About Us
Medicare Insurance Group
is a subsidiary of Health Insurance Exchange of the Midwest that has been helping seniors since 2001.
Along with assisting with Medicare decisions, our agency fills the gaps with many other insurance products to include
Dental, Vision, Long Term Care, Life (Simplified, Term, Whole, Indexed Universal), Annuities, Legal Plans/Will & Trusts, Identity Theft and Property Casualty.
We offer many competitive Medigap, Medicare Advantage and Part D plans your providers may accept in your area:
Aetna, Humana, Blue Cross Blue Shield, Mutual Of Omaha, Silverscript, United Health Care, Cigna, Ascension,
Wellcare, GPM, New Era, ACE, AFLAC, Allstate, GTL, Medico, Prosperity and many more carriers.
There are many Medicare plan choices for those turning 65, who are currently receiving benefits and still others making decisions for their loved ones.
Joanna Prisiajniouk, of Medicare Insurance Group can assist in understanding the concepts of Medicare and selecting
the best coverage solution easily by guiding you through your questions and specific needs.
For potential Medicare enrollees or for those currently enrolled in Medicare, Joanna can help you understand what Medicare covers and help you determine if your current coverage meets your needs for potential necessary
changes as well. We work with many plans available per designated state areas to save your money and keep up to date with changes that occur enrolling folks in a plan best suited for their medical and financial situations.
Once enrolled in Medicare, an annual review of your coverage and deductibles is part of a sound healthcare
management strategy. We can assist in determining whether your current coverage is meeting your medical and drug prescription needs to determine any necessary changes. It's always a good idea to stay on top of Medicare plan changes and reviewing how Medicare works to find the best cost effective solutions that are critical in maximizing the various benefits on an ongoing basis. Let us guide you for all your future Medicare requirements.
CMS Disclaimer: 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.
Joanna Prisiajniouk - Broker/President
New 2023 Medicare Changes
2023 Medicare Numbers to Remember
Basic Part B premium: $164.90 a month
Part B deductible: $226
Part A deductible: $1,600
Part A Premium: (Most Beneficiaries Do Not Incur This Cost). If you paid Medicare taxes for less than 30 quarters, the standard PART A premium is $506. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $278.
Part A Deductible and Coinsurance:
You pay $1,600 deductible for each benefit period
Days 1-60: $0 coinsurance for each benefit period
Days 61-90: $400 coinsurance per day of each benefit period
Days 91 and beyond: $800 coinsurance per each "lifetime reserve day" after day 90 for each benefit period
(up to 60 days over your lifetime. Beyond lifetime reserve days: all costs
For beneficiaries in skilled nursing facilities, the daily coinsurance for days 2 through 100
of extended care services in a benefit period will be $200 in 2023.
Medicare costs at a glance:
CMS Announcement: https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
Part B Premium: $164.90
The standard Part B premium amount in 2023 will be $164.90 (or higher depending on your income).
Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount,
you may pay an Income Related Monthly Adjustment Amount (IRMAA).
Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago.
This is the most recent tax return information provided to Social Security by the IRS.
2023 Medicare Part A and B costs outlined: https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
Part D
Yearly deductible for drug plans
This is the amount you must pay each year for your prescriptions before your Medicare drug plan pays its share.
As background, the standard CMS 2023 Medicare Part D plan includes a $505 initial deductible and although a Medicare plan's initial deductible can range from $0 to $505, most stand-alone 2023 Medicare Part D prescription drug plans (PDPs) will use the CMS standard Medicare Part D plan deductible ($505).
https://q1medicare.com/PartD-The-2023-Medicare-Part-D-Outlook.php#chart
Deductibles vary between Medicare drug plans.
Facts
The Initial Enrollment Period (IEP) for Parts A and B is 7 months, starting 3 months before the month of your Medicare eligibility and ending 3 months after the month of eligibility. The month of eligibility is the month of your 65th birthday, if you become eligible for Medicare because you are turning 65 years old. Or, if you become eligible due to a disability, your month of eligibility is the 25th month of receiving Social Security Disability Insurance (SSDI)
Note: If you delay your enrollment into Part B, you may have to pay a late enrollment penalty of 10% of the current Part B premium amount for each 12-month period you delayed enrollment. However, if you have coverage from an employer group health plan based on current employment, you may not have to pay the penalty.
If you are 65 years old or older and owe the penalty, you have to pay the penalty for as long as you are enrolled in Part B. If you are younger than 65, have Medicare because of a disability and owe the penalty,
the Part B penalty will end when you turn 65 and qualify for Medicare based on age.
Initial Coverage Election Period for Part C
Enrolling in Medicare Part C or a Medicare Advantage (MA) plan is optional. If you want to enroll in a Medicare Advantage plan you must be entitled to both Parts A and B. Your Initial Coverage Election Period (ICEP) to join an MA plan may be 3 months or 7 months
as illustrated by the examples below.
Example 1: A person’s 65th birthday month is April. His IEP for Part B is January 1 to July 31. He enrolls in Part B and the effective date of his Part A and Part B benefits is April 1. Because he enrolls in Medicare during his IEP, his ICEP to join MA plans is January 1 to July 31,
the same 7 months as his IEP for Part B.
