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Helping Seniors Make Better-Informed Medicare Decisions
Trying to pick a health insurance plan can be a chore for anyone. For many people, just mentioning the word "open enrollment" sends shivers down the spine. It seems like there's always a nagging feeling that you're wasting money, choosing a plan with poor in-network care, or both. One would think that health insurance gets easier as you approach retirement age, but the truth is that picking an initial Medicare coverage plan can be daunting.
Unfortunately, the confusing process of signing up for Medicare causes many seniors to forego healthcare coverage altogether. After all, Medicare enrollment can involve several federal agencies, including the Social Security Administration (or SSA) and the Centers for Medicare and Medicaid Services (or CMS).
At Senior Medicare Insurance Services, our passion is guiding seniors through the confusion of Medicare. That way, they can enjoy retirement with peace of mind knowing they are protected and ready for life after 65. We work with dozens of insurance companies, giving our clients the chance to choose a plan that best fits their lifestyle.
We choose to design our senior insurance plans with a focus on optimal benefits structure, lower costs, and personalized service. Some independent insurance agencies see their aging customers as nothing more than a financial transaction waiting to happen. In contrast, we treat each of our clients with respect and dignity as we help them navigate the confusing waters of Medicare. Combined with individualized service, we help older Americans make well-informed decisions about insurance. Whether you're in need of senior Medicare Supplement Plan insurance in Sullivan's Island or simply have questions about signing up for Medicare, our team is here to help.
Service Areas
What is Medicare?
If you're approaching the golden years of your life, it's important you understand what Medicare is if you don't already.
Medicare is a federal health insurance program reserved for people older than 65 who have worked full-time for at least ten years. The Medicare program is paid for by a combination of worker payroll tax, premiums paid by Medicare enrollees, and the U.S. government.
There are four parts of Medicare:
This type of Medicare is free for most U.S. citizens. Medicare Part A helps older adults pay for care in a nursing facility, hospital visits, and some forms of in-home senior care.
This tier costs around $100 per month. It covers different outpatient services like lab tests, preventative care, doctor's visits, mental health care, clinical trials, and some forms of surgery.
This type of Medicare is most often called Medicare Advantage. This tier of Medicare allows seniors to choose health plans provided by insurance companies like Senior Medicare Insurance Services. Individuals who use Medicare Advantage commonly use Medicare supplement plan insurance to help pay for health care costs that Original Medicare won't cover, like coinsurance, deductibles, and copayments.
Sometimes called "PDPs," these plans add drug coverage to standard Medicare, some Medicare Private Fee-for-Service Plans (PFFS), some Medicare Cost Plans, and Medicare Medical Savings Account Plans (MSA).
The amount of money you pay for your health care depends on several factors, including:
- What kind of care you need, and how often it is needed.
- The type of Medicare coverage you choose.
- Whether there are alternative insurance policies that will help fill gaps in your coverage
- Whether a doctor agrees to charge you the same amount that Medicare will cover for a medical service
At Senior Medicare Insurance Services, we offer a number of health insurance solutions for seniors. Two of our most used services include Medicare Advantage plan insurance and Medicare supplement plan insurance.
Senior Medicare Supplement Plan Insurance in Sullivan's Island
Sometimes called Medigap, the purpose of Medicare Supplement Insurance is to help fill in "gaps" that might not be covered by Original Medicare. You can think of a Medigap policy as a supplement for your Original Medicare benefits.
Private companies like Senior Medicare Insurance Services sell this type of insurance right here in South Carolina. While Original Medicare will pay for much of the cost associated with health care services you need, it may not cover all of your expenses. Generally, Medigap policies do not cover costs stemming from eyeglasses, private-duty nurses, dental care, hearing aids, or long-term care.
Depending on the Medicare Supplement Plan that you choose, it may cover out-of-the-country medical services when you travel abroad. Assuming you have Original Medicare coverage, your policy will cover its share of Medicare-approved health care costs. Once your Original Medicare coverage reaches its limit, your Medigap policy will pay its share of the fees.
