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413 N Mission St
Wenatchee, WA 98801

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Author: Matt McColm

We work with all kinds of insurance in Washington State. From Health, Life, Auto, Home, Business and more. If you have an insurance question then let us know.

How Do I Get Health Insurance Before Medicare Kicks In?

Posted on by Matt McColm
Health Insurance

Congratulations on deciding to and being able to retire. You’ve spent a lot of blood, sweat, and tears to get you here, working and saving your pennies. It’s an accomplishment that should not be glossed over or minimized. But if you are like countless other of our neighbors in Eastern Washington who decide to retire a bit before the age of 65, there is one glaring question that comes up. How do you obtain health insurance until Medicare kicks in at 65?

chat with Suzie

Many of the benefits and solutions to your retirement are neatly drawn up and planned out. Even Social Security can start prior to 65 if you want. But health insurance can definitely prove to be tricky if you or your spouse do not qualify for Medicare age wise. So the question that we get frequently from Washingtonians, is how can I get health coverage before we qualify for Medicare. The great news for you is that Wenatchee Insurance has a plan to help you obtain Medical Insurance prior to turning 65 that can fit your personal needs.

Keys To Finding A Great Health Insurance Plan


When you begin to look at your options, we typically break them down into two main options.

  1. Health Insurance Marketplace Plans
  2. COBRA

The key to choosing the best option for you comes down to a series of questions about your situation and needs when considering a health plan. The answers to these questions make it easy to slot into one of the four options listed above. Let’s explore those questions which are the keys to finding a great health insurance plan.

Do you have a pre-existing condition that requires you to have specific hospitals, doctors, or prescription drug coverage in-network with your health insurance coverage?

Are you comfortable paying for medical costs out of pocket when they arise periodically?

What period of time do you need the coverage for to get you to your retiree health benefits?

What is your expected household income since it can affect your health insurance premiums?

How do you consume health care including doctor visits, prescription drug plans, and preventive testing?

Pre-Existing Conditions, Networks, & Time Horizons


The harsh reality of an on-going treatment plan for a diagnosis or a pre-existing condition that you have or are receiving regular treatment for will go a long way towards shaping which medical insurance that you choose to utilize going forward. Private health plans and Catastrophic health plans are immediately eliminated in most cases as they utilize underwriting to determine if they will extend an offer of medical coverage. Given that reality, we are left to compare COBRA plans and plans from the Washington Healthplanfinder.
In the state of Washington, COBRA could be your best option if your budget can afford premiums. That is because your employer group health plan may have a better deductible, maximum out of pocket, prescription drug coverage, and more robust networks of providers than the marketplace plans. The downside to COBRA plans is that you will be time bound to a maximum of 18 months of coverage when you leave your employment. (You can change during Open Enrollment as well). But if you’re in the middle of cancer treatment that 18 month window being covered and knowing that your health coverage is set will provide peace of mind even in spite of a perceived substantial monthly premium.
Conversely, the change in employment status when you retire, or the end of the COBRA time period means that you will qualify for a Special Enrollment Period and can elect to migrate to the marketplace plans at either time. That allows you to keep medical coverage via an affordable health insurance plan when the time is right.

health or medicare enrollment suzie makes it easier

How Do You Use Health Insurance?


Most people who have been on employer group health plans for prolonged periods of time have a tendency to not consider how they use their health care. They know that they schedule a doctor’s appointment or procedure knowing that the insurance company is going to cover the medical expenses regardless of their health conditions. As you make the transitions to retiree health plans here in North Central Washington you begin to realize that the true costs of medical expenses become more real because premiums will likely rise and out of pocket costs may escalate. Understanding that trading a lower premium while paying out of pocket for essential health benefits may make more sense if the math works out.


Or maybe the premium savings on a high deductible health plan means that a quiet year for health care saves you a lot of money even though you paid for that urgent care visit. Or maybe paying cash for a generic maintenance drug because of reduced prescription drug coverage can save you money throughout the year. All of these scenarios have to be considered with choosing your new health insurance policy

How Do You Know Which Plan To Choose?


Fortunately, the independent insurance agents at Wenatchee Insurance have many options available to meet your needs. Those agents use a matrix of options based around these basic questions so that you can find the right health coverage for you while limiting your out of pocket costs for medical expenses. We can help you navigate enrollment periods, premium tax credits, prescription drug plans, health savings accounts, and your retirement budget. It is essential that we work with you to understand the answers to the questions posed to you so that we can make the best recommendations possible.

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Insurance Bundle

Topics: Health Insurance, Apple Health, Ambetter, Lifewise, Community Health Wenatchee Insurance, Delta Dental, Retirement, Suzie, Enrollment, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth,

How much is health insurance cost for 2025?

Posted on by Matt McColm
Health insurance Open Enrollment

The Office of the Insurance Commissioner has approved rates for 2025. Washington state is looking at an average of 10.7% rate increase for 2025 for individual health insurance. For many people this will be a first look at what to expect before the Open Enrollment.

