Monday, August 7, 2017

Medicare & Extra Help

Medicare has four basic forms of coverage:

• Part A: Pays for hospitalization costs
• Part B: Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services
• Part C: Medicare Advantage Plan (like an HMO or PPO) offered by private companies approved by Medicare
• Part D: Assists with the cost of prescription drugs

Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid (e.g. MSPs, QMBs, SLBs, and QIs).

Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100-day limit or skilled nursing facility care that Medicare covers, prescription drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid by Medicare with Medicaid filling in the difference up to the state's payment limit.


Medicaid is a joint federal/state program that helps with medical costs for some people with limited income and resources.

Medicare Savings Programs

State Medicare Savings Programs (MSP) programs help pay premiums, deductibles, coinsurance, copayments, prescription drug coverage costs.


PACE (Program of All-inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet health care needs in community.

Save on drug costs

Qualify for extra help from Medicare to pay the costs of Medicare prescription drug coverage if you meet certain income and resource limits.

Programs for people in U.S. territories

Programs in Puerto Rico, U.S. Virgin Islands, Guam, Northern Mariana Islands, American Samoa, for people with limited income and resources.

Find your level of Extra Help (Part D)

Your level of extra help with Medicare prescription drug costs described on a purple, yellow, green, or orange colored notice from Medicare.

Insure Kids Now

The Children's Health Insurance Program (CHIP) provides free or low-cost health coverage for more than 7 million children up to age 19. CHIP covers U.S. citizens and eligible immigrants.

Supplemental Security Income (SSI)

The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources. SSI benefits also are payable to people 65 and older without disabilities who meet the financial limits.

Where to apply for Medicaid:

Friday, July 28, 2017

Texas Teacher Retirement System (TRS) and Medicare

Teachers are public servants who typically devote years or decades of service and unparalleled commitment to the process of educating a new generation. Texas retired teachers receive benefits through the Teacher Retirement System of Texas (TRS), and Texas teachers’ health care benefits are administered through TRS-Care.
TRS-Care is a network-oriented health benefits program. If you use health providers who are part of the TRS-Care statewide and national network, the plan generally reimburses you for 80% of eligible expenses after your annual deductible is met. For current Medicare recipients, TRS-Care deductibles are fairly high depending on the plan. For Spouses, they range even higher.
The question comes up, “Should someone with TRS as his primary medical insurance even bother to enroll in Medicare”?  The answer is a resounding YES. When a retiree reaches 65, TRS assumes that the retiree has Medicare and pays accordingly. So, for example, if you go to the hospital or to a doctor TRS will assume that Medicare is paying 80 percent of your expenses and TRS will pay the other 20 percent minus the deductible. If you do not have Medicare to pay the remaining balance you will be responsible for it.
With changes being made to the TRS Care budget, retired teachers in Texas are estimated to face large rate increases on their coverage, possibly doubling or tripling their current premiums, deductibles, and co-pays for health care in 2018.

Less Expensive Alternatives to TRS

With the cost of TRS plans, deductibles and co-pays rising higher every year, especially for Medicare eligible spouses, looking at non-TRS alternative plans can make a huge difference in the lives of retired teachers living on fixed incomes.
Remember, once you leave TRS benefits they will not let you back in, but with their track record does this really financially matter? 


Also called Medicare Part C plans, Medicare Advantage plans are offered by Medicare-approved private companies to Medicare recipients throughout Texas. If you’re already enrolled in both Medicare Part A and Medicare Part B, you have the option of replacing your Part A and Part B coverage with similar coverage provided by your Part C plan. But there is more. A great thing about Medicare Advantage is that it can cover a wide range of services: dental, vision, hearing, and prescription drugs to name just a few, that Original Medicare does not.
Another great thing about Medicare Advantage is its affordability. There may even be a Medicare Advantage plan that doesn’t require you to pay a monthly premium! 


Medicare Supplement (or Medigap) plans are designed to help fill the gaps in Original Medicare Part A and Part B coverage. Medigap plans are sold by private insurance companies to people already enrolled in Medicare Parts A and B.
Insurance companies offering the same Medigap plans have to offer the same benefits. However, companies are free to apply their own pricing and underwriting practices. Therefore, it is important to shop the market before choosing a plan. 

In Summary

You are probably being bombarded by information about Medicare and how to supplement your current health care coverage. But before making a decision about what coverage is best for you, you can’t go wrong by comparing your Medicare plan options anomalously at It also won’t cost you a cent if you need to talk to one of our licensed, bonded senior healthcare representatives.
You can compare the top-rated companies and options to find the coverage and rates that best suit your needs and budget. While others claim to shop the competition on your behalf, at you can do it yourself.
If you have any questions about Original Medicare (Medicare Part A and Part B), Medicare Supplement Plans (Medigap), Medicare Advantage (Part C), or Prescription Drug Plans (Part D), is at your service. For the best health care coverage at the very best price, why not give a click or call today?
Sonia Ashford

Sonia Ashford is an Independent Insurance Agent in the Medicare field and has delivered hundreds of speeches about turning 65, Medicare Advantage Plans and Medicare Supplement Insurance Plans to consumers in Tarrant, Dallas & surrounding counties. A respected agent within the Medicare Insurance industry, she is the owner of Ashford Insurance Services, LLC and a Member of Agents Legacy Group, LLC. Visit Sonia's agency website: to learn more about how she can help you with your Medicare decisions. Visit to research, compare, select and enroll in Medicare Insurance Plans Online. 