Our Medigap policies are drafted to meet your specific needs, and can help cover remaining health care costs such as:
Deductibles
Copayments
Coinsurance
Important Information About Senior Supplement Plan Insurance
To dispel some confusion, you should know that a Medigap policy is not the same as a Medicare Advantage Plan. The latter helps you receive Medicare benefits, while the former supplements the benefits you obtain through your Original Medicare plan. As you begin to explore Medicare Supplement Insurance Plans, keep the following important information in mind:
As you begin to explore Medicare Supplement Insurance Plans, keep the following important information in mind:
- To qualify for a Medigap policy, you must first have Medicare Part A and Medicare Part B.
- Payments on your Medicare Supplement Insurance Plan will be made to the private insurance company that you choose, like Senior Medicare Insurance Services. These payments are made every month and are paid in addition to the monthly payment you make for Medicare Part B.
- If you are the holder of a Medicare Advantage Plan, it is illegal for an insurance company to sell you a senior Medicare Supplement Policy. If you plan on switching back to an Original Medicare plan, you may be able to purchase a Medigap policy.
- If you have health problems as you age, your standardized Medigap policy is guaranteed to be renewable. So long as you pay your monthly premium, your insurance provider cannot cancel your policy.
- Medigap policies only cover one person. If you have a spouse or family member that would like coverage, they must purchase a separate policy.
- You may only buy a Senior Medicare Supplement Plan from an insurance agent that is licensed to sell them in your state. Senior Medicare Insurance Services has been licensed to sell Medigap policies in South Carolina for years. We have helped countless seniors get the Medicare coverage they need and continue to do so to this day.
- In the past, Medigap policies were able to cover costs related to prescription drugs. As of January 1st, 2006, prescription drug coverage is not available on Medicare Supplement Plans. The best way to get coverage for your prescription drugs is to join a Medicare Prescription Drug Plan, often called Part D. Contact our office today to learn more about paying premiums on Medigap and Medicare plans.
For many people, the best time to buy senior Medicare Supplement Plan Insurance in Sullivan's Island is during the 7 months Medigap Open Enrollment Period. This period starts the day you turn 65 years old, so long as you hold Medical Insurance (Medicare Part B). Generally, during the enrollment period, you get more policy choices and better pricing. Once the enrollment period is over, you may not be able to purchase a Medigap policy. Contact Senior Medicare Insurance Services today to determine if you qualify for a Medicare Supplement Insurance Plan.
Senior Medicare Advantage Plan Insurance in Sullivan's Island, SC
A Medicare Advantage Plan is a kind of Medicare health coverage designed to provide seniors with all their Part A and Part B Medicare benefits. Many Medicare Advantage Plans will often include coverage of the following:
- Preferred Provider Organizations
- Special Needs Plans
- Private Fee-for-Service
- Medicare Medical Savings Account Plans
- Health Maintenance Organizations
In addition, most Medicare Advantage Plans give seniors coverage for their prescription drug needs. When you enroll in a Medicare Advantage Plan through Senior Medicare Insurance Services, your Medicare benefits are covered through your plan and will not be paid for by traditional Medicare.
How Medicare Advantage Plans Work
Sometimes called "MA Plans" or "Part C," Medicare Advantage Plans are considered an "all in one" solution to Original Medicare. Senior Medicare Advantage Plans are only offered by private companies that are approved, like Senior Medicare Insurance Services. Seniors who enroll in a Medicare Advantage Plan are still on Medicare. However, these individuals enjoy bundled plans that give seniors the benefits of hospital insurance (Medicare Part A), medical insurance (Medicare Part B), and sometimes drug coverage (Part D).
Medicare Advantage Plans are very popular because they cover all Medicare services and make life a little easier for seniors who have trouble understanding the nuances of Medicare.
When you contact Senior Medicare Insurance Services to choose your Medicare Advantage Plan, ask your agent about Medicare prescription drug coverage. Unless you already have drug coverage (Part D), you should seriously consider Part D coverage to help reduce costs associated with prescription drugs. You may also want to consider a Medicare Supplement Insurance Plan to help fill gaps in coverage that Original Medicare will not cover.
Medicare Advantage Plan Insurance Rules
Medicare works by paying a set amount of money to the companies that offer senior Medicare Advantage Plan insurance in Sullivan's Island. That money is used to pay for the care services that you need. Because Medicare Advantage Plans are different, you should expect out-of-pocket costs to vary depending on the plan you choose.
