medicare. Part D plans can vary in terms of costs, covered drugs (formulary), and pharmacy networks.

Why is Part D Important?

Medications can be a significant part of your healthcare needs, and having the right Part D plan ensures you have access to the drugs you need without breaking the bank. Here are the key aspects of Medicare Part D:

  1. Formulary: A formulary is a list of drugs covered by a Part D plan. Each plan has its own formulary, which can change annually. It’s crucial to ensure that your medications are covered each year.

     

  2. Costs: Costs associated with Part D include premiums, deductibles, copayments, and coinsurance. These costs can vary widely between plans and can change every year.

     

  3. Pharmacy Network: Part D plans have a network of pharmacies where you can fill your prescriptions. Using an in-network pharmacy typically costs less than going out-of-network.

     

  4. Coverage Gap (Donut Hole): The coverage gap, commonly known as the donut hole, is a temporary limit on what the drug plan will cover for drugs. After spending a certain amount on covered drugs, you enter the donut hole, where you may pay higher out-of-pocket costs until you reach the catastrophic coverage threshold. In 2025 the coverage gap will be capped at $2,000.

Staying Up-to-Date with Part D Changes

Because Part D plans and formularies can change every year, it’s essential to review your plan annually to ensure it still meets your needs. Changes in your health or medication needs, as well as changes in the plan’s formulary, can impact your out-of-pocket costs and coverage. Hilgerman Insurance Solutions spends many hours each year learning and researching all the changes with Part D. This makes it very easy for you to get the correct information and help finding the best plan for you.

How Hilgerman Insurance Solutions Can Help

At Hilgerman Insurance Solutions, staying current with Medicare Part D changes is one of our specialties. We understand that keeping up with these changes can be overwhelming. That’s why we take care of it for you. Each year, we research all the changes and available plans to make sure you’re getting the best coverage for your needs at the best cost.

By working with us, you can be confident that you won’t overpay for your medications or lose access to the drugs you need. I, Deborah Hilgerman, am dedicated to helping you navigate the complexities of Medicare Part D, ensuring you have peace of mind and the right coverage.

Get the Help You Need

Let us help you make the best choice for your prescription drug coverage. Visit our website https://hilgermanins.com/ to request assistance. Together, we can make sure you have the coverage you need at a price you can afford, without the stress of keeping up with constant changes.

Hilgerman Insurance Solutions of Camarillo is an independent insurance agency that specializes in the senior market, while offering health insurance solutions for small businesses and individuals. We are contracted with most of the top insurance providers to offer you plans that best suit your needs, all with personal hands-on service and support. 

Our commitment is to provide expertise, friendly service along with a timely response. Please feel free to contact us today for a quote and/or no-cost consultation.   

 

Hilgerman Insurance Solutions
(805) 279-5482
deb@hilgermanins.com  
www.hilgermanins.com

 

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