November 1 – December 15 for Health Insurance 2025 plans.

Why is this occurring?

The cost of care is a big factor in driving the costs. All the plans spent more than 80% of premiums on claims. The Affordable Care Act requires the insurance companies to either spend at least 80% on claims or else they have to issue rebate checks to the policy owners. A couple of the companies had significant risk adjustment payments that drove down their profitability as well. The Office of Insurance has made a five suggestions on how to lower the rates and we will see if the state legislatures respond.

How does it impact me?

It is important to shop your health insurance plans. Since you had a birthday then you know that the price went up. Also since we are dealing with an average, some plans may increase while others decrease to arrive at that average. If your tax subsidy is small then you will notice the increase more. If you qualified for a plan regardless of immigration status then you will notice the increase more because you don’t receive the federal subsidies.

Why setting an appointment early is important?

Suzie and Matt are seeing big changes for 2025 when it comes to Insurance.

  • Massive Medicare Prescription Changes from Inflation Reduction Act
  • Dreamers have a Special Enrollment starting November 1st
  • Average increase of over 10% for individual health.

Medicare Annual Enrollment runs October 15th through December 7th.

Healthcare Open Enrollment runs from November 1st through December 15th for plans starting January 1st. (Enrollment of Dec 16 through Jan 15 has a starting date of Feb 1st!)

Suzie and Matt have been assisting people understand and enroll in health insurance for over a decade in Wenatchee. They do not charge fees and answer questions throughout the year.

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Wenatchee insurance is a independent agency that offers a wide variety of products for our clients.

Do I Need to Enroll in Medicare if I Am Working in Washington State?

Posted on by Matt McColm
Medicare Advantage or Medigap Suzie at wenatchee can help

The Question: So, you’re still clocking in at the 9-to-5 grind, enjoying those free office donuts, and now, on top of that, Medicare is knocking on your door. You’re probably thinking, “Do I really need to enroll in Medicare while I’m still working?” Well, don’t worry—Suzie from Wenatchee Insurance has got your back, and she’s got answers that are as clear as a sunny day in North Central Washington!

1. Is Your Employer Big Enough to Be a Bouncer?

  • Large Employers (20 or more employees): If your employer is big enough to need name tags at the company picnic, they probably have a health plan that stays primary while Medicare takes a back seat. You can think of Medicare Part B as that friend who always offers to pay, but you don’t really need them to—yet. Suzie suggests you might want to grab Part A (it’s free, like a leftover doughnut in the break room), but hold off on Part B if you’re happy with your employer’s coverage.
  • Small Employers (fewer than 20 employees): If your employer is more like a cozy family reunion where everyone knows your middle name, then Medicare will want to be your primary insurance. Suzie says this is the time to roll out the red carpet for Medicare Part A and B, or you might find yourself stuck with some unexpected bills—like when you forget it’s your turn to bring snacks to the staff meeting.
talk with Suzie

2. Are You Playing HSA Roulette?

  • HSAs and Medicare: A Tricky Tango: If you’re still playing the HSA game, you’ve got to be careful. Suzie warns that enrolling in Medicare will throw your HSA contributions out the window faster than your New Year’s resolutions. If you’re not ready to give up on that sweet, sweet HSA money, you might want to keep Medicare at bay for a little while longer.

3. Dodge the Medicare Penalty Like a Pro

  • Suzie’s Tip: If you think you’re too cool for Medicare Part B, think again! Suzie’s seen too many folks who thought they could outsmart the system, only to end up paying a penalty that follows them like a persistent telemarketer. So unless you’re into paying more for less, make sure you don’t miss that Special Enrollment Period (SEP).

4. Special Enrollment Period: Your Get-Out-of-Jail-Free Card

  • Still working and covered by your employer? Great news! Suzie says you’ve got a Special Enrollment Period to sign up for Medicare Part B whenever you’re ready—or within eight months after you finally decide to trade your desk job for a hammock. No penalty, no problem. It’s like finding out you don’t have to attend the annual budget meeting after all!

5. What About Part D?

  • Is Your Prescription Coverage Up to Snuff? If your employer’s prescription plan is as strong as the coffee in the break room, you can skip Part D for now. But if your plan’s looking a little weak, like the decaf everyone avoids, Suzie suggests enrolling in Part D to avoid any late penalties. Nobody likes paying extra, especially when that money could be spent on something important—like more office donuts.

In Summary: If you’re still working, it’s not a one-size-fits-all when it comes to Medicare. Suzie from Wenatchee Insurance is here to help you navigate the maze of Medicare decisions without breaking a sweat. Whether you’re working for a big corporation or a small business, Suzie’s got the advice you need to keep your coverage (and your sanity) in check. After all, the only thing more confusing than Medicare is trying to figure out who took the last donut!

Talk with Suzie for Medicare

Topics: health insurance, Medicare, Medicare Advantage, Home Insurance, Car Insurance, Business Insurance, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,

calling suzie for medicare or health insurance help

Can I Switch Medicare Plans, and If So, How Often?

