At Emerald Medicare, we’re committed to empowering our clients with the knowledge they need to make informed decisions about their healthcare. Hearing care is a critical – yet often overlooked – aspect of overall health, and we believe the topic deserves special attention. To shed light on the subject, we had the pleasure of speaking with Dr. Kathleen Wallace, Au.D., from Anywhere Audiology. Dr. Wallace is a well-respected and innovative audiologist with years of experience in hearing care & aural management. In this interview, Dr. Wallace shares her insights on hearing loss, the latest advancements in hearing aids, and how Medicare beneficiaries can access the care they need. Whether you’re already experiencing hearing loss or simply planning for the future, her expertise offers invaluable guidance.

Q: How does untreated hearing loss affect a person’s overall health, independence, and quality of life?

A: Untreated hearing loss has been linked to every facet of someone’s life; Studies show untreated hearing loss is linked to a reduction in quality of life, increased loneliness & social isolation, poorer mood, and increased depression. In addition, there are effects on your earning potential, relationship strain, and, when severe enough, safety concerns that may impact one’s independence. Perhaps most compelling is the correlation with dementia… Untreated hearing loss, particularly in mid-life, has been found to be the largest potentially modifiable risk factor for dementia in large studies published by the Lancet Commission and Johns Hopkins, to name a few. I must emphasize, however, that this is an example of correlation and not causation, meaning hearing loss itself does not cause dementia, but they often happen together. In other words, there are some changes that result from hearing loss (changes to the brain, social behavior, and cognitive load) that we know are not good for brain function. The good news is there is a robust body of evidence supporting the reversal of many of these negative effects of unmanaged hearing loss when hearing loss is managed through audiologic care, including the use of hearing aids, auditory training, or cochlear implantation. 

Q: How often should seniors get hearing exams, and why is it important to do so?

A: Ideally, folks over the age of 65 should be getting annual hearing tests, first to establish a baseline and to assess changes thereafter. This is particularly important for two reasons: 1. We are not very good at perceiving our own hearing sensitivity. The best course of action is to actually measure it to allow for more timely intervention, which will ultimately lead to better outcomes. 2. Not only does hearing loss become more prevalent as we age, but so do other health conditions that may increase your risk of hearing loss. Hearing is an important part of your overall health management, particularly when we think about healthy aging and maintaining independence. 

Q: Are there specific signs that indicate a senior should seek hearing care?

A: If you’ve never had a formal hearing test, or haven’t had a hearing test in a number of years, I highly recommend you get a test to establish a baseline. There is a lot of power in simply knowing your hearing sensitivity, and there is never an expectation for you to move forward immediately with hearing aids. Beyond that, it is important for you to have an honest look at your hearing – are you asking others to repeat themselves? Do you feel less confident at parties or social gatherings? Are you avoiding the phone? Do you need closed captions on your TV? Are family members or loved ones noticing your hearing? It might be uncomfortable to think about, but there is no shame in hearing loss.

There is a great questionnaire called the Hearing Handicap Inventory for Adults; this is a free online tool that may be a good place to start, whether it’s for yourself or for a family member. Lastly, it is recommended to pursue hearing care if you have ringing or buzzing in your ears (tinnitus), and medical evaluation by an ENT is recommended for any pain, fullness, discharge, dizziness, or sudden changes in hearing. 

Q: Have hearing aids evolved in terms of technology and usability and pricing for seniors? If so, how?

A: Hearing aids have changed drastically over the last 5 years, and even more dramatically when compared to those of previous generations. Modern hearing aids are essentially tiny computers- they have chips inside that use advanced algorithms to sample the sounds in your listening environment (up to thousands of times per second!) and automatically adjust themselves to the most appropriate setting for your environment. For example: are you at the beach with windy noise? Reading in a quiet room? At the theater? Eating out at a restaurant? All of these are very different environments from an acoustic perspective, and today’s hearing aids can automatically adjust & compensate appropriately.

