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Medicare Annual Enrollment: Mid-October –Early December each year !
This is the time to review and make changes to your plan. The "Scope of Appointment" rule requires Medicare beneficiaries to sign a Scope of Appointment form a minimum of 48 hours in advance of meeting with an agent. This will be sent to you electronically by your Agent, Karen Vachon, once you schedule your appointment.
You can call 207-544-4119 or click here to request an appointment. We look forward to helping you!
Medicare Plans in Maine
Knowing your Medicare options is important as you approach retirement. Medicare is a federal health insurance program that protects people age 65 and over, as well as some individuals under 65 with specific illness and/or impairments. The Vachon Agency can assist you in choosing the best Medicare plan for you. Our expert knowledge of the various plan nuances coupled with available resources; throughout Maine – including Scarborough, Cape Elizabeth, Portland, Kittery, Kennebunk, Augusta, Bangor, Eastport and all the spots in between, we can help you find the right plan to address your individual and personal circumstance.
Are you aging into Medicare? Over 65 and planning to leave your employer’s health insurance plan? Would you like to optimize your Medicaid or VA benefits? Or simply wondering if your Medicare plan is the best fit for you? Want to learn more about Part B savings and buy-back options?
For further assistance or to enroll in Medicare, please contact us today. We can help! Take charge of your healthcare today and secure your future with the peace of mind with Medicare.
Original Medicare
Medicare Coverage is Complex. We’re Here to Help You Handle It All—Original Medicare, Medi-Gap & Medicare Advantage Plan
Medicare is a Federal Government/private health insurance program. There are letters associated with each part – A, B, C, and D.
“Original Medicare” is the Federal Government piece. It has two parts: Part A and Part B. Part A helps pay for hospital and in-patient care. Part B helps pay for outpatient care.
It is available to people aged 65+ and some people under 65 with disabilities.
People who have worked the equivalent of full-time for ten years (40 quarters) have been paying into the system through payroll taxes—therefore, they will not have to pay for Part A. You will pay a Part A premium if you haven’t satisfied the 40 quarters.
Part B has a monthly premium determined annually based on your household income.
“Original Medicare” has limitations:
- It doesn’t cover you out of the country.
- It doesn’t include prescription drug coverage.
- It has no maximum out-of-pocket cap.
- Part A has deductibles—every 60 days, co-pays, and limits lifetime days of coverage.
- Part B has an annual deductible and a 20% co-insurance.
Private Health Insurance
Address the Limitation of Medicare. We’re Here to Help You Choose the Right Option—Medi-Gap or Medicare Advantage Plan
Private health insurance companies address the limitations of “Original Medicare” by offering options to fill the holes in coverage. There are two options.
- Option 1: Pick up a Medicare Supplement (Also called a Medi-gap) plan -PLUS—enroll in a standalone Medicare Prescription Drug plan—called Part D.
- Option 2: Pick up a Medicare Advantage Plan—called Part C.
Note: You may choose option 1 or option 2—you cannot have both; however, whichever option you choose, you must have Original Medicare Part A and Part B, and you must continue to pay your Part B premium.
Best Health Options
How to Decide Which Option is Best for You? We’re Here to Help Choose the Best Option.
We help you carefully weigh your options to make an informed choice. Medicare’s official site is a great place to learn about plans in your area. Also, local agents certified with CMS and appointed with various carriers put a local face on complex choices. It costs nothing to work with an agent; if you enroll in a plan, the carrier compensates us directly.
The Centers for Medicare and Medicaid (CMS) oversees the private health insurance program. Prescription Drug Plans (PDPs) and Medicare Advantage Plans (MA/MAPDs) are evaluated by a star rating system based on various measures of the plan’s performance and customer service. 5 stars is the highest rating; 1 star is the lowest.
Preparing for Maine Medicare
Turning 65 in the next six months? We’re Here to Help You Handle It All.
“Aging into Medicare?” You need to know and do a few things no later than four months before you turn 65. If you receive Social Security before you turn 65, you don’t need to sign up for Medicare Part A and B. Your “Original Medicare” card will be automatically sent to you.
If you are turning 65, don’t have employer coverage, and are not collecting social security, you must apply for “Original Medicare” first. Go to www.medicare.gov or visit your local SS office. Sign up for Medicare Part A and Part B. Generally, it takes about three weeks to receive your “Original Medicare” card in the mail.
If you are turning 65 and have employer coverage, a “Qualified Health Plan,” you may stay on that plan or move to Medicare. NOTE: Once you leave employer coverage, you may not be able to get back on – choose carefully!
Medicare Enrollment Periods
Initial Enrollment Period (IEP):
It lasts seven months—Three months before you turn 65, the month of your birthday, and three months after. During this period, you may enroll in Original Medicare A & B and choose either a PDP or a MA/MAPD plan.
Annual Enrollment Period (AEP):
This season runs from October 15th—December 7th. Consumers can change, drop, and select either a new PDP or an MA/MAPD for the coming year—starting January 1st.
Medicare Advantage Open Enrollment Period (OEP):
This season runs from January 1st—March 31st. If you are unhappy with your MA/MAPD plan, you are allowed to make one switch to a new MA/MAPD plan.
Special Enrollment Period (SEP):
There are certain circumstances include:
- Plan leaves service area.
- Beneficiary moves out of service area.
- Dual Eligible (Medicaid and Medicare beneficiaries)
- Beneficiaries are eligible for Extra Help.
- Beneficiaries who retire and/or lose employer coverage.
- Beneficiaries diagnosed with a qualifying disability or chronic health condition.
5-Star Enrollment SEP:
Runs December 8th—November 30th. If there is a 5-Star plan in your service area, you may switch anytime during Enrollment.
Would you like to shop a plan on your own?
We understand. Some people like to shop around on their own, hassle-free, with no phone calls.
The Vachon Agency is happy to offer you this safe zone. Here’s the deal: You call. We won’t call you—unless you want us to.
Simply click My Plan Enroll Partner Website to view plans, prices, and benefits. If you need help, we are happy to assist. If you don’t, that’s perfectly okay too!
To shop a plan on your own, click the button below. From there, you will be walked through the process from start to finish. We are here to help if you get stuck or have questions.
Medicare Disclaimer
Currently, we represent seven organizations that offer 65 products in your area. You can always contact
www.Medicare.gov,
1-800-MEDICARE, or your local State Health Insurance Program for help with plan choices.