Wednesday, June 7, 2017

MEDICARE: Common Myths Debunked

I receive many questions on a daily basis on the phone and in our social media.  Medicare, because of its many unique regulations and rules along with the fact that it is ever changing and evolving, is outright confusing.  Here are some of the top myths/concerns that I hear on a regular basis, to explain the truth to you. Are there any concerns or questions about Medicare that we can answer for you? 

Myth: The cost of Medicare is free

Truth:  Medicare is far from free. You may pay monthly or quarterly premiums, along with deductibles, coinsurance, and co-pays. The amounts for 2017 are as follows:

Part A: Usually there is no premium charge for Part A IF you and/or your spouse has worked and paid into Medicare taxes for 40 quarters (10 taxable years). If you have a premium payment for Part A you may pay up to $413 a month.  Also, the “per benefit period” deductible for Part A is $1316.

Part B: The monthly premium for 2017 is $134. People with income over specific limits will pay more. The annual deductible is $183. After having met your deductible you will typically pay 20% of the “Medicare approved amount” for most of your doctor services, outpatient therapy, and durable medical equipment. 

Part C: Medicare Advantage Plans. The Part C monthly premiums and co-pays varies by plan. 

Part D: These monthly premiums also will vary by plan.

Myth: When I turn 65 I can enroll in Medicare whenever I choose

Truth: For first-time enrollees, it is wise to enroll at age 65. You will have a 7-month Initial Coverage Enrollment Period (ICEP) that begins 3 months preceding your 65th birthday and will cover the month of your birth, and the 3 months immediately following in which to enroll. As far as enrollment goes, the sooner the better. Procrastinating too long could mean facing financial penalties later. 
If you are continuing to work past age 65 and have coverage through an employer, or if you are 65 and plan to remain on your spouse’s health plan, you could delay your Medicare enrollment as long as your current coverage is considered “creditable”, meaning it’s as good as Medicare. OR you may elect Part A only (which is usually premium free) and delay Part B until you retire.  Depending on the size of the group health plan, one would pay primary while the other pays secondary. Always consult with your HR department to first make sure your current coverage is considered creditable.  Once no longer employed you will be able to enroll in Medicare within an 8 month period of time.

For existing Medicare beneficiaries, there is an Annual Open Enrollment Period that runs from October 15th to December 7th every year. This is the time when everyone on Medicare can change their Medicare health plans and prescription drug plans for the next year if they see the need to. During this time period, I suggest that you take the time to review your plan, and any changes providers may implement for the upcoming year to make sure your needs will be covered and that you are still in the "RightFit" plan. 

Myth: Medicare Pays for Everything

Truth: There are a number of services that Medicare does not cover. For example, Medicare does not cover standard dental, vision, or hearing care. If these are services that you find yourself in need of, you may want to consider a Medicare Advantage plan that has these extras, or you may wish to purchase separate health insurance plans for these services from a private insurer. If you find that these are needs your current Medicare coverage does not provide and you need some guidance in this area, give me a call and I can provide assistance with that. 

Myth: My bad health will disqualify me for Medicare Coverage

Fact: Sadly, many people think that they can be denied Medicare coverage because of preexisting conditions or are in poor health. However, this is not the case. You can receive Medicare coverage once you qualify for it by either turning 65 or after having been on Medicare disability for 23 months. 

Note, Medicare supplement plans are different when it comes to their acceptance. If you are in your Medicare Supplement (MediGap) Open Enrollment Period- the 6 month period that coincides with your 65th birthday or your Medicare Part B start date, supplemental insurers cannot deny your application for Medigap insurance.  Once outside of this Open Enrollment period, they may be able to deny you coverage depending on your health in some cases.

Sonia Ashford

Sonia Ashford is an Independent Insurance Agent in the Medicare field and has delivered hundreds of speeches about turning 65, Medicare Advantage Plans and Medicare Supplement Insurance Plans to consumers in Tarrant, Dallas & surrounding counties. A respected agent within the Medicare Insurance industry, she is the owner of Ashford Insurance Services, LLC and a Member of Agents Legacy Group, LLC. Visit Sonia's agency website: to learn more about how she can help you with your Medicare decisions. Visit to research, compare, select and enroll in Medicare Insurance Plans Online. 

Thursday, May 11, 2017

Doctors Offices, Retain Your Senior Patients

We help Doctors and Medical Offices with patients who are turning 65. Increase your patient retention by having your Medicare-eligible patients enroll in one of the Medicare Insurance plans you except. This ensures they continue to see you to get the medical attention they need.

We also offer this service at no cost to you or your Patients because the insurance carriers we represent compensate us for each enrollment.  We also offer, an online website platform where Patients can go, research, choose, and enroll in one of the plans you accept. Call today and make an appointment for us to meet with your Office Manager.


1600 Airport Freeway Ste. 340