Further, hearing aids are programmed uniquely to your own ears and tailored to sensitive areas across the frequency spectrum (or ‘pitches’) that you may have trouble with. Nowadays, they can go a step further to determine what amplification method(s) to employ based on the nature of the incoming sound in real time (ie. Dialogue vs. ambient noise vs. musical sounds, etc.). In this regard, it is almost like having a sound mixer in your ears.

While all of this might sound overwhelming, the good news is the advancements in technology have allowed for nearly all of this work to happen behind the scenes – and is based on how the audiologist programs your hearing aids. As the hearing aid user, all you must worry about is putting them in in the morning, taking them out at night, and some minimal cleaning. Hearing aids are often rechargeable now and offer Bluetooth connectivity if those are additional features you desire. 

Q: What are the core features that patients should consider when comparing different hearing aid models and brands?

A: The top priorities should always be sound quality for the user and practicality. 1: is it giving you the improvement you need in as natural a sound quality as possible? And 2: Can you use the hearing aids daily? Do they create more problems than they solve? I encourage anyone interested in exploring hearing aids to hear it for yourself – visit your Audiologist and demo multiple models from different manufacturers. From there, I’d say it’s the audiologist’s job to guide you on the pros and cons of all the additional features and considerations based on your unique hearing needs.

For example, you may desire the smallest hearing aid on the market, but your ear anatomy and/or severity of hearing loss may tell us that this is not the best treatment option for you. In addition, I think it’s important to mention if you intend to use your hearing aids everyday, make sure your audiologist understands your daily life. Maybe you are an avid golfer; you’d then need a hearing aid that can deal with wind noises well. If you love audiobooks, Bluetooth streaming may be important. If your hands aren’t working quite like they used to, rechargeable devices may be easier to use. 

Q: What are some common misconceptions about hearing care or hearing aids that you wish more people understood?

A: A lot of people think that hearing care equals hearing aids and that hearing aids are a “plug and play” solution. Your auditory system is quite complex, however, and hearing loss can lead to significant distortion and/or permanent damage to the hearing organs. There is a lot that goes into properly fitting hearing aids, and how the devices are programmed is far more important than the technology itself. If they are not set up appropriately for your hearing loss and anatomy, you will be substantially limiting your hearing aid benefit, if not further impacting your hearing abilities. I’d also mention that hearing aids, even when programmed well, should not be thought of as a “cure-all” solution; unfortunately, hearing loss is irreversible. We employ hearing aids to essentially harness & repurpose the hearing capacity that you have left.  You may need to use other tools like good communication strategies, remote microphones, or auditory training programs to maximize your benefit. 

Q: Could you talk about some of the social aspects of hearing loss? How may hearing loss affect one’s social life?

A: Evidence shows untreated hearing loss is linked to social isolation and loneliness, as well as reduced fulfillment in interpersonal relationships. To me, this is the most important aspect of hearing loss to consider. This also tends to be the most powerful motivator for people to do something about their untreated hearing. If you notice yourself withdrawing from conversation, opting out of social gatherings, or choosing not to take part in activities that typically bring you joy, I’d highly encourage you to think about how your hearing may be factoring in.

I’d also think about whether this is affecting anyone else in your life. There is something called Third Party Disability, which is the idea that your health condition could have an impact on loved one even if they do not have the condition themself. This is very common for people with hearing loss. For example, if one person in a married couple is withdrawing from social situations, odds are it will begin to impact the social life of their spouse as well. The good news is hearing loss management leads to a reversal of many of these negative social effects, not just for the person with hearing loss but also their loved ones. 

Q: What role(s) do family members or caregivers play in supporting seniors with hearing loss, and how can they be more involved in the process?

