Medicare-Eligible?

 

About Me

Timothy Kelley

Licensed Insurance Agent

I moved to Oregon in 1976 where my spouse and I raised our 5 children. I started, built and sold 2 insurance agencies. I managed a large property and casualty insurance agency for 10 years and changed positions as Systems Administrator for another 8 years. I’m familiar with several different types of insurance policies. In February of 2023, I decided to retire from my prior agency and begin my career as a Medicare Advantage and Supplemental Insurance Agent. Throughout the years, I have met some wonderful people and have appreciated hearing their life experiences.

Timothy Kelley

 Services

Medicare Advantage

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare.

Medicare Supplement Insurance Plans 

Medigap or a Medicare Supplement helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs like copayments, coinsurance, and ductibles.

Hospital Plans

Depending on the state you live in and the insurance carrier some insurance plans may be available to help cover out-of-pocket expenses for hospital care and fill all or some of the gap in most Medicare Advantage Plans. Many hospital plans are indemnity type plans, meaning they pay the insured directly, regardless of other insurance coverage. Health questions may be included to determine eligibility.

Part D – Prescription Drug Plans

Original Medicare does not cover normal dental, vision or hearing costs. Some Medicare Advantage Plans may offer some coverage to these costs. Insurance and discount plans are available through private insurance companies to help cover these costs. These companies determine what the plans will cover, if there will be a deductible or co-pay, and how much the premiums will be. Some plans may exclude some pre-existing conditions.

Cancer, Heart Attack, Stroke Plans

Original Medicare and Medicare Advantage Plans pay part of cancer treatments. Other cancer insurance plans are built to pay a lump-sum benefit to help pay coinsurance and co-payments often accompanying cancer treatments. Plans may also be available in your state to cover advanced screening. Qualification includes pre-existing condition look-backs. Contact us for details of these plans and availability in your state.

 Dental, Vision, and Hearing Plans

Original Medicare does not cover normal dental, vision or hearing costs. Some Medicare Advantage Plans may offer some coverage to these costs. Insurance and discount plans are available through private insurance companies to help cover these costs. These companies determine what the plans will cover, if there will be a deductible or co-pay, and how much the premiums will be. Some plans may exclude some pre-existing conditions.

I am Contracted With

Aetna

Atrio

Pacific Source

Regence Blue Cross Shield

United HealthCare®

Coverage You Need

Medicare can be confusing. Get Medicare Tips. I am here to help you with any questions you may have.

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Experienced Insurance Agent

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No high pressure sales here, only education & advise

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Flexible & Virtual Appointments Available

ANSWERING YOUR TOP QUESTIONS &

Helping Clients Understand Plan Options ?

 

CAN I CONTINUE TO WORK AND ENROLL IN MEDICARE?

Yes, you can! But, we recommend evaluating all of your healthcare options (i.e., enrolling into Medicare versus staying on an employer group health plan or vice versa) instead of assuming that one is better for you than another. We can help you determine this so you are able to rest assured, knowing you have made a confident, educated decision for your health care needs.

 

WHAT IS A MEDICARE ADVANTAGE PLAN?

Medicare Advantage Plan, also known as Part C, is a Medicare Plan run by private insurance companies.  A Medicare Advantage Plan offers all of the benefits covered under Original Medicare and more. Medicare pays a fixed fee to the plan you choose in accordance with the 2003 Medicare Prescription Drug, Improvement, and Modernization Act. It covers all of the benefits covered under original medicare plus additional benefits.

8 THINGS TO KNOW ABOUT MEDIGAP POLICIES
  1. You must have Medicare Part A and Part B.
  2. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
  3. You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
  4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
  5. You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
  6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
  7. Some Medigap policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
  8. It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you’re switching back to Original Medicare. In other words, you cannot have both a Medigap policy and a Medicare Advantage Plan.
I AM DISABLED - WHEN CAN I GET MEDICARE?
You automatically get Part A and Part B after you get one of these:

  • Disability benefits from Social Security for 24 months
  • Certain disability benefits from the RRB for 24 months

You don’t need to sign up if you automatically get Part A and Part B. You’ll get your red, white, and blue Medicare card in the mail 3 months before your 25th month of disability.

When you decide how to get your Medicare coverage, you might choose:

  • Medicare Advantage Plan (Part C)
  • Medicare prescription drug coverage (Part D)

There are specific times when you can sign up for these plans, or make changes to coverage you already have.

WHAT IS THE DIFFERENCE BETWEEN MEDICARE & MEDICAID?

Medicare and Medicaid are both government health care programs but they are very different. Medicare is generally for people who are older or disabled. Medicaid is for people with limited income and resources. When a person qualifies for both programs out-of-pocket costs can be minimal.ps.

Contact Me

Send Me an Email

By providing the information above, I grant permission for a licensed insurance agent to contact me regarding my Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug plans. “A sales agent may mail, call, or e-mail as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans, or Medicare Supplement Insurance.”

503.949.1648

Calling the number above will direct you to a licensed insurance agent.

timothyjohnkelleysr@gmail.com

HOURS

M-F: 9am – 5pm

Weekends & Evenings

by Appointment

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Licensed In Oregon, Washington and Nevada