A TRUSTED MEDICARE RESOURCE FOR YOUR COMMUNITY
A Medicare Resource for the People You Serve
When Medicare questions come up, your staff doesn’t need to have all the answers. California Benefits Insurance Center can provide knowledgeable, personalized Medicare guidance to help the people you serve better understand their options and make informed decisions.
Support When They Need It
From someone approaching Medicare eligibility to an existing beneficiary with questions about their coverage, our team is available for one-on-one assistance and ongoing support throughout the year.
Medicare Education at Your Location
Want to bring Medicare education directly to your community? We offer complimentary educational seminars and Q&A sessions for organizations serving seniors, providing clear and approachable Medicare information in a comfortable setting.
Medicare Enrollment Guide
Who Qualifies?
This is for people who are first becoming eligible for Medicare, most often around age 65, and for some people who qualify earlier because of disability, ESRD, or ALS.
Enrollment Timeline
Your IEP is a 7-month window that begins 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Missing this window can create coverage delays and possible Part B or Part D late-enrollment penalties.
Key Considerations
Review Original Medicare Part A and Part B, Medicare Advantage Part C, standalone Part D, and Medigap options. Doctors, prescriptions, pharmacies, travel needs, premiums, and expected out-of-pocket costs should all be checked before you enroll.
Who Should Review Coverage?
AEP is for people already on Medicare who want to review or change Medicare Advantage or Part D coverage for the next plan year.
Enrollment Window
AEP runs October 15 through December 7 each year. Changes generally take effect January 1. This is also when many people review their Annual Notice of Change, also called an ANOC, to see what is changing for the coming year.
Available Plan Changes
During AEP, you may be able to switch Medicare Advantage plans, change Part D plans, move from Original Medicare to Medicare Advantage, or return from Medicare Advantage to Original Medicare and consider separate drug coverage.
Qualifying Events
A SEP may be available when certain life or coverage changes happen, such as moving, losing employer or union coverage, entering or leaving a plan service area, qualifying for Medicaid, or receiving Extra Help with drug costs.
SEP Eligibility
SEP timing depends on the event and the coverage you already have. Some windows are short, so it is best to review your options as soon as the change happens.
Coverage Options
A SEP may allow you to enroll, disenroll, or switch plans outside AEP. The choices available depend on the qualifying event, your current coverage, and the type of Medicare plan involved.
Coverage Overview
Medicare Advantage, standalone Part D, and Medigap serve different needs. Medicare Advantage is private Medicare coverage, Part D helps with prescription drugs, and Medigap works with Original Medicare to help reduce certain out-of-pocket costs.
How Each Plan Differs
Medicare Advantage plans often use HMO or PPO networks and may include extra benefits. Medigap usually offers more provider flexibility with Original Medicare, but generally does not include Part D drug coverage. Part D plans vary by formulary, drug tier, pharmacy, and prior authorization rules.
Compare Before Enrolling
Compare more than the premium. Review MOOP limits, copays, coinsurance, formularies, drug tiers, preferred pharmacies, referrals, prior authorizations, provider networks, and whether underwriting may apply for Medigap outside certain windows.
Medicare Questions
Yes. There is no cost to use California Benefits Insurance Center for Medicare plan review help. Our licensed agents help you understand your options, compare plans based on your doctors, prescriptions, preferred pharmacies, and budget, and make choosing coverage as simple as possible.
Yes. California Benefits Insurance Center can review doctors, medical groups, hospitals, prescriptions, drug tiers, pharmacies, and formularies before you apply. This is especially important because Medicare Advantage networks and Part D formularies can change from year to year.
Medicare Advantage is private Medicare coverage that may use a network and often includes extra benefits. Medigap works with Original Medicare and can reduce certain out-of-pocket costs, but it usually does not include Part D prescription drug coverage. California Benefits Insurance Center can help explain how each option fits your needs.
No. Sometimes the best choice is to keep what you already have. California Benefits Insurance Center compares your current plan, doctors, prescriptions, costs, and benefits against available options so you can make a confident decision.
You may have to wait for another enrollment window unless you qualify for a SEP. Depending on the situation, missing the right window can also create coverage gaps or late-enrollment penalties. California Benefits Insurance Center can help you understand which enrollment options may be available.
This is a solicitation for insurance. A licensed insurance agent may contact you.
We do not offer every plan available in your area. We represent multiple organizations and products. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
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