When can I enroll in Medicare?

Most people first become eligible during their Initial Enrollment Period, a seven-month window that starts three months before the month you turn 65 and ends three months after. There is also an Annual Enrollment Period each year from October 15 to December 7, when you can change Medicare Advantage or Part D plans, and a Medicare Advantage Open Enrollment Period from January 1 to March 31. Special Enrollment Periods may apply if you lose other coverage or move. We can help you figure out which window applies to your situation.

What is the difference between Medigap and Medicare Advantage?

Medicare Supplement (Medigap) works alongside Original Medicare and helps pay costs like deductibles and coinsurance, letting you see any provider that accepts Medicare nationwide, usually for a monthly premium. Medicare Advantage (Part C) replaces Original Medicare with a private plan that often bundles prescription drug coverage and extras like dental or vision, typically using a provider network with lower or no premiums but more cost-sharing as you use care. Which is better depends on your health, budget, providers, and travel. We walk you through the trade-offs for your specific circumstances.

Do I have to pay to work with a Medicare insurance agent?

No. Our services come at no cost to you. Medicare agents and brokers are paid commissions by the insurance carriers, so you pay the same plan premium whether you enroll through us or on your own. Working with a licensed agent gives you help comparing options at no additional charge.

Can I get Medicare coverage if I have kidney disease or am on dialysis?

Yes. People with End-Stage Renal Disease (ESRD) can qualify for Medicare, and recent rule changes have expanded Medicare Advantage options for people on dialysis or awaiting a kidney transplant. The right choice depends on your treatment, providers, and transplant plans, and the details matter a great deal. We have specific experience helping dialysis and transplant patients navigate these decisions.

Do you only serve clients in Port St. Lucie?

We are based in Port St. Lucie and serve the Treasure Coast in person, but as a licensed Florida agent we help clients across the state by phone and video. Most of our work is done remotely, so you can get the same guidance whether you are local or elsewhere in Florida.

Are You A New Dialysis Patient? - Sean Watson Insurance

Are You A New Dialysis Patient?

Summary

Starting dialysis and becoming eligible for Medicare can feel overwhelming. Dialysis clinics may provide basic insurance education, but they cannot recommend specific plans. A licensed Medicare insurance agent, like us, can help compare coverage, costs, provider networks, and financial assistance options, especially for patients facing high premiums or limited plan availability before age 65.

If you’re new to dialysis and you’re getting your treatments at a major dialysis clinic, and you’ve just recently become eligible for Medicare, you’re probably realizing that there’s a lot to learn when it comes to understanding your Medicare insurance option.

Some of these dialysis clinics try to assists their patients by providing some sort of basic level insurance education through some sort of in-house educational department.

These individuals are typically trained to provide some sort of generalized insurance education to their patients, to help them become more knowledgeable about the insurance products available to help cover the high cost of care associated with being a dialysis patient.

This is a wonderful service that’s provided, but it very often lacks a very important piece of the puzzle, which is to help patients to actually select which Medicare insurance plans to enroll in. One of the main reasons why these “insurance educators” are unable to assist in this regard is because they’re usually not licensed insurance sales agents. This prevents them from being able to make any type of plan-specific recommendations.

For someone who is on dialysis and brand new to Medicare, trying to navigate the vast number of different plans that are on the market, combined with doing all of the necessary research to find out if all of one’s doctors and healthcare providers are in-network with these plans, can be quite a huge undertaking, and will require a considerable amount of time, and this is really the area that the assistance of a licensed insurance sales agent, like myself, is most needed.

Depending on the state you live in, and the insurance products available in your coverage area, some of these Medicare insurance plans may have a monthly premium, especially when you’re looking at Medicare Supplement plans. These plan premiums can very often be several hundred dollars per month, and for many dialysis patients, this can be a rather large expense, especially if you’re on a fixed income and you’re only receiving Social Security disability income benefits. Some states will even penalize you by charging a significantly higher premium, or not even offer Medicare supplement plans as an option, if you are under the age of 65. For some patients, financial assistance may be available for those who qualify. Please feel free to reach out to us if this may be something of interest to you.