Example 2: A person’s 65th birthday month is April and her IEP for Parts A and B is January 1 to July 31. She does not enroll in Part B because she continues to work and is covered by her employer’s group health plan. She retires and then enrolls in Part B which becomes effective December 1. In this case, her ICEP to enroll in an MA plan is September 1 to November 30, 3 months before the effective date for both Parts A and B.
Initial Enrollment Period for Part D
If you are newly eligible for Medicare, your IEP to enroll in a Part D plan is the same as your IEP for Parts A and B. To enroll in a Medicare Part D plan, you must be eligible for either Part A or Part B. People who have Medicare due to a disability have another IEP for Part D when they turn 65 years old. If you don't enroll in a Medicare drug plan during your IEP, you can enroll during the Annual Election Period (October 15 – December 7) or during a Special Enrollment Period, explained below. Also, if you do not join a Part D plan during your IEP, do not have creditable coverage for your drugs (prescription drug coverage that is at least as good as Medicare’s Part D benefit), and you enroll later, you may incur a penalty. The penalty is 1% of the average national premium for every month you were eligible and did not sign up. (The average national premium is $32.34 in 2011 and changes each year.) This amount is added to your drug plan premium and you pay it as long as you are in a Part D plan or MA plan with prescription drug coverage.
Note: If you enroll in an MA plan during the ICEP or Part D plan during the IEP and the plan becomes effective,
you may not make another election even though
the ICEP or IEP has not expired.
General Enrollment Period
People who did not enroll in Part A or B during their IEP, or terminated their Part A or Part B benefits and want to re-enroll, may enroll in either or both Parts during the General Enrollment Period (GEP), which is January 1 to March 31 of each year. If you enroll during the GEP, your benefits will begin the following July 1. If you enroll in Part B during the GEP, you may have to pay the Part B late enrollment penalty mentioned above.
Annual Election Period
The Annual Election Period (AEP) is October 15 to December 7 of every year beginning in 2011.
During this time frame, people can join, change or drop an MA plan or Part D plan.
For example:
• If you did not enroll in an MA plan during your ICEP or a Part D plan during your IEP, you may enroll in
an MA plan or Part D plan during the AEP.
• If you are already in an MA plan or Part D plan, you may change plans or disenroll from your plan during the AEP.
• If you had an MA plan and went back to Original Medicare and now want to be in an MA plan again,
you may enroll during the AEP.
You may make more than one election during the AEP. Your final election during that period is the one that counts. The last election (or only election) made during the AEP will be effective January 1 of the following year.
Special Enrollment Period
A Special Enrollment Period (SEP) exists for Part B, and Special Election Periods (also referred to as SEPs) exist for MA plans and Part D plans in certain circumstances (see below). For Part B, an SEP is available only for people who delay enrollment in Part B because they have employer group coverage. If you become eligible for Medicare at 65, and have coverage from an employer group health plan based on your or your spouse’s employment, you may delay enrollment in Part B. When you stop working or your employer group health coverage ends, you have an SEP to enroll in Part B. The SEP is 8 months following the end of employment or employer group health coverage, whichever is earlier. If you enroll during the SEP, you do not owe the late enrollment penalty for Part B (explained above).
Note: if you have end stage renal disease,
you do not have this same SEP.
Special Election Periods
Special Election Periods (SEPs) for MA and Part D plans may be available depending on the situation. Examples:
• If you move, you may change to a different plan not offered in the area where you formerly lived.
• If your coverage through your employer or union group health plan ends, you have an SEP to enroll in an MA or
Part D plan. The SEP ends 2 months after the month
your coverage through the group plan ends.
• If you are eligible for full Medi-Cal benefits, you have an ongoing SEP to enroll in or change MA or Part D plans.
• If you lose your full Medi-Cal benefits, you have a 3-month SEP to change MA or Part D plans, starting the month you are notified ofthe loss of Medi-Cal eligibility.
• If you become eligible for the low-income subsidy (LIS) or extra help, you have an ongoing SEP as long as you qualify for the LIS. You can change Part D plans or MA plans with prescription drug coverage on a monthly basis.
• If you lose the LIS, you have a 3-month SEP beginning
in the month you receive notice of
losing the low-income subsidy.
• If you enroll in Part B during the GEP (but are not entitled to premium-free Part A), you have an SEP to enroll in a
Part D plan between April 1 and June 30.
If you enroll in a Part D plan during this SEP, your plan becomes effective July 1.
• If you enroll in an MA plan during the ICEP around your 65th birthday, you have an SEP to disenroll from
the MA plan during your first 12 months in the plan
and return to Original Medicare.
Medicare Advantage Open Enrollment Period (OEP)
From January 1 – March 31 each year, if you’re enrolled
in a Medicare Advantage Plan, you can switch to
a different Medicare Advantage Plan or switch to
Original Medicare (and join a separate
Medicare drug plan) once during this time.
Note: You can only switch plans once during this period.