Different plans have different rules for how you receive services, such as:
If you must go to facilities, suppliers, or doctors that belong to your Advantage Plan for non-urgent and non-emergency care.-
Whether you must get a referral to see a specialized doctor
Companies that offer Medicare Advantage Plans must follow strict rules, which are set by Medicare and can change every year.
Paying for Your Senior Medicare Advantage Plan Insurance
How much you pay for your Medicare Advantage Plan varies and depends on a few different factors. In most cases, if you need a kind of medical service, you will need to rely on the doctors and providers in your plan's service area and network to pay the lowest amounts. In some cases, if you choose to use a service outside of your plan's network of coverage, you may have to pay out-of-pocket.
We encourage you to contact our office today to learn more about Medicare Advantage Plans, how they work, what your options are, and how often you will have to pay out-of-pocket, if at all.
The Senior Medicare Insurance Services Commitment
Since our company was founded, we have led the insurance industry by providing our clients with the most valuable, helpful insurance solutions available. We are fully committed to our current and prospective clients by:
Choosing to focus on personalized, one-on-one service. When you work with our team, know that we will always design your health insurance plan with your best interests in mind.-
Listening to your specific needs. -
Responding to all inquiries and questions promptly and with a friendly attitude. -
Providing you with the best customer service in the senior health insurance industry, whether you have questions or are ready to move forward with a Medicare plan.
Our mission is to help give seniors the best Medicare assistance available so that they may understand the Medicare process and make an informed health coverage decision. We have the knowledge, skills, and experience to assist anyone interested in Medicare. Our personal goal is to become a lifetime resource for our clients and give them greater confidence in choosing their insurance plans.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 82 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.
Latest News in Sullivan's Island, SC
Visitors and residents recall coyote encounters, attacks on Sullivan’s Island
Caitlin Ashbaughhttps://www.live5news.com/2023/08/29/visitors-recall-personal-coyote-encounters-attacks-sullivans-island/
SULLIVAN’S ISLAND, S.C. (WCSC) - Several Sullivan’s Island dog walkers and regulars are speaking up about their personal experiences with coyotes.This comes a day after town officials reported five coyote-led attacks involving dogs within the month of August.They say the wild animals has been approaching people, dogs and roaming open areas of the beach more often than usual.The Jourdan family says they experienced a too-close encounter with a coyote over the weekend.“They were out halfway to the ...
SULLIVAN’S ISLAND, S.C. (WCSC) - Several Sullivan’s Island dog walkers and regulars are speaking up about their personal experiences with coyotes.
This comes a day after town officials reported five coyote-led attacks involving dogs within the month of August.
They say the wild animals has been approaching people, dogs and roaming open areas of the beach more often than usual.
The Jourdan family says they experienced a too-close encounter with a coyote over the weekend.
“They were out halfway to the water, from the dune, so middle of the beach. And they were attacked by coyotes,” Jourdan said.
Five-year-old Willie Nelson, the Jourdan family dog, was taken by two coyotes early Saturday morning while on a walk with a babysitter.
Jourdan says it happened in broad daylight and in the middle of the beach.
He adds the family was devastated by the loss of their “wonder dog.”
“I was trying to get closure for my family’s sake, for Willie, because we weren’t even there. Which was frustrating. I crawled on my belly for over four miles between stations 26 and 28,” Jourdan said.
The attack occurred at Station 27, a part of the beach several residents have called a “breeding ground” for coyote packs.
Officials with the South Carolina Department of Natural Resources say the breed has been approaching people, dogs and roaming open areas of the beach more often.
They add that mid-summer and fall are peak active times for these animals, meaning it is when coyotes migrate to new spaces, feed and have young.
SCDNR officials say another reason for the increased interactions could be from them being opportunistic feeders, meaning they will be quick and take anything they need.
Others say they have been chased by coyotes in the past but escaped.
“We were walking in June when a coyote came out of the dunes and started chasing,” Sullivan’s regular Shelly Carson said. “I was able to chase it away, and it ran down the beach to chase a golden retriever.”
Now, they avoid the area altogether or take proactive measures to be able to walk safely.
“I’ve always known there are coyotes here,” Carson said. “Never seen one until this year. Really, March was the first time I had my first sighting and started carrying pepper spray on the beach. In June I started carrying a birdie alarm. And now I carry a stick with me too.”