A: Family members can be very valuable assets to an audiology appointment. Because hearing loss tends to occur gradually over time, it is common for people’s loved ones to pick up on the hearing loss before they recognize it in themselves. To put it simply- you don’t know what you don’t hear. I find it helpful, when done tactfully, for family members to share their perspective and insights. The key, however, is to continue to emphasize that this is coming from a caring place and wanting the best for them. It should never be combative or a blame game, especially if the person is in denial. When a family member does pursue hearing care, I encourage you to be supportive and patient. Hearing loss and hearing aids are not easy! There may be a learning curve and there may still be times when you’ll need to repeat yourself. Just continue to be supportive and encouraging. As far as day-to-day maintenance, family members can be helpful to check if the hearing aids are inserted properly, the devices are being charged, or the batteries have been changed, and potentially taking on some of the tasks that require good vision and dexterity if those are concerns for the patient. 

Q: Could you share some important statistics on hearing loss amongst seniors today and/or overtime?

A: A simplification of the prevalence of hearing loss with age is that roughly 60% of people in their 60s, 70% of people in their 70s, 80% of people in the 80s and over 90% of people in their 90s have hearing loss. The odds are it will affect you at some point in your life!

Over 50 million adults in the United States have hearing loss and it ranks as the third most prevalent chronic condition in the US. Yet, only about 20% of people who would benefit from hearing aids actually use them. There are many contributing factors that tell us why this is the case, but the top 3 typically are: not perceiving enough difficulty, stigma, and price/cost.

Q: Do you ever encounter patients struggling to afford hearing aids? If so, what advice do you offer to seniors seeking affordable solutions?

A: Yes, unfortunately. Traditionally, hearing aids have not been covered, or are fairly limited in their coverage. This includes Medicare and dates back to how audiologists were categorized as providers with CMS and an outdated understanding of hearing treatment. Hearing aids typically retail anywhere from $3000 – $7000 for a pair through most practices, with no assistance from insurance. There are a few supplemental plans that may offer some limited coverage, but I’d be sure to read those benefits carefully to understand if there is a particular manufacturer of hearing aid or clinic you must use to take advantage of the benefit. If hearing aids remain out of reach, you can discuss a payment plan with the audiologist, consider an older model, see if you qualify for services through the VA if you are a veteran, look for funding through local organizations, determine if Costco is appropriate for you, or check if you meet the criteria for over the counter hearing aid options. There are also a few non-profits out there who offer hearing aids, but that will depend on your region.

Q: What advice would you give to seniors about selecting a hearing care provider or audiologist?

A: I think it is very important for you to select a hearing provider / audiologist you can trust. Typically, it is a good sign when an audiologist works with multiple hearing aid manufacturers because this will give you as many care options as possible. I’d find one that is in a location that is accessible and with a schedule that works for you. I’d also ask them questions about how they approach clinical decision making to see if matches your preference. For example, some people want joint decision making and others prefer more of a “doctor-knows-best” strategy. Lastly, ask around and see if there is someone your community trusts. This could be through word-of-mouth or reading reviews online.

I’m also happy to answer any questions you may have! And if you believe being seen in your home would be best for you, please let me know! Anywhere Audiology sees residents throughout the New York Tristate Area and we’re proud to be an independent, brand agnostic team of doctors of audiology.

Advice from the Experts: Medicare Guidance at Emerald Medicare

We want to extend our heartfelt thanks to Dr. Kathleen Wallace for sharing her invaluable expertise on hearing care and hearing benefits. At Emerald Medicare, we are committed to supporting your health and well-being, which includes providing education on aligned health subjects that impact your quality of life.

If you’d like to explore your Medicare options or need personalized advice, our expert team is here to help. Click below to schedule an appointment with one of our licensed brokers through Calendly, or contact us directly at the number or email below.

Contact Us:

• Phone: (888) 683-6372 or (845) 358-1220
• Email: office@emeraldmedicare.com

Vision and hearing care are vital for maintaining independence, social confidence, and overall health as we age. While these benefits are often taken for granted during working years with employer-provided coverage, transitioning to Medicare requires careful evaluation of available plans to ensure your needs are met. We’re here to help you navigate the changing landscape of Medicare Advantage benefits, and today we’ll turn our attention to vision and hearing care.

