Medicare – Sound Insurance Northwest
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Formerly Sound Business & Health Insurance

Medicare

Simplifying the Medicare Journey 

I’m here to help simplify your journey through the world of Medicare. Navigating healthcare options can be overwhelming, especially when it comes to understanding the ins and outs of Medicare coverage. With years of Healthcare experience I appreciate the opportunity to assist individuals. I am dedicated to making this process more understandable and easier for you.

Everyone is Unique

Whether you’re new to Medicare, considering your coverage options, or looking to optimize your plan to better suit your evolving needs, I’m here to offer personalized guidance. I understand that everyone’s healthcare requirements are unique, and my goal is to help you tailor the right Medicare solution for you.

Ongoing Support

I provide ongoing support even after you’ve enrolled in a plan. I can help address questions or concerns that may arise, assist with understanding coverage changes, and help you reassess your plan annually during the enrollment periods.

Never a Fee for My Assistance

I would appreciate the opportunity to work together to simplify your Medicare experience and ensure you have the coverage that provides peace of mind. My passion is to help people. Medicare is not simple and with my expertise and background I enjoy assisting people, stepping them through the process of enrolling, explaining your Medicare options (providing pros and cons of each option) and reviewing insurance carrier plans and benefits. My time is about supporting you through the Medicare process and there is never a fee for my services.

Susie Ross
Medicare Insurance Specialist

Questions? We're Here to Help

Medicare Inquiry
First
Last
mike smithmike smith
20:48 01 Apr 24
Highly recommend. Susie helped us immensely through setting up our Medicare Part B and all the stuff that goes with that. It can be very complex, but she handled it with ease. All we had to do was decide what was best for us and she guided us through that. Wonderful experience.
WFLBoardMaryWFLBoardMary
19:08 09 Mar 24
My husband and I had a recent meeting with Susie Ross at Sound Health Insurance to discuss Medicare coverage and we were so impressed. She is extremely knowledgeable and helpful and gave us excellent information with no sales pressure in the slightest. Highly recommend using Susie to help navigate the options for supplements to Medicare coverage, she knows her stuff, takes her time and is extremely professional.
Elaine PerusseElaine Perusse
01:13 19 Feb 24
Such a wealth of great knowledge at SHI. Susie Ross is a gem to work with, she's really on top of her game and extremely thorough. I feel fortunate to have her so available for my needs. Top notch without a doubt.
Dalen MasonDalen Mason
03:06 07 Dec 23
Susy was very knowledgeable and helpful. I would highly recommend her to any of my friends.
Paula LillardPaula Lillard
19:48 22 Nov 23
I have used this agency to shop my Medicare Advantage policy and automobile policy. I have been extraordinarily happy with the thoroughness of their explanations and comparisons of policies available to me. Susie was kind and took all the time I needed to make an informed decision about my healthcare and medical requirements
Cap'n CarlCap'n Carl
14:53 17 Oct 23
After finding myself in need of assistance in researching insurance, I found Susie! She was a delight to meet with and with her knowledge and expertise, I found exactly what I was looking for.When it comes to insurance, cut to the chase and give Susie a call. You'll be glad you did.
Kenneth davidsonKenneth davidson
03:05 25 Mar 23
Susie was the best she helped with all my Medicare questions. I was lost and she came to my rescue.
Paul BergPaul Berg
22:25 21 Feb 23
Susie has been a professional throughout all my insurance needs. She has provide the best options during dark times in in my wife's insurance needs before she passed. Now she has helped me in my hour of need and has made it painless.Thanks Susie
Tari SarvielTari Sarviel
00:28 08 Dec 22
Susie spent 2 hours with my husband and I explaining the way too complicated Medicare system and advantages/disadvantages of each system. She also informed us of benefits we had that we were unaware of. We we REALLY impressed and appreciative!
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Enrolling in Medicare

Enrolling in Medicare at the right time is crucial to avoid penalties and ensure continuous healthcare coverage. The timing of enrollment depends on several factors:

  1. Initial Enrollment Period (IEP): This is the first opportunity for most people to enroll in Medicare. It starts three months before your 65th birthday month, includes your birthday month, and extends for three months afterward. If you’re automatically enrolled in Medicare due to receiving Social Security benefits, your Medicare card will typically arrive three months before you turn 65.
  2. Special Enrollment Period (SEP): You may qualify for a Special Enrollment Period if you have coverage through an employer or union after turning 65. This allows you to enroll without penalties when your employment-based coverage ends.
  3. General Enrollment Period (GEP): If you missed your Initial Enrollment Period and don’t qualify for a Special Enrollment Period, the General Enrollment Period runs from January 1 to March 31 each year. However, enrolling during this period might result in late penalties and delayed coverage.
  4. Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, individuals enrolled in a Medicare Advantage plan can switch to another Medicare Advantage plan or return to Original Medicare with or without a Part D plan.
  5. Annual Enrollment Period (AEP): From October 15 to December 7 each year, anyone with Medicare can make changes to their coverage for the upcoming year. This includes switching between Original Medicare and Medicare Advantage or changing Part D plans.