Visitors are asking for help from officials to curb the problem.
“It’s close to our hearts, but the coyote system is unfortunately not something that is new, declining or lessened. Rather the opposite,” Jourdan said.
They ask for coyote population control, area management and listening to residential concerns.
Town officials say they do have systems in place to manage the problem, which include education, tracking, hazing and lethal control.
They ask anyone who experiences an encounter or sighting to report the problem immediately.
If you run into a coyote, you’re advised to react loudly, throw small sticks or cans or spray the animal with water.
For more information on coyotes along Sullivan’s Island, click here.
Copyright 2023 WCSC. All rights reserved.
Sullivan’s Island agrees to pay $227k amid contract dispute with Charleston Water System
Jordan Cioppahttps://www.counton2.com/news/sullivans-island-agrees-to-pay-227k-amid-contract-dispute-with-charleston-water-system/
SULLIVAN’S ISLAND, S.C. (WCBD) – The Town of Sullivan’s Island has agreed to pay just over $227,000 to Charleston Water System amid a contract dispute.Sullivan’s Island Town Council spent almost an hour in an executive session on Monday night while they received legal advice on contractual negotiations with Charleston Water System.“That signed contract constitutes a valuable asset of the town and provides certainty regarding the rates that our residents pay for water. Years ago, Charleston Water Sy...
SULLIVAN’S ISLAND, S.C. (WCBD) – The Town of Sullivan’s Island has agreed to pay just over $227,000 to Charleston Water System amid a contract dispute.
Sullivan’s Island Town Council spent almost an hour in an executive session on Monday night while they received legal advice on contractual negotiations with Charleston Water System.
“That signed contract constitutes a valuable asset of the town and provides certainty regarding the rates that our residents pay for water. Years ago, Charleston Water System decided to raise our rates as if our signed contract did not exist,” said Town Councilman and Mayor Pro Tem Justin Novak, as he read aloud a lengthy motion upon council’s return to open session.
As News 2 reported last month, Charleston Water System claimed in an October 2023 letter to the town that Sullivan’s Island has been paying less than the correct rate since 2017. A spokesperson for CWS said the town owed $1,078,000 as of the beginning of March.
The letter also said the 30-year contract between CWS, and the town will expire on July 19, 2024 and if there is not a new contract by then, water service will be disconnected for the town’s 2,000 on July 20th.
“The town disputed that rate increase and continued to pay the undisputed amount owed in accordance with our longstanding signed agreement and placed the disputed amount in escrow pending the resolution of that dispute,” Councilman Novak read.
He continued with the motion and said CWS is ignoring the other terms and stated the town would not accept any of the water system’s proposals in the contractual dispute.
“The town must stand firm that signed contracts are signed contracts,” the councilman said as part of the motion.
The town used who leaders said is a nationally recognized rate consultant to calculate what they owe.
“Accordingly, I move that town council authorize the payment of $227,361 to satisfy in full the disputed portion of arrearage now calculated to be owed under the terms of our written agreement with Charleston Water System,” Councilman Novak finished.
The motion passed unanimously. News 2 reached out to Charleston Water System after the meeting. A spokesperson said they are evaluating the action taken.
Sullivan's Island saved 100 Palmetto trees from being axed. They are again at risk.
Anna Sharpe asharpe@postandcourier.comhttps://www.postandcourier.com/news/dominion-tree-trimming-sullivans-island-january-2024/article_4b5f53ec-a4f8-11ee-9d29-0f3356f1c1be.html
Middle Street on Sullivan’s Island could look sparse in the new year. Sixteen miles of streets and roadways on the barrier island are part of Dominion Energy's routine tree-trimming project at the start of 2024.Dominion Energy has contracted with Xylem Tree Experts to trim limbs that are within unsafe proximity to power lines, beginning Jan. 2. Work will begin near Fort Moultrie, and crews will make their way toward Breach Inlet over an eight- to 10-week period.The 16-mile collection of streets and roads on Sullivan&rsquo...
Middle Street on Sullivan’s Island could look sparse in the new year. Sixteen miles of streets and roadways on the barrier island are part of Dominion Energy's routine tree-trimming project at the start of 2024.
