AEP Open Enrollment (October 15th - December 7th)
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About Gerald Hauser and his Team
Experienced Medicare Specialists
Gerald Hauser is a Medicare Specialist who works with multiple insurance companies to help clients navigate Medicare Advantage, prescription drug plans, Medicare Supplements, and other Health Insurance options.
His areas of expertise include:
- Medicare Advantage Plans with prescription drug coverage (MAPD)
- Medicare Advantage Plans without prescription drug coverage (MA)
- Prescription Drug Plans (PDP)
- Medicare Supplement plans
- VA and TRICARE-related coverage
- TRICARE for Life relationships
- Medical insurance for individuals under 65
- Supplemental insurance for individuals over 65
- Travel medical insurance
- International medical insurance for Americans and Canadians living abroad
Medicare Basics
Medicare covers all persons 65 or more that have contributed to Part A of Medicare or those that have the right to buy into Medicare Part A. Medicare is also available for those persons on social security disability for at least 24 months. Medicare is also available for those persons with special chronic illnesses.
Part A
Hospitalization
- Covers inpatient hospital stays.
- Helps cover skilled nursing facility care.
- Covers hospice care for eligible patients.
- May cover certain home health care services.
- Helps pay for covered hospital-related services and supplies.
Part B
Doctors, medical services and labs
- Covers doctor and healthcare provider services.
- Helps cover outpatient medical services.
- Includes many preventive services and screenings.
- May cover durable medical equipment.
- Helps cover medically necessary tests, treatments, and services.
Part C
Medicare Advantage plans
- Explore Medicare Advantage plans with or without prescription drug coverage.
- Provides Medicare Part A and Part B benefits through private Medicare-approved plans.
- Many plans include prescription drug coverage.
- Plans may offer additional benefits such as dental, vision, or hearing coverage.
- Costs, benefits, provider networks, and coverage rules vary by plan.
- Plans generally have an annual limit on out-of-pocket costs for covered services.
- Understand your eligibility and available enrollment periods.
- Compare plans based on coverage, costs, prescription benefits, and provider networks.
- Find options that align with your healthcare needs and personal circumstances.
- Get personalized guidance to better understand your Medicare choices and enrollment options.
Part D
Prescription Drug Coverage
- Provides prescription drug coverage through Medicare-approved private plans.
- Helps cover the cost of prescription medications.
- Available as a standalone prescription drug plan for people with Original Medicare.
- Prescription drug coverage can also be included in many Medicare Advantage plans.
- Costs, covered medications, pharmacies, and coverage rules vary by plan.
- Understand your eligibility and enrollment periods for prescription drug coverage.
- Licensed Medicare Agent: Mr. Hauser and his team are licensed across all U.S. states, with multiple insurance companies and participating hospitals.
- International Hospital Access: Medicare recipients may have access to direct-billing arrangements at select hospitals in Panama and Mexico, including Pacifica Salud, Panama Clinic, Chiriqui Hospital, and San Antonio Hospital.
- Medical Insurance: Coverage options are available for individuals under 65 and those over 65 seeking supplemental Medicare coverage.
- Travel & International Insurance: Medical and related insurance services are available for U.S. and Canadian citizens living or traveling abroad.
Enrollment times for Medicare Advantage Plans are:
Initial Enrollment Period (IEP)
Persons turning 65 may enroll beginning 3 months before their 65th birthday, during their birthday month, and for 3 months after their 65th birthday.
Social Security Disability Enrollment
Persons who have been receiving Social Security Disability benefits for at least 24 months may become eligible for Medicare.
Annual Enrollment Period (AEP)
October 15 to December 7 each year. This period allows eligible Medicare beneficiaries to review and make changes to their Medicare coverage.
Medicare Advantage Open Enrollment Period (OEP)
January 1 to March 31 each year for eligible Medicare Advantage enrollees who wish to make certain changes to their Advantage plan.
Special Enrollment Period (SEP)
Certain qualifying circumstances may allow individuals to enroll in or change Medicare coverage outside the standard enrollment periods. These may include moving to a new residence, being affected by certain major disasters or emergencies, losing qualifying employer coverage, having Medicaid, or other qualifying situations.
VA Health Care & Medicare
VA health care and Medicare are separate systems. Eligible Veterans may use both, but each generally pays within its own system.
How They Work Together
- VA does not bill Medicare for care received at a VA facility.
- Medicare generally does not pay for services received at a VA facility.
- Keeping Medicare can provide access to non-VA doctors and hospitals.
- Before delaying or dropping Part B, consider future healthcare access needs and the possibility of a Part B late-enrollment penalty.
Military & Veteran Health Benefits
Medicare covers all persons 65 or more that have contributed to Part A of Medicare or those that have the right to buy into Medicare Part A. Medicare is also available for those persons on social security disability for at least 24 months. Medicare is also available for those persons with special chronic illnesses.
VA HEALTH CARE AND MEDICARE
VA health care and Medicare are separate systems. Eligible Veterans may use both, but each generally pays only within its own system.
How they work together
- VA does not bill Medicare for care received at a VA facility.
- Medicare generally does not pay for services received at a VA facility.
- Keeping Medicare can provide access to non-VA doctors and hospitals.
Important decision
- Consider future access needs and the Part B late-enrollment penalty before delaying or dropping Part B.
TRICARE FOR LIFE AND MEDICARE
TFL is Medicare-wraparound coverage for TRICARE-eligible beneficiaries with Medicare Part A and Part B.
Coverage coordination
- In the U.S. and U.S. territories, Medicare generally pays first and TFL pays second.
- For services covered by both programs, members generally have no out-of-pocket cost.
- Members must continue paying the Medicare Part B premium.
Prescription coverage
- Medicare Part D is not required to keep the TRICARE pharmacy benefit.
CHAMPVA AND MEDICARE
CHAMPVA may cover eligible spouses, dependent children, and survivors of certain Veterans. A person eligible for TRICARE cannot receive CHAMPVA.
When Medicare applies
- Medicare-eligible beneficiaries generally need Part A and Part B to get or keep CHAMPVA.
- Medicare usually pays first; CHAMPVA generally pays second for covered services.
- A Medicare Advantage plan also meets the Part A and Part B requirement.
Keep records current
- Report Medicare and other health insurance information to CHAMPVA.
TRANSITIONAL COVERAGE: TAMP AND CHCBP
TAMP and CHCBP may bridge coverage after active-duty service or another loss of TRICARE eligibility.
TAMP — Transitional Assistance Management Program
- Provides 180 days of premium-free transitional TRICARE coverage to eligible service members and family members.
- Eligibility is determined through the service branch and recorded in DEERS.
CHCBP — Continued Health Care Benefit Program
- Premium-based temporary continuation coverage after TRICARE eligibility ends.
- Coverage may last 18 or 36 months, depending on beneficiary status; enrollment deadlines apply.
SPINA BIFIDA HEALTH CARE BENEFITS PROGRAM
This VA program provides health care benefits for certain biological children of Veterans with qualifying service who have spina bifida.
Who may qualify
- The child must have a form of spina bifida other than spina bifida occulta.
- The Veteran parent must meet qualifying Vietnam or certain Korean service requirements.
- The child must have been conceived after the Veteran’s qualifying service.
What the program can provide
- Covered care and services related to spina bifida; separate compensation and vocational benefits may also be available.
AEP Open Enrollment
( October 15th - December 7th )
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