Having a local agent who understands the ever-changing Medicare landscape is crucial. The agents of Shield Financial & Insurance Services take pride in helping our clients understand their Medicare options and empowering them to make the best choices for their healthcare needs. We represent multiple companies across numerous states and have access to products, including:

• Medicare Advantage Plans
• Medicare Supplements
• Medicare Part D Plans
• Claims Assistance
• Medicare Appeals
• Low Income and Part D Penalty Help
• Military and VA Benefits available to those who qualify

For more information about these plans, please reach out through the contact form or call us at 801.209.9598.

Initial Enrollment Period (IEP)
This period usually begins when a newly eligible Medicare beneficiary’s Part B (Medical) coverage starts, providing a window to enroll in a Medicare product of their choice. For most Medicare recipients, this occurs three months prior to three months after the month the recipient turns 65.

Annual Enrollment Period (AEP)
AEP takes place each year from October 15 to December 7. During this time, Medicare members can change their plans for coverage for the upcoming year.
Medicare Advantage Open Enrollment Period (OEP)
From January 1st to March 31st each year, you can make the following changes during the Medicare Advantage Open Enrollment Period:

• Switch from one Medicare Advantage Plan (with or without drug coverage) to
• Disenroll from your Medicare Advantage Plan and return to Original Medicare, allowing you to join a Stand-Alone Medicare Prescription Drug Plan (Part D).
• If you enrolled in a Medicare Advantage Plan during your Initial Enrollment Period, you could change plans or return to Original Medicare within the first three months of having Medicare.

During this period, you cannot:

• Switch from Original Medicare to a Medicare Advantage
• Join a Medicare Prescription Drug Plan if you’re an Original

Special Enrollment Periods typically occur when a Medicare recipient has a major life event occur, such as:

• Moving outside their plan’s service area

• Losing certain employer-sponsored insurance benefits that were continued beyond one’s initial eligibility period

• Qualifying due to a specific health issue (i.e. End-Stage Renal Disease and other health issues)

We’re here to help you navigate all enrollment and disenrollment options. If you have any questions, or if you are not sure which enrollment period applies to your situation, feel free to fill out the contact form or call our office at 801.209.9598 to speak with an agent of S.H.I.E.L.D. Financial & Insurance Services.

Medicare recipients have a variety of options to choose from, which can be grouped into a few main categories:

Original Medicare (Parts A and B):

• Part A: Covers 80% of costs due to hospital stays after a $1,676 deductible (for 2025). There are co-insurance payments for daily hospitalization as well. Part A also covers 80% of skilled nursing facility care, hospice, and some home health. The cost for Medicare Part A was paid for through the taxes you (or your spouse) paid during their working years, so it will, with some exceptions, have a $0 premium.

• Part B: Covers 80% of outpatient care, doctor visits, preventive services, and some home health. Premiums for Part B are $185 per month (for 2025) and can be billed either to the recipient or deducted from their Social Security benefits. Medicare Part B has a deductible (for 2025) of $257.

Remember that Original Medicare will only cover about 80% of the cost for your care. To cover the remaining 20%, along with the deductibles and co-payments, we suggest you get either a Medicare Supplement or Medicare Advantage plan. These are discussed below.

Medicare Advantage Plans (Part C):

• Offered by private insurance companies, these plans:
• Include all benefits of Original Medicare (Parts A and B).
• Generally include prescription drug coverage (Part D).
• Have a variety of network choices, including HMOs, PPOs, and more.
• Often include additional benefits like vision, dental, and hearing coverage.

Will offer perks such as gym membership reimbursement and cash benefits that help pay for necessities such as groceries, gas and utility bills. Medicare Advantage (Part C) plans typically come with annual deductibles, co-payments and coinsurance (in addition to the deductibles of Original Medicare). Many Medicare Advantage plans are available for as little as $0 a month.

Medicare Prescription Drug Plans (Part D):
Stand-alone plans that provide coverage for prescription medications. These can be added to Original Medicare or included in Medicare Advantage plans. New for 2025 Medicare prescription drug plans, the most a recipient should expect to pay for their medications is $2,000.

Medicare Supplement Insurance Plans (Medigap Plans G, K-N):

• Offered by private insurance companies, these plans:
  Cover out-of-pocket costs not covered by Original Medicare (i.e. deductibles for hospitalization, co-insurance and co-pays, tests, imaging, surgeries, etc., with some exceptions).
• Will cover any visit with any doctor that accepts Medicare (Less the annual Part B deductible… with some exception).
• Are not restrictive like an HMO, which requires specialist referrals from a primary care physician.
• There will be a premium attached, which is generally determined by the insurance company through whom the plan was purchased.

With the exception of a Medicare recipient’s Initial Enrollment Period (IEP), Medigap plans must be underwritten. Participation in these plans may be denied if the applicant has experienced any one of a variety of medical conditions. Each option has its own benefits, costs, and coverage rules, so recipients should carefully consider their healthcare needs and financial situation when choosing a plan.

We’re here to help you understand your Medicare coverage options. If you have any questions, or if you are not sure which plan best fits your situation, fill out the contact form or call our office at 801.209.9598 to speak with an agent of S.H.I.E.L.D. Financial & Insurance Services.

Medicare charges different late enrollment penalties for Part A, Part B, and Part D:

Part A Penalty
The penalty is 10% of your monthly premium for each year you delayed enrollment, but it’s charged for double the number of years you delayed. For example, if you delayed enrollment by two years, you’ll be charged for four years.

Part B Penalty
The penalty is 10% of your premium for each year you could’ve enrolled. The penalty applies for life or until you leave your Part B plan.

Part D Penalty
The penalty for not signing up for a prescription drug plan is 1% of your monthly premium. This penalty is payable as long as you’re enrolled in Part D. You may also have to pay a late enrollment penalty if you go longer than 63 days without having prescription drug coverage of any kind.

Insurance carriers may cancel your coverage if you do not pay your premiums. If you miss a payment, you will enter a 90-day grace period, during which you can catch up on your payments. Bring your payments current and you will not lose your coverage.

Avoiding late penalties is something every Medicare recipient should strive for. It is important to make timely decisions about your Medicare options, even if you don’t think you will ever use them (like a prescription drug plan). If you have any questions, or if you think you might be subject to a Medicare penalty, fill out the contact form or call our office at 801.209.9598 to speak with an agent of S.H.I.E.L.D. Financial & Insurance Services.