Medicare Resources

Medicare ResourcesIn Belvidere, Rockford, IL, Marengo, Joliet, Morris, Woodstock, and the surrounding areas

* Areas served vary by plan.

Medicare: What You Need to Know

Medicare has:

Part A Hospital Insurance – Most people don’t pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Part B Medical Insurance – Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors’ services and outpatient care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

Prescription Drug Coverage – Most people will pay a monthly premium for this coverage. In January 1, 2006, Medicare prescription drug coverage became available to everyone with Medicare. This coverage is to help you lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

* This information comes from www.cms.gov

Are You Eligible for Medicare?

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States.

If you are not 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

While you don’t have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don’t get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.

Have questions?

Give us a call and let us help you with your Medicare Health insurance needs.

By contacting the phone number on this website you will be directed to a licensed agent.

Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:

If you are under 65, you can get Part A without having to pay premiums if:

Medicare-Related Enrollment Dates and Guidelines

Mark your calendar with these key dates!

October 1, 2025

Start comparing your current Medicare health or drug coverage with options for 2026. You may be able to save money or get extra benefits.

October 15 - December 7, 2025

Change your Medicare health or drug coverage for 2026, if you decide to. You can join, switch or drop a Medicare Advantage Plan or Medicare drug plan, or switch to Original Medicare during this Open Enrollment Period each year.

January 1, 2026

New coverage begins if you made a change. If you kept your existing coverage and your plan’s costs or benefits changed, those changes also start on this date. (Contact your plan if these changes aren’t in your account after 10 days.)

January 1 - March 31, 2026

If you’re in a Medicare Advantage Plan, you can change to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time. Any changes you make will be effective the first day of the month after the plan gets your request.

During this period, you can’t switch from Original Medicare to a Medicare Advantage Plan, join a Medicare drug plan if you’re in Original Medicare, or switch from one Medicare drug plan to another if you’re in Original Medicare.

When should I buy a Medicare Supplement policy?

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which is the six-month period that begins on the first day of the month in which you turn 65 or older and have enrolled in Part B. (Some states have additional Open Enrollment Periods.) After this enrollment period, you may not be able to buy a Medigap policy. If you are able to buy one, it may cost more.

If you delay in Part B because you have group health coverage based on your (or your spouse’s) current employment, your Medigap Open Enrollment Period won’t start until you sign up for Part B.

What to consider when choosing or changing my coverage

As you review your Medicare health coverage, here are some things to consider to determine if you have the right coverage or should be loking for a new policy.

Coverage

How well does the plan cover the services you need?

Your other coverage:

If you have other types of ealth or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your benefits administrator or insurer before making any changes.

Costs:

How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you could pay out-of-pocket for medical services? Make sure you understand any coverage rules that may affect your costs.

Doctor and hospital choice:

Do your doctors accept the coverage?
Are the doctors you want to see accepting new patients?
Do you have to choose your hospital and health care providers from a network?
Do you need to get referrals?

Prescription drugs:

Do you need to join a Medicare Prescription Drug Plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What’s the plan’s overall star rating? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions? Are you eligible for a free Medication Therapy Management (MTM) program?

Quality of care:

Are you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. How have Medicare and other people with Medicare rated your health and drug plan’s care and services? Get help comparing plans and providers.

Convenience:

Where are the doctor’s offices? What are their hours? Which pharmacies can you use? Can you get your prescriptions by mail? Do the doctors use electronic health records (EHRs) or E-prescribe? Can you get an electronic copy of your information by email or to store in a personal health record? Which pharmacies can you use? Is the pharmacy you use in the plan’s network? If it’s in the network and your plan offers preferred cost sharing, does your pharmacy offer preferred cost sharing? You may pay less for some drugs at pharmacies that offer preferred cost sharing. Can you get your prescriptions by mail?

Travel:

Will the plan cover you if you travel to another state or outside the U.S.?

Information obtained from www.medicare.gov

We know you have questions.

Please give us a call so that we can help you make the right decision about the policies that best suit your needs.

Where to Get Your Medicare Questions Answered

Medicare.gov

To get general or claims specific Medicare information and important telephone numbers. If you need help in a language other than English or Spanish, say “Agent” to talk to a customer service representative.

1-800-633-4227
TTY: 1-877-486-2048

Website: www.medicare.gov

State Health Insurance Assistance Program (SHIP)

To get free personalized Medicare counseling on decisions about coverage; help with claims, billing, or appeals; and information on programs for people with limited income and resources.

Call 1 800 MEDICARE to get the telephone numbers of SHIPs in other states.

Social Security

To get a replacement Medicare card; change your address or name; get information about Part A and/or Part B eligibility, entitlement, and enrollment; apply for Extra Help with Medicare prescription drug costs; ask questions about premiums; and report a death.

1-800-772-1213
TTY: 1-800-325-0778

Website: www.socialsecurity.gov

Coordination of Benefits Contractor

To get information on whether Medicare or your other insurance pays first and to report changes in your insurance information.

1-800-999-1118
TTY: 1-800-318-8782

Department of Defense

To get information about TRICARE for Life and the TRICARE Pharmacy Program.

1-866-773-0404 (TFL)
TTY 1-866-773-0405

1-877-363-1303 (Pharmacy)
TTY 1-877-540-6261

Website: www.tricare.mil/mybenefit

Department of Health and Human Services

Office of Inspector General—If you suspect Medicare fraud.

1-800-447-8477
TTY 1-800-377-4950

Website: www.stopmedicarefraud.gov

Office for Civil Rights

If you think you were discriminated against or if your health information privacy rights were violated.

1-800-368-1019
TTY 1-800-537-7697

Website: www.hhs.gov/ocr

Department of Veterans Affairs

If you’re a veteran or have served in the U.S. military.

1-800-827-1000
TTY 1-800-829-4833

Website: www.va.gov

Office of Personnel Management

To get information about the Federal Employee Health Benefits Program for current and retired Federal employees.

1-888-767-6738
TTY 1-800-878-5707

Website: www.opm.gov/insure

Railroad Retirement Board (RRB)

If you have benefits from the RRB, call them to change your address or name, check eligibility, enroll in Medicare, replace your Medicare card, and report a death.

Local RRB office or 1- 877-772-5772

Quality Improvement Organization (QIO)

To ask questions or report complaints about the quality of care for a Medicare covered service or if you think your service is ending too soon.

Call 1-800-MEDICARE to get the telephone number for your QIO.

Our commitment is to provide honest, personal, and experienced guidance that helps you protect your health and your savings.

Contact us today to learn more about Medicaid insurance, Medigap, Medicare, and more in Belvidere, Rockford, Marengo, Joliet, Morris, Woodstock, IL, or the surrounding areas.