For those who are eligible for Medicare due to disability, the Initial Enrollment Period often starts based on the date of their disability benefits.

Remember, enrolling in Medicare late might lead to permanent late penalties, higher premiums, and gaps in coverage. It’s crucial to understand your specific enrollment period, as it varies depending on your circumstances. If you’re unsure about when to enroll or which enrollment period applies to you, for personalized guidance please contact either our office at (253) 858-9988, Social Security or Medicare.

Understanding the 4 Parts of Medicare

Medicare is divided into four main parts, each offering coverage for specific services. Here’s what you need to know.

Part A - Hospital Insurance

Medicare Part A covers inpatient hospital stays, skilled nursing facilities, hospice, and certain forms of home health care. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working. If you haven’t paid Medicare taxes for a sufficient duration, you may have to pay a premium .

Part B - Medical Insurance

Medicare Part B medical insurance covers certain doctor services, outpatient care, medical supplies, and preventive services. It encompasses essential services required for the prevention, diagnosis, and treatment of specific conditions. Part B requires a monthly premium, and the amount depends on income .

Part C - Medicare Advantage

Medicare Part C, commonly referred to as Medicare Advantage, enables approved private insurance companies to deliver Medicare benefits. Medicare Advantage plans integrate Parts A, B, and often D, along with additional coverage for services not typically included in basic Medicare, such as hearing, vision, and dental care. Participants still need to pay their Part B premium and an additional premium for Part C, if there is one.

Part D - Prescription Drugs

Medicare Part D is a prescription drug coverage offered through private insurance companies that are approved by Medicare. Part D plans include coverage for both generic and brand-name medications. Its primary objective is to assist individuals dealing with escalating or already high prescription drug costs.

Each Medicare part (A, B, C, D) covers different aspects of healthcare, and individuals can choose to combine certain parts of opt for Medicare Advantage plans (Part C) that might offer additional coverage beyond Original Medicare.  Understanding these parts and their types of coverage options are crucial for individuals to make informed decisions about their healthcare needs and expenses.

Medicare Supplement

A Medicare Supplement, also know as Medigap, is a type of private health insurance designed to complement Original Medicare (Part A and Part B).  It helps fill the “gaps” in coverage that Original Medicare doesn’t pay for, such as copayments, coinsurance, and deductibles. A good way to think about a supplement is a secondary coverage to Original Medicare (Part A and Part B)

Comparing Your Medicare Options

Understanding the differences between Original Medicare, Original Medicare with a Supplement and Medicare Advantage (Part C).

Original Medicare
Original Medicare with Medigap
Medicare Advantage
Coverage
Parts A & B
Parts A & B
Typically Parts A & B, and additional benefits like Part D (Prescription drug coverage), dental, vision, etc. (See additional benefits below)
Cost-sharing
Deductibles, coinsurance, and copayments for services covered by Parts A & B
Medigap helps cover decutibles, coinsurance, and copayments of Original Medicare
Copayments, coinsurance, deductibles, and often a monthly premium
Provider Network
Any provider that accepts Medicare
Any provider that accepts Medicare
Typically within a network of doctors and hospitals, out-of-network care may have higher costs
Referrals
Generally not required
Generally not required
May require referrals to see specialists in some plans
Prescription Drug Coverage
Not included (unless enrolled in a separate Part D plan)
Not included (unless enrolled in a separate Part D plan)
Often included (Part D)
Additional Benefits
Limited extra benefits (e.g., some preventives services)
No additional benefits besides Original Medicare coverage
May include dental, vision, hearing, fitness memberships, alternative care therapies and other services
Monthly Premiums
Part B premium required
Part B premium + Medigap premium
Varies; may have lower premiums compared to Medigap but may have higher out-of-pocket costs

Please note that this chart provides a general overview.  The specific coverage, costs, and benefits can vary based on the particular plan, insurance company, and location.  It’s essential to compare plans carefully, considering individual healthcare needs, budget, and preferences before choosing the most suitable option.

The Importance of Working with a Medicare Insurance Broker​

Working with a Medicare broker or agent can be beneficial for individuals navigating the complexities of Medicare. There are several reasons why working with a Medicare broker can be important.

Ready for the next step?

Call us at (253) 858-9988 or request contact.

Disclaimer: Licensed to sell 12 Medicare organization with 69 plans for 2024. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Ready for the next step?

Call us at (253) 858-9988 or request a quote.

Formerly Sound Business & Health Insurance

Sound Insurance Northwest

3312 Rosedale Street, Suite 103
Gig Harbor, WA 98335

(253) 858-9988

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