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Medicare guide

A closer look at Medicare Advantage.

Understand what a private Medicare plan includes and what to check beyond its monthly premium.

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Play video: Original Medicare vs. Medicare Advantage: The Two Paths, 1:13
Watch · 1:13 Original Medicare vs. Medicare Advantage: The Two Paths
Read the transcript

There are two ways to get your Medicare insurance. I'm going to explain it in about 60 seconds. Hi, I'm Julianne Dickey, We Care Medicare, your local Medicare insurance advocate.

Path one is Original Medicare, Parts A and B. This acts as your primary. Most people add a Medicare Supplement and a separate drug plan.

The Medicare Supplement, also called Medigap insurance. There are many plans to choose from, and I help you choose the right one. Path two.

Medicare Advantage. This is a private plan that has equivalent to A and B, and usually includes your Part D, all in one card. The differences that matter are networks, referrals, co-pays, out-of-pocket limits, premiums versus co-pays, and extra benefits like dental and vision.

Neither path fits everyone. Your doctors and prescriptions decide, not the ads. Bring me your doctors and we'll compare.

Let's make Medicare make sense together.

This time of year

Review your plan every fall.

What the Annual Notice of Change tells you, and what to check during annual enrollment.

Play video: Medicare Annual Notice of Change: Don't Toss That Letter, 1:27

Medicare Annual Notice of Change: Don't Toss That Letter 1:27

Read the transcript

Sometime before the end of September, you'll receive a letter from your insurance company. Most people toss it in the recycling. Please don't.

That's your Annual Notice of Change. I'm Julianne Dickey, We Care Medicare, your local Medicare insurance advocate. Now, an Annual Notice of Change. can be one of two things.

The first kind shows you the changes from year to year of your premiums, copays, and deductibles. This can be for a standalone prescription drug plan or a Medicare Advantage plan. The second kind is a termination letter.

Your plan is no longer going to be offered in the following year. Keep that letter. It enables you to have a special enrollment period.

And it means we can plan accordingly, together, and see which plan is right for you in the upcoming year. If your plan still fits, wonderful! You'll sleep well.

If it doesn't, the annual enrollment period, October 15th through December 7th, is exactly when we fix it. Either way, you'll know where you stand. The review costs you nothing.

So give me a call. Let's make Medicare make sense together.

Play video: Your Medicare Annual Enrollment Check-In (Oct 15 – Dec 7), 1:20

Your Medicare Annual Enrollment Check-In (Oct 15 – Dec 7) 1:20

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Hi, this is Julianne Dickey, We Care Medicare, your Medicare insurance advocate. Once a year, Medicare gives you this time frame from October 15th through December 7th. This is the time of year to review what you have, see if anything's changed from last year.

Your plan's drug list changes year to year. That's why the drug coverage is the first thing I look at. Have your doctors changed?

Have you seen a new specialist? Maybe you're thinking about seeing someone who's outside of your network. That also matters.

The plans change year to year. The premiums, co-pays, networks, and benefits. What fit you last year may not fit you this year.

That's exactly why Medicare gives you this time frame. So gather all of your medication lists and your doctors' names and let's review them together. This review costs you nothing.

I also offer educational workshops throughout the county. You can find locations, times, and dates on my website. Call me before December 7th and let's make sure your plan still fits your life.

Let's make Medicare make sense together.

Your plan-fit checklist

Look past the plan premium.

  • Your doctors

    Doctors, specialists and hospitals in the plan network.

  • Your prescriptions

    Covered drugs, pharmacy access and prescription costs.

  • Your costs

    Premiums, deductibles, cost-sharing and the medical out-of-pocket limit.

  • Your care

    Referrals, prior authorization, travel and care outside the service area.

Plan benefits, networks and drug coverage can change each year. Review the specific plan available where you live.

What Part C does

Medicare Advantage is another way to receive your Parts A and B benefits through a Medicare-approved private insurer. Most plans also include Part D prescription drug coverage. You generally continue paying your Part B premium.

Some plans offer low or $0 plan premiums and benefits such as dental, vision, hearing, fitness memberships, or over-the-counter allowances. Benefits and eligibility differ by plan and location.

HMO, PPO, and Special Needs Plans

An HMO generally uses a network of providers. A PPO may offer out-of-network access at a different cost. Ask about referrals, specialist access, prior authorization, and the hospitals you use.

Chronic Condition Special Needs Plans, or C-SNPs, are designed for people with qualifying chronic conditions. Dual Eligible Special Needs Plans, or D-SNPs, serve people eligible for both Medicare and Medicaid. Eligibility is specific to the plan.

Some Medicare Advantage plans do not include prescription drug coverage. These may be relevant to certain veterans who have other drug benefits. Review the interaction with your existing coverage before choosing one.

Compare the details you will actually use

A plan needs to fit your care, not just its brochure. Julianne can review represented plans against your providers, prescriptions, and preferred pharmacy.

  • Confirm each doctor and hospital participates in the specific plan.
  • Check covered drugs, pharmacy networks, and prescription cost-sharing.
  • Review deductibles, copayments, coinsurance, and the annual medical out-of-pocket maximum.
  • Understand travel and care outside the service area.
  • Check whether referrals or prior authorization are required for services you expect to use.

Review it again each year

Plan benefits, costs, provider participation, and drug coverage can change annually. Your own needs can change too. Read the annual change notice and arrange a review rather than assuming last year's choice still fits.

Annual Medicare Open Enrollment runs October 15 through December 7. Other enrollment opportunities depend on your circumstances.

Talk it through

Your questions belong here.

Julianne can help you understand how this applies to your own coverage and plans.

Call Julianne

No fee for Medicare guidance. Julianne is paid directly by insurance companies.

A conversation is a good place to start

You don't have to work this out alone.

Tell Julianne what's changing in your life. Together, you can work through your coverage questions and next steps.

Call (805) 441-9093Send a message

Contact Julianne

What would you like help with?

Send a message or request a conversation. Julianne will follow up with you directly.

(805) 441-9093
support@wecaremedicareplans.com

Monday through Friday
8:00 am to 5:00 pm
Closed Saturday and Sunday

Serving San Luis Obispo and Santa Barbara counties, from Paso Robles to Lompoc. Meetings at your home or an agreed location. Before any in-home appointment, California law requires 24 hours’ written notice, which Julianne sends you in advance.

Name, email and phone are required.

Please do not include medical information, prescriptions, Medicare identifiers, Social Security numbers, or other sensitive personal information.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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