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Medigap vs. Medicare Advantage: What You Need to Know

Original Medicare doesn’t provide coverage for routine vision exams or hearing aids, though it does cover certain specialist visits, including audiology, optometry, and ophthalmology.

In contrast, Medicare Advantage (Part C) plans have increasingly expanded their vision and hearing benefits to address these gaps. 

As Medicare Advantage plans continue to evolve, they are enhancing their offerings in vision and hearing care, providing more comprehensive coverage for beneficiaries. Let’s take a closer look at what’s changing for 2025 and how you can make the most of your benefits.

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Expanding Vision and Hearing Coverage in 2025

In 2025, Medicare Advantage plans will further standardize and improve their vision and hearing benefits. These updates aim to enhance access to care while potentially lowering out-of-pocket costs for beneficiaries.

• Vision Care Enhancements: Plans are expanding allowances for prescription glasses and contact lenses, as well as covering a broader range of vision services.
• Hearing Aid Benefits: New standalone hearing aid benefits will introduce increasing annual allowances, ensuring beneficiaries can access financial support as their needs evolve:
• Year 1: $500
• Year 2: $1,000
• Year 3: $1,500

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Vision Coverage: What’s Included?

Medicare Advantage plans are designed to address the vision care needs of beneficiaries, offering benefits that often include:

• Routine Eye Exams: Most plans cover annual eye exams, essential for monitoring eye health and updating prescriptions, at no additional cost when using in-network providers.
• Prescription Glasses and Contacts: Many plans offer allowances for eyeglasses or contact lenses, making vision correction more affordable.
• Corrective Eye Surgeries: Some plans provide partial coverage for procedures like cataract surgery or LASIK, helping beneficiaries manage costs for these often-expensive treatments.
• Specialized Vision Devices: Coverage may also include adaptive devices, such as magnifiers, for those with specific vision needs.

Hearing Coverage: What’s Included?

Hearing care is another critical area of focus for Medicare Advantage plans. Here’s what beneficiaries can expect:

• Annual Hearing Exams: Covered by most plans to help identify hearing issues early and provide timely support.
• Hearing Aids and Fittings: Many plans cover the cost of hearing aids, including fittings and adjustments, ensuring the right fit and optimal assistance.
• Standalone Hearing Aid Benefits: As mentioned, these new benefits offer increasing allowances, helping beneficiaries afford hearing aids over time.
• Lower Out-of-Pocket Costs: By reducing copayments and coinsurance for hearing aids and related services, plans to make these essential devices more accessible.

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Maximizing Your Vision & Hearing Benefits

To make the most of your Medicare Advantage vision and hearing benefits, consider these tips:

1. Schedule Preventive Exams Early: Ensure you use the fully covered annual eye and hearing exams provided by your plan.
2. Check Allowances for Glasses and Hearing Aids: Understand your plan’s annual allowances and plan your purchases accordingly.
3. Use In-Network Providers: Save on costs by staying within your plan’s provider network.
4. Evaluate Your Plan During AEP: Use the Medicare Annual Enrollment Period to compare plans and switch to one that better fits your vision and hearing needs if necessary.

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Look Ahead to 2025 with Emerald Medicare

Medicare Advantage plans are continually enhancing their vision and hearing benefits, making them an attractive option for beneficiaries seeking comprehensive healthcare coverage. At Emerald Medicare, we’re here to guide you through these changes and ensure you find the best plan for your needs.

If you’re ready to explore your Medicare Advantage options, our team of expert advisors is here to help. Click below to schedule an appointment with one of our brokers through Calendly, or contact us directly at the number or email below.

Contact Us:

• Phone: (888) 683-6372 or (845) 358-1220
• Email: office@emeraldmedicare.com

As your trusted Medicare experts, Emerald Medicare is committed to helping you navigate your healthcare options with ease. Medicare Advantage (Part C) plans are a popular choice among beneficiaries, offering comprehensive coverage with additional benefits not included in Original Medicare. If you’re considering Medicare Advantage, this guide will walk you through how these plans work, their benefits, and how to choose the best plan for your needs.

