While Medicare may be daunting, turning 65 and becoming Medicare eligible can be a smooth transition with the right assistance.
As you read below, please keep in mind that these guidelines may vary depending on your individual circumstances. This is very generalized information as Medicare has so many caveats.
To ensure you are getting the proper information, please call our office. And there is no cost to utilize our expertise.
Michelle Thomas
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Michelle has lived in Bend since 1997 and is grateful to call Central Oregon home. You will find her and Boomer taking full advantage of all that the Northwest has to offer; seeking out new trails, kayaking and trying not to fall off their new paddle board!
As an animal lover Michelle has been volunteering with Street Dog Hero’s and has fostered several dogs transitioning into their new “forever homes”. While she struggles to say goodbye to the sweet pups (like Boomer) it warms her heart playing a small role in connecting a loving companion to his new family.
If she has any time off, she is quick to grab her passport and see what the world has to offer. Though the pandemic, while travel was unavailable, she attempted to knit (but never made it past the washcloth stage) and to improve her cooking skills with (sadly) the same level of success.
Michelle founded Fall River Health Insurance in 2009 and has been working in the Medicare market since 1991. As a Medicare specialist she recognized that transitioning onto Medicare is overly complex and wanted to create an agency that helps simplify the process.
Though the years Michelle has proudly helped several thousand clients with Medicare solutions.
Kelly Schroeder
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Kelly was born and raised in the California Bay Area and relocated to Bend in 1996. She has worked in the industry since 2006 and finds that helping folks navigate through the "Medicare Maze" to be extremely rewarding! Kelly's background is certainly extensive and will give you confidence in her ability to assist you through the Medicare process.
Her experience in both healthcare and insurance makes her the perfect fit when it comes to helping clients. A people person, undoubtedly, Kelly feels that every new client is also a new friend!
In her spare time, she is most likely outdoors and enjoys exploring and discovering new spots of beauty in and around Central Oregon. A self-proclaimed sports fanatic, she follows the Blazers and Ducks religiously as well as her hometown football and baseball teams.
Kelly has two grown daughters and most of her family lives in the area as well. "Enjoying the Central Oregon life with my family brings me joy! There is so much to do here in our community. I look forward to being here a very long time!"
Makayla Bullock
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After falling in love with the area, Makayla and her family moved to Bend at the beginning of 2022. Makayla enjoys taking advantage of all that Bend has to offer. You can find her biking, hiking, or paddle boarding in her spare time with her husband and their two small children. Makayla also firmly believes that you can never have too many hobbies. She enjoys photography, sewing, and reading, to name a few!
While in college, Makayla volunteered at a Marine Corps Air Station base, where she helped military families navigate military life. She graduated from Northern Arizona University in 2019 and was immediately drawn to helping people navigate Medicare. She finds assisting the people in her community to be incredibly rewarding.
Makayla worked as a Medicare broker in Idaho for a few years before moving to Bend. She and her family have made a home and plan to be here for many years. “I take pride in being a trusted resource and friendly face for my clients.
“I look forward to getting to know this community better!”
Boomer
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Fall River Health Insurance has their own Baby Boomer 😊
Little Boomer was a foster pup that kept getting “returned”. As a Chiweenie puppy he had two speeds: turbo and sleep, which was too much for most folks.
His real name is Boomerang as he just kept coming back… and we are so thankful he did!
When should I enroll onto Medicare?
If you are currently drawing Social Security, you will automatically be enrolled onto Medicare Parts A and B. If not, you may enroll online up to three months before your 65th birthday. Please call our office as we are happy to email the enrollment link.
If you currently have an employer plan, please call us before moving forward as you may be able to keep your employer plan and may not need Medicare quite yet.
I have coverage through my employer, do I need to take Medicare Part B?
This depends on several factors and with a quick call to our office we can better advise you.
However, in a nutshell, if your employer has under 20 employees you will absolutely need Parts A and B of Medicare as it will be “primary” coverage. Meaning Medicare pays before your employer plan pays on a claim. If you do not have Medicare in place, then your employer plan will not pay anything toward your expenses.
Also, Medicare and HSA’s (health savings accounts) do not play well together so if you have an HSA we should discuss this in more detail.
I have coverage through my employer, should I keep it or go onto Medicare?
This depends on several factors:
- What does your current health plan cover?
- Does this coverage meet your needs?
- Are you paying for the coverage or is your employer?
- If you are paying for the coverage, is it more expensive than Medicare would be?
- Do you have a spouse that is on your employer’s policy that would be impacted by a change?
I have coverage through the Veteran’s Administration, should I take Medicare as well?
Probably. There are a few things to consider as you look at Medicare and the VA:
- Do you have TriCare for Life coverage?
- Are you getting your medications through the VA?
- Would it be more convenient to work outside of the VA system?
- Are you experiencing issues with the referral process or unable to get in to see your VA physician in a timely manner?
- Would you like to see both civilian and VA physicians?
For instance, many Medicare Advantage plans offer “zero premium” policies (that’s right, it will not cost you a penny!) if you access your medications through the VA. These zero premium plans will offer you access to civilian care without jumping through the referral process required by the VA. The VA is a fantastic option, and we can very easily enhance these benefits at little or no cost to you.
Do I have to take Social Security when I go onto Medicare?
No. You can enroll onto Medicare and elect Social Security at a later date.
I do not take any medications do I need a prescription (Part D) plan?
Medicare really encourages you to have a drug plan. If you have coverage through your employer or the VA, you may not need any additional coverage. Be aware, if you choose to go without prescription coverage, Medicare has a penalty for late enrollment.
However, there are some very affordable prescription plans that will satisfy this requirement without breaking the bank. We are happy to provide you with the available options.
What is the difference between a Medicare Supplemental policy and a Medigap policy?
Nothing, these terms are synonymous, and Medicare uses both terms interchangeably.
What is the difference between a Medigap plan and a Medicare Advantage plan?
Both are very popular options, but it is an individual decision based on many factors (Are you a snowbird? Do you have VA coverage? Which physicians and clinics will you use?).
In a nutshell, Medicare Advantage plans have medical and prescription benefits rolled into one policy and typically have “extras” such as vision, dental, gym memberships and alternative care (acupuncture, chiropractic and naturopath). These premiums tend to be lower in exchange for copays as you seek medical services. These plans are often HMO’s so we need to make sure your physician is contracted accordingly.
Medigap policies have a small deductible and typically do not have copays for any services however the higher premiums reflect the benefit level. These policies do not include the “extras”. Medigap policies are medical only and would have to be paired with a prescription plan.
These plans are “apples and oranges” so we should review your specific needs to determine the best fit.
When can I change plans?
If you have a Medigap policy, we can review your options during your birthday month.
If you have a Medicare Advantage plan or a stand-alone prescription plan, we review your options in the Fall. Every October 15th through December 7th is the Annual Open Enrollment period. We will assist you in reviewing your current plan. If there is room for improvement we can change your plan for the following year.
I’ve just moved, do I need to change plans?
Maybe. Medicare plans vary state to state and even county to county. A simple change in your zip code will determine the plans available to you.