Dominion Energy has contracted with Xylem Tree Experts to trim limbs that are within unsafe proximity to power lines, beginning Jan. 2. Work will begin near Fort Moultrie, and crews will make their way toward Breach Inlet over an eight- to 10-week period.
The 16-mile collection of streets and roads on Sullivan’s Island is part of a larger trimming effort that spans 87 miles and includes portions of Mount Pleasant, Isle of Palms and Goat Island.
Each time a trimming project is announced, feedback and concern from residents is expected — particularly when the removal of palmetto trees is a possibility.
Sullivan’s Island is no stranger to this: the power utility had plans to remove over 200 palmetto trees on the island in 2020, but paused the effort following a meeting with the town’s mayor, Patrick O’Neil.
“We certainly understand the passion surrounding trees in the Lowcountry; we work and live here, too," said Dominion Energy spokesman Paul Fischer. "These are our communities, as well, and we understand that, but safeguarding overhead electric lines is critical to keeping the lights on for all the customers we serve.”
About 100 palmetto trees were not cut down as a result of that meeting and continued to grow, O'Neil said. This time around, Sullivan's Island may not get so lucky.
"We got a stay of execution for about 100 or so of them that were not definitely intruding on the required space that power lines have around them," O'Neil said. "I'm assuming a large number of them will have to go this time, unfortunately. But you know, we've made it clear to them that we hope they won't do anything more than is absolutely necessary."
Fischer said there are currently no palmetto trees specifically targeted for removal, but the trees that pose a risk to overhead lines soon will be identified. Trees needing removal will be marked with spray paint at the base, Mark Branham, Dominion Energy forester, said during a presentation to Sullivan’s Island Town Council on Dec. 19.
Charleston Water System responds to Sullivan’s Island Council decision amid contract dispute
Jordan Cioppahttps://www.counton2.com/news/charleston-water-system-responds-to-sullivans-island-council-decision-amid-contract-dispute/
SULLIVAN’S ISLAND, S.C. (WCBD) – The future of water service on Sullivan’s Island remains uncertain amid a contractual dispute between the town and Charleston Water System.“The island has the ability to generate taxes and they need to figure it out because what they did in 2017 was, they just quit paying,” said Sullivan’s Island resident, Dave Spurgin.A 30-year water supply contract between CWS and the Town of Sullivan’s Island went into effect on July 19, 1994.Based on letters p...
SULLIVAN’S ISLAND, S.C. (WCBD) – The future of water service on Sullivan’s Island remains uncertain amid a contractual dispute between the town and Charleston Water System.
“The island has the ability to generate taxes and they need to figure it out because what they did in 2017 was, they just quit paying,” said Sullivan’s Island resident, Dave Spurgin.
A 30-year water supply contract between CWS and the Town of Sullivan’s Island went into effect on July 19, 1994.
Based on letters provided by CWS, there has been a disagreement over the rates since 2017. The water system claims the town owes them $1,078,000 as of last month.
“Years ago, Charleston Water System decided to raise our rates as if our signed contract did not exist. The town disputed that rate increase and has continued to pay the undisputed amount owed in accordance with our longstanding signed agreement,” said Sullivan’s Island Town Councilman Justin Novak on Monday night during a special council meeting.
The statement was part of a longer motion read aloud before council voted to pay $227,361 to satisfy the disputed portion of the amount owed. Island leaders said the amount was calculated by a nationally recognized rate consultant.
CWS CEO Mark Cline released the following statement to News 2 on Tuesday.
“Charleston Water System does not agree with the Town of Sullivan’s Island’s viewpoint or its recollection of the historical facts. We fully intend to discontinue the Town’s water service July 20 unless their past due amount is fully paid and they have entered into a new contract that appropriately covers the costs of providing water service to their community. It’s not fair that our other customers have been subsidizing the Town’s service for years now, and that would continue under their terms.”
Spurgin, who has lived on Sullivan’s Island for nearly 30 years, said he is not concerned about the potential water shut-off.
“No, because we’re going to need our water. They’re not going to shut the water off. The town’s going to have to figure out, the town council is going to have to figure out how to come up with the money,” Spurgin told News 2.
Sullivan’s Island Mayor Pat O’Neil released the following statement.
