Your qualifiers- Prepare to enroll

Do you currently have a Medicare Card with both Original Medicare Part A and Part B? A Forward Card (Medicaid) and or any Consideration of Chronic Conditions? A Veteran?

Medicare Card : 

In order to apply for a privatized Medicare plan you will either need to currently have both Original Medicare Part A and Part B, or Part A and Medicaid that is covering either a part or all of your Part B costs. Part A is basic facility care and Part B is dedicated to physician services. Unless you are on Medicaid, you are paying 148.50 each month for Part B in 2021. If you have the right card, you should see these parts and their effective enrollment dates for each on the card. Have questions on how to enroll into part A or B? Reach out info@wisins.info or text or call 920 883-7259. 

Forward Card [Medicaid] : 

If you have a Forward card from the State of Wisconsin, there is a chance you are paying less than the 148.50 or receiving a full federal subsidy and are not being billed at all for this. 

Having each or a combination of each will qualify you for different plans. It is very important to know this information and have your Medicare Card and Forward Card (if you have one,) ready for your meeting with your agent. Even whether the dates of eligibility for Part A and B match - will qualify you for different plans, different start dates and in some cases, a penalty. 

Special Chronic Needs [C-SPN]:

If you have chronic conditions please be prepared to notify the Agent. In many cases agents are not allowed to ask the questions about the conditions you may have. You must be forthright about situations for which an agent will shop for you to find you the right plan.

TRICARE VS CHAMPVA: Specialized plans and guidelines exist. Be sure you alert your agent to your situation.

 Do you reside in the Service Area County?

Privatized Medicare Advantage, Prescription and Supplement Plans in Wisconsin are available per the County you reside in and your permanent address can dictate your choice of plans. These plans can appear as different types that can be as Health Maintenance Organizations, (HMO)s; Preferred Provider Organization (PPO) plans; Private Fee-For-Service (PFFS) plans or Special Needs Plans (SNP). There are also Medical Savings Accounts (MSA). There are some exceptions. Your agent will be able to help you further decipher your situation if you travel a lot or have more than one residence. 

Are You The Beneficiary? Is a Power of Attorney handling your affairs?

As the beneficiary and person signing official enrollment documents you may be faced with answering some uncomfortable questions regarding the ability to handle your own affairs. Do not be offended by these. These questions are necessary to decipher whether another supportive individual will need to be recognized in the event the immediate beneficiary cannot conduct affairs. This is another person charged with the responsibility of planning for the wishes of the beneficiary. Please be clear with your Agent so that the agent may handle all documentation for the desired outcomes.

Reading and Understanding Plan Summary

Set aside some time for reading through this document when and after your agent provides this to you. Expect your Independent agent will be able to have a number of hard copy plans with them that they have shopped for based upon the information you have volunteered and have been forthcoming about. Agents are prevented from asking certain questions and you may not think to provide information you may not realize would have been important for the agent to select plans for you, so speak up!  Your agent should go through the plans with you line item by line item so that you feel comfortable knowing what is in the plan and readily compare the plans available to you for your situation at your permanent residence. 

When Will You Enroll and When Will Your Plan Go Into Effect?  Medicare Seasons and Individual Circumstances

The World of Medicare is broken into different parts for which become available within various windows of time and further specified within a variety of individual circumstances. This is where you really will come to depend upon close communication with your agent as not to miss out on important plan change dates or benefits that might result in an unplanned for charge you might have assumed was covered. For example, are you a member of the military on TRICARE? Did you know that you generally must enroll in Part A and Part B WHEN you are first eligible to keep your TRICARE coverage; However, if you are an active duty service member or family member you may not have to- See Medicare and You 2021 p. 86. 



There are many rules that guide these periods above. A good idea to use these rules to your advantage is to begin looking into your options when you turn 64 to bring yourself up to speed on planning for your best health care insurance coverage to avoid taking action on a plan you otherwise would not have.  

Be sure to obtain a copy of Medicare and You 2021. Feel free to reach out to us here at 920 883-7259 or info@wisins.info to help you find either an electronic copy and hard copy if you qualify for that. 

Underwriting & Additional Requirements What's the Surprise?

Nobody likes surprises. Additional requirements per an underwriting specialist may require you to verify you are a risk they can afford. Given this possibility- expect to budget time for this by ideally beginning your search as early as the age of 64. Examples of verifying whether or not you could qualify for a plan include everything from having to take a physical,  to an authorization, depending upon your individual circumstances to avoid unplanned for out of pocket costs and coverage amounts.