Independent Health Insurance Counseling

What is an Independent Medicare Consultant?

  • Independent Medicare Consultants are trained counselors who are well educated in Medicare and provide FREE and unbiased health insurance counseling to Medicare beneficiaries or those who will soon qualify for Medicare benefits.  All of our counselors are well trained in Medicare and will review your options.  These options include Medicare Parts A and B, Medicare Advantage (Part C), Medicare Prescription Drug Plans (Part D) and Medicare Supplemental Plans (Medigaps).  We will also review eligibility for Public Assistance programs such as Prescription Advantage, Extra Help from Social Security, MassHealth and other programs to assist beneficiaries with limited resource to pay for health care costs.  Independent Medicare Insurance Consultants are available to assist Seekonk residents navigate the Medicare maze to help make informed and educated decisions on their health care options. 

Navigating Medicare and Frequently Asked Questions--

What is Medicare?

  • Medicare is health insurance for individuals aged 65 and older who have worked and paid into the Social Security system, and for individuals receiving Social Security Disability. 
  • Prior to turning 65 if NOT receiving Social Security Benefits you must contact the Social Security Administration to sign up for Medicare. 
  • You have a seven-month window to do so starting three months prior to your 65th birthday. 

 Parts of Medicare

 Part A – Hospital Insurance

  • Covers Inpatient Hospital stays

 Part B – Medical Insurance

  • Covers outpatient services including doctors visits and testing
  • Part B is optional and may be deferred if the beneficiary or his/her spouse is still working and has group health coverage through their employer. 

 Part C – Medicare Advantage Plans

  • A combination of Medicare Part A (Hospital) and Part B (Medical) benefits, additional health insurance and prescription drugs.
  • These plans are typically Health Maintenance Organization (HMO); meaning a beneficiary must go to the doctors and hospital contracted with the plan.  Or a Preferred Provider Organization (PPO); A beneficiary can go to doctors outside of the plans network, however the doctor or hospital must agree to accept the insurance.
  • Usually have monthly premiums, co-pays and deductibles
  • Subject to the coverage gaps
  • These plans may offer “extras” like annual physicals, dental, vision, gym memberships, etc.  

 Part D – Prescription Drug Plans

  • Private drug plans that contract with Medicare to provide prescription drug coverage. 
  • Anyone with Part A and B is eligible for Part D
  • Covers full or partial cost of prescription drug cost at pharmacy
  • These plans have monthly premiums, deductibles, co-pays, and are subject to coverage gap. 

 Medigaps – Supplemental Plan

  • Medicare Part A and B only pays 80% of medical costs.   Medigap plans compliment Medicare A and B covering part of or all of what Medicare does not cover.
  • Medigaps are not networked so a beneficiary can go to any doctor or hospital that accepts Medicare, nationwide.
  • Medigaps DO NOT cover prescription drugs.
  • A Medicare Prescription Drug Plan (or Part D Plan) is required in addition to your Medigap.

Can I change my coverage following enrollment?

  • Each year, Medicare Beneficiaries can review and make changes to their existing coverage during Open Enrollment (October 5th through December 7th)
  • Each year changes are implemented; it is important to review your plan do to changes in coverage and potential higher out of pocket costs.
  • For assistance in reviewing your coverage during open enrollment, fill out a “Part D Drug” form and return to Seekonk Human Services Medicare Consultant for review

Who can help me sign up or answer questions regarding Medicare?

  • Independent Medicare Consultants are trained counselors who can provide FREE and unbiased health insurance counseling to Medicare beneficiaries or those soon qualifying for Medicare benefits. 
  • Seekonk Human services have available consultants to assist Seekonk residents navigate and make an informed educated decision on their health care options.

For any additional Questions regarding your Medicare Coverage please contact Seekonk Human Services to Schedule an appointment with our Independent Medicare Consultants at 508-336-8772