What is Medicare Advantage?

Medicare Advantage (Part C) is an alternative to Original Medicare (Parts A & B) offered by private insurance companies approved by Medicare. These plans bundle hospital (Part A), medical (Part B), and prescription drug coverage (Part D) into one all-inclusive plan. Many also offer extra benefits like dental, vision, hearing, and even wellness programs—making them an attractive option for those seeking added value beyond traditional Medicare.

With Medicare Advantage, all healthcare services are managed through your plan’s network of doctors, hospitals, and pharmacies. While this structure helps control costs, it’s important to understand how provider networks function before enrolling, and how this may limit your options for medical care.

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What Do Medicare Advantage Plans Cover?

Unlike Original Medicare, which requires separate coverage for prescriptions (Part D) and supplemental benefits (Medigap), Medicare Advantage plans integrate multiple types of coverage into a single, bundled plan. Here’s what’s typically included:

Hospital Coverage (Part A) – Inpatient stays, skilled nursing facility care, and some home healthcare services.
Medical Coverage (Part B) – Doctor visits, outpatient services, diagnostic tests, preventive care, and durable medical equipment.
Prescription Drug Coverage (Part D) – Most Medicare Advantage plans include built-in drug coverage, covering a range of prescription medications.

Additional Benefits – Many Medicare Advantage plans also offer:

• Dental Coverage (routine cleanings, fillings, dentures, etc.)
• Vision Coverage (eye exams, glasses, and contacts)
• Hearing Coverage (hearing exams and hearing aids)
• Fitness Benefits (gym memberships, virtual exercise programs)
• Transportation (rides to medical appointments)
• Over-the-Counter (OTC) Allowances (stipends for medical supplies and everyday wellness products)

Because benefits vary by plan, it’s essential to compare options carefully or consult a Medicare expert to find the best fit for your healthcare needs.

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Why Should I Choose a Medicare Advantage Plan?

Medicare Advantage plans combine coverage, convenience, and cost savings into a single plan, making them a great option for many beneficiaries. Here’s why they appeal to millions of Medicare enrollees:

1. Comprehensive Coverage

Unlike Original Medicare, which requires additional plans for prescriptions and supplemental coverage, Medicare Advantage offers all-in-one protection with extra benefits.

2. Lower Out-of-Pocket Costs

Many Medicare Advantage plans have low or $0 monthly premiums, and they cap out-of-pocket expenses, protecting beneficiaries from excessive costs. In contrast, Original Medicare has no limit on annual medical expenses unless paired with a Medigap policy.

3. Extra Benefits Beyond Original Medicare

With dental, vision, hearing, and wellness perks, Medicare Advantage covers services not included in traditional Medicare, making healthcare more affordable and accessible.

4. Preventive Care & Care Coordination

Many Medicare Advantage plans focus on preventive care and managed healthcare, offering case management services, wellness incentives, and telehealth options for added convenience.

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Medicare Advantage vs. Medigap: Key Differences

Understanding the distinction between Medicare Advantage and Medigap (Medicare Supplement Insurance) is crucial when choosing a plan.

Medicare Advantage is best for those who prefer bundled coverage and lower upfront costs, while Medigap is ideal for those who want broad provider access and more predictable expenses.

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How to Choose the Right Medicare Advantage Plan

When selecting a Medicare Advantage plan, consider the following:

🔹 Provider Network: Does your preferred doctor, hospital, or pharmacy accept the plan? HMOs require referrals and network providers, while PPOs offer more flexibility.
🔹 Prescription Drug Coverage: Check the plan’s formulary (covered drug list) to ensure your medications are included.
🔹 Extra Benefits: Need dental or vision care? Want access to telehealth or home fitness programs? Compare added perks to find a plan that suits your lifestyle.
🔹 Out-of-Pocket Costs: Compare premiums, deductibles, copays, and maximum out-of-pocket (MOOP) limits to determine your total expected expenses for the year.
🔹 Star Ratings: Medicare.gov rates plans on a 5-star scale based on customer satisfaction and quality of care. A higher-rated plan often means better coverage and service review from real beneficiaries.

