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Ashford Insurance

Medicare Open Enrollment or Annual Enrollment Period

Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford is the owner of Ashford Insurance, an independent health insurance agency specializing in Texas Medicare insurance.

During this time, patients can switch from Original Medicare to Medicare Advantage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are a type of Medicare health plan offered by private companies that contract with Medicare.

Medicare open enrollment for coverage begins Oct. 15 and runs through Dec. 7.

During this time, patients can switch from Original Medicare to Medicare Advantage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are a type of Medicare health plan offered by private companies that contract with Medicare. Medicare Advantage Plans provide all of a patient’s Part A and Part B benefits. Most MA Plans offer prescription drug coverage, “Part D.”

Patients can join a Medicare Advantage Plan if they live in the service area of the plan they wish to join, if they already have Medicare Part A and Part B, and if they don’t already have end-stage renal disease. Patients who join MA Plans are still in the Medicare Program with all of its rights and protections.

Some of the types of MA Plans:

— HMO-POS (Health Maintenance Organization Plan – Point of Sale): Allows patients to see doctors, hospitals and other health professionals that participate in its network. These are HMO plans that may allow you to get some services out-of-network for a higher co-payment or coinsurance. In most cases, Just like HMOs they require patients to pick a primary care physician, and they need a referral to see a specialist in most cases.

— RPPO (Regional Preferred Provider Organization Plan): RPPO plans offer coverage through a network of providers, but patients are allowed to access out-of-network care for covered services, usually for a high cost. If patients go to doctors and hospitals in the plan’s network, they will generally pay less. Patients do not need to choose a primary care doctor with a RPPO, and usually do not need a referral to see a specialist.

— SNP (Special Needs Plans): SNPs are only available to Medicare beneficiaries with specific diseases, health conditions or financial circumstances. The plans are structured to benefit their members according to their health needs. With an SNP, patients need to visit in-network doctors and hospitals, unless they need emergency or urgent care or in other limited situations. The plans usually require that patients have a primary care doctor or a care coordinator. In addition, patients usually need a referral to see a specialist.

For more information on Medicare and Medicare Advantage Plans, please visit https://ashfordinsurancegroup.com/ or call 817-952-3153.

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Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford, “The Medicare Insurance Lady”, has been helping Medicare eligibles in Texas with their Medicare Insurance since 2005.