Find Help Navigating The Medicare Maze

Author

AIS Medicare & More

For more information about the author, click to view their website: AIS Medicare & More

Posted on

Apr 09, 2020

Book/Edition

Colorado - Southern Colorado

Medicare can seem like a confusing web of options. Many seniors choose to rely on licensed professionals for help navigate an average of 24 plans they have to choose from. The amount of choices can be overwhelming. Adding to the confusion not all plans are available in all areas or to all beneficiaries. If you work with an agent, its important to keep in mind that the agent might not be contracted with all insurance companies that offer plans in your area. This means the agent might not take a look at every coverage choice available to you. Make sure they have evaluated your options through multiple carriers. With plans changing from year to year and new ones available in many areas, there could be a better choice out there for you both in terms of cost and coverage. Your agent should check whether your doctor, hospital, preferred pharmacy and other providers are considered in network.

Be aware that if you call a number on an ad you see on TV or elsewhere, you will not have a face to face, local agent to assist you if there are problems in future. Also, some Medicare agents focus on selling only supplemental insurance, or Medigap. Those policies help you with copays, deductibles and other out-of-pocket expenses, and can only be paired with original Medicare. While original Medicare with Medigap might be the option for you, you wont know if you or your agent doesnt check. You should work with an agent that represents both Medicare Advantage and Medigap plans to be aware of all of your options. There are federal and state laws governing agents or brokers who sell Medicare plans, which include things such as barring them from showing up uninvited at your house to pitch a plan or trying to lure you with a cash offer. They also cannot legally charge you a fee to process your enrollment as agents generally are compensated through commissions from the insurance carriers they are licensed with.

Make sure you are working with an actual licensed agent. Unlicensed volunteers can unintentionally cause you big problems. If they help you choose a plan and enroll and there is a mistake, unlicensed volunteers arent held accountable like a licensed agent would be. They do not receive the same annual training as licensed agents and may not be aware of all plan nuances and features because they do not receive carrier to agent communications.
Ideally the agents will be well-versed in Medicare matters and should be able to assist clients in applying for Medicare Savings Reimbursement, Extra Help and pharmaceutical prescription assistance programs if applicable.
If you pick an Advantage Plan during fall enrollment and realize afterward that its not a good fit, you may be able to switch to another plan or to original Medicare and a stand-alone Part D prescription plan between January 1 and March 31. Reach out to a local agent for assistance if you feel you enrolled in a plan that does not fit your needs.

Editors Note: This article was submitted by Jolynn Allen of Allen Insurance Services. She can be reached at 719-404-3202.

Other Articles You May Like

What is Ahead for Medicare in 2026

Medicare has been changing yearly and 2026 will be no exception. What is ahead for Medicare this fall and why?Carriers are still feeling the effects of the Inflation Reduction Act, which passed in 2022, but just took full effect in January of 2025. Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage, won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications, the donut hole or coverage gap is eliminated and there is a new payment plan to spread drug costs through the year. Those changes came at a cost to other benefits. The Inflation Reduction Act significantly increased the carriers expenses and in response benefit cuts occurred for 2025 and will continue for 2026. Carriers had to absorb the steep cost increase for the mandatory prescription drug plan changes by balancing the budget, which included increases in beneficiaries copays, deductibles added to plans, the plan maximum out of pocket increased, non-medical benefits were reduced, a prescription drug deductible was added, and prescriptions were re-tiered or eliminated from the list of covered drugs. 2026 will see further adjustments as the carriers remove most benefits deemed non-medical. Seniors who have grown accustomed to benefits such as an over-the-counter allowance or food subsidy may see those benefits sharply reduced or eliminated this fall. Plans must be submitted to Centers for Medicare & Medicaid Services for approval in early spring to be ready for the enrollment period in fall to be active for the following calendar year, so carriers have had little time to study the impact of the Inflation Reduction Act on overall costs. Insurance moves slowly. The changes we are feeling in 2025 are the result of a bill passed in 2022 and will continue to affect plans in 2026. This fall will feel like a continuation of the benefit cuts seniors faced in the fall of 2024 as carriers work to balance the budget while considering the increased prescription costs and trying to maintain the plan benefits seniors rely on. For more information visit: aismedicareandmore.com Editors Note: This article was submitted by Jolynn Allen with AIS Medicare & More.  Jolynn is the owner of AIS Medicare & More and may be reached at:  719-404-3202

In-Home Supportive Services

In Colorado, In-Home Supportive Services (IHSS) is a Medicaid-funded program designed to assist individuals with disabilities or elderly individuals who need help with daily activities. These services enable individuals to live independently in their own homes rather than in institutional settings. IHSS provides support with tasks like personal care, housekeeping, meal preparation, and medication management.Eligible participants must meet specific criteria, including being a Colorado resident, requiring assistance due to a disability, and meeting income and resource limits. Services are tailored to each individual's needs and are delivered by trained caregivers, who may be family members or professional aides.IHSS is an essential resource for people with disabilities or the elderly, enhancing their quality of life by promoting independence while providing necessary care. It also alleviates the financial burden of long-term institutional care, offering a more cost-effective and personalized solution for those in need. Editor's Note: This article was submitted by Amazing Care Home Health Services. For more information they may be reached at 303-755-3170.

A New Era of Compassionate Dementia Care in Southern Colorado

For 40 years, Sangre de Cristo Community Care has provided compassionate, expert support to patients and families facing chronic and serious illnesses. Now, we are proud to introduce our new Dementia Care Program, a groundbreaking initiative designed to enhance the quality of life for individuals living with dementia while providing much-needed support for their caregivers.This Medicare-approved program offers dedicated care navigators, 24/7 nurse support, caregiver training, and respite careall aimed at enabling individuals to remain in their homes and communities for as long as possible. With a mission deeply rooted in dignity and quality of life, our team ensures that both patients and caregivers receive personalized guidance and access to essential community resources.Available throughout Southern Colorado, this program is open to Medicare beneficiaries with a dementia diagnosis who are not in a nursing home or PACE program. Self-referrals and provider referrals are accepted.If you or a loved one could benefit from this program, please call 719-553-1919 to learn more. At Sangre de Cristo Community Care, we continue to expand our services with compassion, knowledge, and positivitybecause every moment matters.  Editors note: This article was submitted by Stephanie Ivankovich, Marketing Communications Manager for Sangre de Cristo Community Care, and many be reached at 719-542-0032 or by email at stephanie.ivankovich@sangre.org. 

Local Services By This Author

AIS Medicare & More

Medicare Advantage Plans 3030 North Hancock Avenue, Colorado Springs, Colorado, 80907

AIS Medicare & More has been serving Southern Colorado seniors since 2008. We have started to spread all throughout Colorado, to broaden our reach and help more Colorado seniors. Our complimentary Medicare appointments are available in office, at your home, by phone or by computer. We believe in educating you about your Medicare options and both Medicare systems, so you can make an educated and informed decision that meets both your health insurance needs and fits your budget. Our agents are with you for life. We provide annual policy reviews, lifetime claims service, account management and prefer if you call us not the carriers. We want to know what is going on in order to better assist you with any of your needs in the future. We help you with State and Federal programs, Medicare Savings Reimbursement, Extra Help, Pharmaceutical Assistance Programs, Veterans Programs, Long Term Care Medicaid and more. By combining all of the programs available to you with your Medicare plan benefits, we can improve your overall coverage and reduce your out of pocket expenses. We are on your team! We want to ensure that you are taking advantage of all of the benefits available for you.