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How to Enroll in a Medicare Advantage Plan

You can enroll in a Medicare Advantage plan during specific enrollment periods:

📌 Initial Enrollment Period (IEP) 
Starts 3 months before you turn 65 and continues 3 months after your birthday month.
📌 Annual Enrollment Period (AEP) 
October 15th – December 7th each year. You can switch, join, or drop a Medicare Advantage plan.
📌 Medicare Advantage Open Enrollment Period
January 1st – March 31st each year. If you’re already enrolled in a Medicare Advantage plan, you can switch to a different plan or return to Original Medicare during this time.

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Explore Medicare Advantage with Emerald Medicare

Choosing a Medicare Advantage plan is an important decision that requires careful consideration of your healthcare needs, provider preferences, and financial situation. At Emerald Medicare, we’re dedicated to helping you find the best-fit plan with zero-cost expert guidance.

If you’re considering a Medicare Advantage plan or need help comparing options, we’re here for you! Click below to schedule an appointment with one of our expert brokers through Calendly or contact us directly:

As your dedicated team at Emerald Medicare, we understand that navigating the Medicare enrollment process can be overwhelming. That’s why we’re here to provide clarity on one of the most valuable options available to Medicare beneficiaries: Medicare Supplement Insurance, also known as Medigap. This comprehensive guide will walk you through what Medigap plans are, how they work, and how they can benefit you by filling the gaps left by Original Medicare.

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What are Medicare Supplement (Medigap) Plans?
A Comprehensive Guide

A Medigap plan (Plan G, Plan N, etc.) is private health insurance designed to work alongside Original Medicare (Parts A & B).

While Original Medicare provides broad coverage, it doesn’t cover everything. For example, beneficiaries are still responsible for certain deductibles, co-pays, coinsurance, and out-of-pocket costs. Medigap plans help cover these “gaps” in Medicare, providing financial protection and peace of mind.

Here’s how it works:

• Original Medicare pays for its share of covered healthcare services (typically 80% of approved costs).
• Medigap plans help pay for the remaining out-of-pocket costs, like the 20% co-insurance on doctor visits or hospital stays.

What Do Medigap Plans Cover?

Medigap plans can help pay for various out-of-pocket expenses that Original Medicare doesn’t cover. Depending on the Medigap plan you choose, it may cover:

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance or copayments
• The first three pints of blood used in a medical procedure
• Part A hospice care coinsurance or copayments
• Skilled nursing facility care coinsurance
• Part A deductible
• Part B deductible (for some older plans)
• Part B excess charges
• Foreign travel emergency coverage (up to plan limits)

Each Medigap plan is standardized, meaning that the benefits for each plan type are the same no matter which insurance company offers the plan. For example, Medigap Plan G from one insurance company will offer the same benefits as Medigap Plan G from another. However, premiums can vary based on things like your home state, income, and more, so it’s essential to compare offerings or work with a Medicare broker, like our team at Emerald Medicare, to find the best plan for your needs and budget.

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Why Should I Choose a Medigap Plan?

Medigap plans, as opposed to Medicare Advantage (Part C) plans, are particularly beneficial for individuals who:

• Want predictable healthcare costs: If you want to avoid unexpected out-of-pocket expenses, a Medigap plan can provide peace of mind by covering those costs.
• Travel frequently: Some Medigap plans offer coverage for medical care when traveling outside the U.S. (a benefit not offered by Original Medicare).
• Need frequent medical care: If you visit doctors or specialists regularly or require frequent hospital stays, Medigap plans can help reduce the financial burden of these services.
• Prefer flexibility in healthcare providers: Unlike Medicare Advantage plans, Medigap plans don’t have network restrictions. You can see any doctor or specialist nationwide who accepts Medicare.

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Medigap vs. Medicare Advantage: What’s the Difference?

It’s essential to understand that Medigap and Medicare Advantage plans are different, and you cannot have both – only one or the other.