“Apparently CWS is having very-late-onset buyer’s remorse about a legally binding contract they willingly entered into almost 30 years ago. When we entered into this agreement in the aftermath of Hurricane Hugo, the Island was at one of its most vulnerable points in its centuries-long history. Nonetheless we have abided by the language of this contract. It’s hard to accept that CWS (or anyone else) is “subsidizing” SI when we paid almost $2 million (in 1994 dollars) to support the infrastructure that allowed them to sell water to us and to our neighbors on the Isle of Palms, and when in 2020 we gave them an easement through our public park and playground so there would be additional capacity to sell water to our neighbors in Mount Pleasant.”
Sullivan’s Island at risk of losing water if water expense debt isn’t paid
Anna Harrishttps://www.live5news.com/2024/03/25/sullivans-island-risk-losing-water-if-water-expense-debt-isnt-paid/
SULLIVAN’S ISLAND, S.C. (WCSC) - A yearslong dispute between Sullivan’s Island and the Charleston Water System could leave thousands of residents without water starting in July if over $600,000 in debt is not paid.As of Sept. 28, 2021, Charleston Water System claims Sullivan’s Island owes them $197,468 in billed, but unpaid, volumetric charges and $442,478 in billed but unpaid capital charges.Charleston Water says the town changed how much they paid per 1,000 gallons in 2017, even after paying the same amount ...
SULLIVAN’S ISLAND, S.C. (WCSC) - A yearslong dispute between Sullivan’s Island and the Charleston Water System could leave thousands of residents without water starting in July if over $600,000 in debt is not paid.
As of Sept. 28, 2021, Charleston Water System claims Sullivan’s Island owes them $197,468 in billed, but unpaid, volumetric charges and $442,478 in billed but unpaid capital charges.
Charleston Water says the town changed how much they paid per 1,000 gallons in 2017, even after paying the same amount since the contract began in 1994.
They say that the paid charge went from $1.22 per 1,000 gallons to 88 cents per 1,000 gallons.
Charleston Water wrote in a January 2019 letter that “after more than 20 years, the town of Sullivan’s Island does not believe the contract requires them to pay any portion of Charleston Water’s capital expenses, a belief which has no support whatsoever of our board of commissioners or legal counsel.”
After getting a rate consultant, Charleston Water offered Sullivan’s to pay 89 cents per 1000 gallons. According to numerous letters, the island refused.
An opinion from the state Attorney General in 2019, states Sullivan’s Island does not have the authority to interpret contracts, but believes both of these parties must finish their initial term of 30 years and then they are able to terminate it if everyone is notified.
Sullivan’s Island says they disagree with this opinion and there are four unresolved topics between the two: capital charges, fire hydrants, the municipal wholesale rate as an excess demand charge and the rate formula.
Charleston Water says Sullivan’s Island has two choices: to pay all outstanding balances and they can continue to purchase water at the then-published municipal whole rate or find an alternate water source starting July 20 of this year.
In a 2021 resolution from Charleston Water, they say they discovered through this lack of payment that 18 fire hydrants were not being paid for on the island. If they’re not paid, all will be removed except for those used for water main flushing.
Starting this month, they will send out delinquent notices to DHEC, the State Fire Marshal, Sullivan’s Island residents and other state agencies on a monthly basis that the water will be shut off starting July 20 – when the 30-year contract is up – if this procedures are not followed.
In response to these letters, Andy Benke, the town administrator for Sullivan’s Island, provided this statement:
It’s disappointing that the leadership at Charleston Water System has apparently decided to ignore the confidentiality agreement put in place during the mediation of our long-standing dispute.
Years ago, CWS decided to raise our rates as if our signed contract with them did not exist.
As CWS knows, we’ve simply been continuing to pay the undisputed amount set in our long-standing, signed agreement.
We hope everyone will understand we’re standing firm on the principle that signed contracts are signed contracts. It’s the right thing to do for our citizens.
We will continue our good faith efforts to reach an appropriate agreement through mediation, or if need be, in the court.
Charleston Water claims Sullivan’s Island revised its interpretation of the 1994 agreement in 2016 and part of the dispute is whether the island should have to pay any portion of CWS’s capital expenses.
Charleston Water System says they can’t make any further comment because it’s still in legal mediation.
You can read more about the dispute below, or click here.
Copyright 2024 WCSC. All rights reserved.
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