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‘We will shop the market for you’

BUSINESS PROFILE: Medicare Insurance Advisors, Sartell

Medicare Insurance Advisors will guide clients to best plan... at no cost

By Scott Thoma


Medicare options are continually changing from year to year, making decisions even more stressful for those approaching Medicare eligibility or who are already enrolled.


There are several changes to Medicare for 2025 that seniors will want to know about, further complicating matters.


Fortunately, there is help available in understanding the various plans and changes at no cost. Paul and Patricia Hamilton of Medicare Insurance Advisors of Sartell are eager to assist you in explaining the enrollment dates and new changes to previous plans; while also helping you find a plan that fits your needs and budget.


“There is no upcharge or obligation to work with us,” said Paul.  “We will shop the market for you, and we work with all major carriers.”


The Hamiltons have over 20 years of experience working in the senior market, specializing in products that assist seniors mitigate risk. They value their relationships with their clients.


The Medicare Insurance Advisors team of, left to right: Paul Hamilton, William Hamilton, Patricia Hamilton, Grant Hamilton. Contributed photo

“We understand how hard some of these plans are to understand,” said Paul. “We’re happy to answer any questions you have and also help you understand everything before you make a decision.”


Medicare is the government-run health insurance coverage for those 65 years of age or older, or those with certain disabilities and conditions.


Medicare beneficiaries have the chance to change coverage during the Annual Enrollment Period (AEP) each year. Choosing the right plan can not only improve your health, but it can also allow you to have financial and emotional peace of mind.


Changes to Medicare in 2025 will include:


• A new $2,000 out-of-pocket spending cap on Part D prescription drugs.


• Elimination of the coverage gap phase.  


“New legislature takes effect in January called the Inflation Reduction Act,” said Paul. “This will be impacting the prescription plan (Part D). In 2025, Part D enrollees’ out-of-pocket drug costs will be capped at $2,000.”


The amount will be indexed to rise each year after 2025 at the rate of growth in per capita Part D costs.  For Part D enrollees who take only brand-name drugs, annual out-of-pocket costs will fall from around $3,300 in 2024 to $2,000 in 2025. In other words, Part D enrollees who take only brands and have drug costs high enough to reach the catastrophic threshold could see savings of about $1,300 in 2025 relative to what they will spend in 2024.


“This will be a benefit to those part D recipients with large prescription costs.” said Paul. “People need to check prescription drugs and make sure they’re covered by their plan. There could some drugs not covered in specific plans. Those enrolled need to read their annual Notice of Change that comes in late September to make sure they are on the right plan.”


The $2,000 cap will likely save money for some Medicare beneficiaries, particularly ones taking expensive brand-name drugs.


Medicare Insurance Advisors’ advice for people looking to enroll in Medicare Part D plans in 2025 is to review your choices with them to see whether the prescriptions you take will be covered by the plan.


“We want to help people understand these important Medicare policies,” said Patricia. “It can be very hard and frustrating to figure these things out. We will thoroughly evaluate your prescription needs and work with you on selecting a plan that could save you money.”


Medicare Insurance Advisors won’t pressure clients into purchasing a Medicare plan, nor will they recommend a particular plan. What they offer is unbiased and easy to understand information about various Medicare options, enabling a client to choose the plan that best suits them.


“I have found that Medicare Insurance Advisors truly act in my best interests,” said Joanne D. “They review my policy and prescriptions annually to make sure I’m getting the best coverage and rate. They are always more than happy to answer my questions, too.”


The following are important dates coming up involving Medicare: 


• Annual Election Period (AEP): Oct. 15 thru Dec. 7.


• Open Enrollment Period (OEP):  January thru March.


• Initial Election Period (IEP): A 7-month window (3 months before birthday month, 3 months after birthday month).


• Special Election Periods (SEP): You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, such as if you move or lose other insurance coverage.


Paul and Patricia Hamilton will be calling each of their clients at Medicare Insurance Advisors of Sartell. The two always check in with their clients each year, and look at options for the coming year. Contributed photo

“We are currently scheduling appointments, so if anyone is nearing 65 years old or is retiring soon and wants to learn about their options, they can call us to reserve an appointment,” said Patricia.


The Hamiltons list several things that seniors should know about Medicare and can offer help with any or all of them.


(1) Flu shots: Medicare covers flu shots once a year during the fall or winter months.


(2) Cardiovascular Screening:  They may have a doctor visit co-payment or additional bills.


(3) In-Patient vs. Observation: In-patient is when you are formally admitted to the hospital. Observation is pending to determine if you are being admitted or discharged.


(4) Traveling: Medicare does not provide coverage outside of the United States. Certain Medicare Advantage plans have travel options.


(5) Medicare Part B Deductible: Medicare Part B has an annual deductible of $233.


(6) VA coverage: VA is considered creditable coverage. No Part D penalty. May have additional coverage, such as Medicare Advantage plan in addition to VA.


(7) RX Savings: This includes pill splitting, generic alternatives, over-the-counter, and more.


(8) Eyes, Ears and Teeth: There is very limited coverage for glasses, hearing aids, and dental through Medicare. You will typically owe 100 percent of these services, but some Medicare Advantage plans cover these as extras.


Medicare Insurance Advisors is committed to education. Because the Medicare market is continually changing, Paul and Patricia will work with you one-on-one and review your prescription drugs, your physicians, your provider networks, and the plan options in your area.


 The Hamiltons call each of their clients each year and look into options for the coming year.

 “These folks truly cared about us and took the time to help us understand what we were getting,” said Ted H.


 Medicare Insurance Advisors has several locations in Minnesota. The home office is located  at 2107 Troop Drive in Sartell.


We do not offer every plan available in your area. Currently we represent 11 organizations which offer 113 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.


For more information or to set up an appointment, call Medicare Insurance Advisors at 320-654-6100, or toll free at 888-611-2200, or visit their website at www.MedicareinsAdvisors.com.


This is a paid business profile. If you would like to learn more about promoting your business in the Sr. Perspective with a business profile, call Jim at 320-334-3344.

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