• Medigap works with Original Medicare (Parts A and B) to cover out-of-pocket medical costs, like co-insurance and/or certain deductibles. However, as prescription medications are not covered by Medigap plans, you are also required to enroll in a Part D plan (Prescription Drug Plan) when enrolling in a Supplemental plan. In tandem, A Medigap plan + a Prescription Drug Plan is a highly comprehensive option for a higher monthly premium – with less restrictions than Medicare Advantage. Any doctor’s office in America will accept your Medigap insurance as long as their office accepts Medicare.

• Medicare Advantage (Part C) is an alternative to Medicare Supplement + Part D coverage that combines hospital, medical, and drug coverage into one all-encompassing plan, often including additional benefits like dental or vision. However, Medicare Advantage plans all have their own unique network of ‘preferred’ medical providers that beneficiaries are limited to, meaning the patient will be 100% financially responsible for services received from Out-Of-Network doctors. Furthermore, some Medicare Advantage plans provide less comprehensive drug coverage when compared to dedicated Prescription Drug Plans (Part D) and their formularies.

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How to Enroll in a Medigap Plan

You can enroll in a Medigap plan during your Initial Enrollment Period [IEP] – which begins as you approach age 65 – after enrolling in Original Medicare (Parts A & B). This six-month IEP window is critical because during this time, you have guaranteed issue rights, meaning insurance companies can’t deny you coverage or charge higher premiums based on your health status. After this period, you may still be able to apply for a Medigap plan, but insurers can use medical underwriting to determine your eligibility and rates.

How to Choose the Right Medigap Plan

Choosing the right Medigap plan depends on your specific healthcare needs, budget, and lifestyle. Here are a few tips to help you decide:

1. Assess your current health needs: If you frequently visit doctors or specialists, a Medigap plan that covers Part B copayments and coinsurance can be very beneficial.
2. Consider your travel habits: If you travel frequently, especially outside the U.S., look for a Medigap plan that includes foreign travel emergency coverage.
3. Plan for the long term: While some Medigap plans may have higher premiums, they can save you money in the long run by limiting out-of-pocket expenses.
4. Consult with a Medicare broker: A licensed Medicare broker, like the experts at Emerald Medicare, can help you compare different Medigap options, review costs, and find the plan that best suits your needs.

For advice on choosing a Prescription Drug Plan, read our Blog Post to learn more:  

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Explore Medigap Options with Emerald Medicare

At Emerald Medicare, we’re here to help you make informed decisions about your healthcare. Medigap plans can be a great way to secure financial peace of mind while ensuring that you get the care you need. Our team of licensed Medicare experts will guide you through the process, helping you understand your options and choosing a plan that fits your unique needs.

If you’re interested in learning more about Medigap plans or need help finding the right one for you, we’re here to help. Click below to schedule an appointment with one of our expert brokers through Calendly, or contact us directly:

Contact Us:
Phone: (888) 683-6372 or (845) 358-1220
Email: office@emeraldmedicare.com

Medicare Open Enrollment is one of the most important times of the year for Medicare beneficiaries. It’s your opportunity to review your current healthcare coverage, make changes, or enroll in a new plan to better suit your needs. As your trusted Medicare experts, Emerald Medicare is here to help guide you through the process with objectivity and always with your best interest in mind.

What Can You Do During Medicare Open Enrollment?
During AEP, you have several options for updating your Medicare coverage, including:

1. Switching from Original Medicare to Medicare Advantage
If you’re currently enrolled in Original Medicare (Parts A and B) which is only 80% medical coverage and no Part D coverage and may want to explore additional ancillary benefits and look at the option of a Medicare Advantage (Part C and D) plan. Medicare Advantage plans often offer coverage beyond Original Medicare, such as dental, eye exams, hearing, and prescription drug coverage.

2. Switching from Medicare Advantage back to Original Medicare
If your Medicare Advantage plan no longer meets your needs or you prefer the flexibility of Original Medicare, you may be able to switch back to Original Medicare during AEP based on the state you live in and the pre-existing rules for each state. You may also want to consider enrolling in a Medicare Supplement (Medigap) plan to help cover more of the out-of-pocket costs but with a higher premium cost. These plans are offered without some of the ancillary benefits the Medicare Advantage plans offer.

3. Changing Medicare Advantage plans
If you’re already enrolled in a Medicare Advantage plan but are unsatisfied with your coverage, you can review your doctors and medications to consider a change to a different Medicare Advantage plan during AEP that best suits your health and your needs . This is the best time of year to compare plans and ensure you’re getting the best benefits that you need or want at the cost that fits your budget.

4. Enrolling in or changing your Medicare Part D (Prescription Drug Plan)
If you’re not currently enrolled in a Medicare Part D plan and need prescription drug coverage, you can sign up for one during AEP. Also, you can change to a different Part D plan when you are on Original Medicare if your current plan’s formulary, premiums or co-pay costs has changed.

Key Dates for Medicare Open Enrollment

• October 15: Open Enrollment begins. This is your first chance to review your current coverage and make any changes or enroll in new plans for the upcoming year.
• December 7: Open Enrollment ends. After this date, you won’t be able to make changes to your Medicare coverage unless you qualify for a Special Enrollment Period (SEP). Check with your broker if you have the need to change any of your plan decisions after this date.
• January 1: Any changes made during Open Enrollment will go into effect on this date.

Tips for Making the Most of Medicare Open Enrollment

1. Review Your Current Coverage
• Before making any changes, take the time to review your current plan’s coverage for the new year. A Annual Notie of Change is the document that was sent to you with any changes that your plan is offering for the new year. Ask yourself if your needs or budget have changed over the past year. Have you been prescribed new medications or seeing any new doctors? Do you need additional coverage, such as dental or eye exam coverage?
2. Compare Plans on Medicare.gov
• One of the best tools for comparing Medicare plans is the Medicare Plan Finder on Medicare.gov. This website allows you to compare costs, coverage, and carrier ratings of different Medicare Advantage, Part D, and Medigap plans. The Emerald Medicare team uses this trusted resource to help our Medicare enrollees find the best options for their healthcare needs.
3. Consider Your Medications
• Prescription drug coverage is a critical component of Medicare. If you take medications regularly, it’s important to ensure that your Part D plan’s formulary (the list of covered drugs) still covers your prescriptions at an affordable cost. Make sure to compare different Part D plans to avoid surprises in the new year.
4. Check Your Providers
• If you’re considering a Medicare Advantage plan, it’s important to confirm that your preferred doctors, specialists, and facilities are in-network. Provider networks can change from year to year, so always verify that your healthcare team will be covered by the plan you choose.
5. Look for Changes in Benefits
• Medicare Advantage plans often update their benefits from year to year. During AEP, review the benefits offered by different plans, such as coverage for dental, vision, hearing, and fitness memberships. Be sure to choose a plan that offers the additional benefits you value most. Review your Annual Notice of Change documentation that you received in the mail. Called a ANOC.
6. Get Help from a Medicare Broker
• The Medicare Open Enrollment period can feel overwhelming, but you don’t have to go through it alone. By working with a Medicare broker, you can get expert, personalized advice based on your healthcare needs and budget. At Emerald Medicare, we can walk you through all your options and help you make the best choice for the coming year.

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Stay Prepared for Open Enrollment with Emerald Medicare

The Medicare Annual Enrollment Period is your best chance to review your healthcare coverage and make the changes that will benefit you in the year ahead. By taking the time to compare plans, review your current coverage, and explore new options, you can ensure you have the right plan for your needs.

Need help navigating Medicare Open Enrollment? At Emerald Medicare, we’re here to provide the expert guidance you need to make informed decisions. Click below to schedule an appointment with one of our expert brokers through Calendly, or contact us directly at the number or email below.

Contact Us:

• Phone: (888) 683-6372 or (845) 358-1220
• Email: office@emeraldmedicare.com