Posted on by Matt McColm
switch medicare during annual enrollment for Medicare advantage

Switching Medicare plans is like swapping seats at the Wenatchee Wild—you can do it, but you need to know when and where you’re allowed. Medicare gives you several chances to switch Medicare if your needs change, just like moving from the bleachers to next to the glass when the view isn’t quite right.

Suzie from Wenatchee Insurance is like a friendly usher who knows all the best seats.

talk with Suzie

Annual Enrollment – Oct 15 through Dec 7

During the Medicare Annual Enrollment Period (AEP) from October 15 to December 7, you can switch from Original Medicare to a Medicare Advantage plan, change your Medicare Advantage plan, or sign up for a Part D prescription drug plan.

During the AEP, you want to double-check your plan (ticket) to make sure that it is in the section that you want to be. You also get the chance to change the plan on your side kind of like upgrading your tickets to make sure you’re seeing the action from the best spot.

Medicare Advantage Open Enrollment Jan 1 -March 31

If you’re enrolled in a Medicare Advantage plan and decide it’s not for you, there’s also the Medicare Advantage Open Enrollment Period from January 1 to March 31. Suzie can help you switch back to Original Medicare or find a new Medicare Advantage plan during this time.

Medicare prescription plan d talk to Suzie at Wenatchee about Inflation Reduction Act

Special Enrollment Periods like losing a plan or moving

And if life throws you a curveball, like moving to a new area or losing other insurance, Suzie can check if you qualify for a Special Enrollment Period (SEP), giving you even more flexibility to switch medicare plans.

Suzie tip: We have another blog post that has a timeline for a Medicare Advantage plan leaving Washington State.

So, whether you’re looking for a better seat or just want to see the game from a new angle, Suzie will make sure you have the perfect Medicare plan to enjoy the show.

Suzie with Wenatchee Insurance has been helping people in Washington State navigate the twists and turns of Medicare for over a decade. If you have been a long-time resident, you may have encountered her when she was a Pharmacy Technician in Wenatchee. She has people who have set appointments years in advance to do the change from healthcare to Medicare.

Suzie Appointment
insurance bundle Wenatchee insurance

Topics: health insurance, Medicare, Medicare Advantage, health alliance, wellcare, Molina, humana, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat, switch medicare,

Who do I call for Medicare Fraud

Posted on by Matt McColm

We hear about medicare fraud more than we like. Suzie and Matt have been working with health and medicare insurance for over a decade in Washington State. In addition with Shayla we make up Wenatchee Insurance. We do not work for Medicare. Here is the disclaimer:

“We do not offer every plan available in your area. Currently, we represent 16 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.”

Every agent is required to tell you a disclaimer and you will even see them on their websites. If you don’t receive one then you know that something strange is occuring.

Medicare Fraud does occur during the annual enrollment period.

The Medicare annual enrollment period runs October 15 through December 7 every year. It allows people with Medicare Prescription plans and Medicare Advantage plans to review and change plans every year. There is a lot of activity and chaos so we want to make sure that if you encounter anything strange that you can lend a hand in prevention. Having an appointment with an agent that you know can reduce the chance of fraud from occurring.

recommend setting appointment

If you are not in our office in Wenatchee at 413 Mission Street then we are talking over the phone, it is on a recorded line. Medicare enrollments over the phone have been required for the last couple of years to be recorded. Yes, trained medicare agents record calls.

Medicare Fraud prevention tips

The Washington Office of the Insurance Commissioner has some great medicare fraud tips. The suggest checking the credentials when ever you have a question about who is selling you a medicare plan. We post copies of our licenses in our office lobby.

If you see Fraud then call 800-562-6900

When you report them. Let them know who they said they were and their phone number.

What Is Medicare, and Who Is Eligible for It?

Posted on by Matt McColm
wenatchee medicare suzie

Suzie from Wenatchee Insurance— has seen this before. She can be your guide through the trails of Medicare Mountain. Suzie’s like the friendly tour guide; she has been trained about the ins and outs of Medicare and can make the whole experience as smooth as a glass of your favorite local vintage.

OK, storytime.  You are strolling through one of the scenic vineyards near Lake Chelan sipping on a crisp glass of Riesling and enjoying the view. Life is pretty sweet, but you are getting close to 65, and suddenly, Medicare looms on the horizon like a far-off mountain range. You have had coverage for years from your job. What is this Medicare everyone’s talking about, and do you need to start climbing that mountain now?

Medicare 101

Medicare is a federal health insurance program designed primarily for people aged 65 and older, though younger folks with certain disabilities or conditions like End-Stage Renal Disease (ESRD) can also qualify. Think of Medicare as a big safety net, ensuring that as you transition into your golden years, you’re covered for hospital visits, doctor’s appointments, and other essential health services.

But wait—Medicare isn’t just one massive umbrella. It’s more like a series of cozy cabins at Mt Index’s Espresso Chalet, each with a different purpose:

  • Part A covers your hospital stays, kind of like the main lodge where you’ll spend most of your time resting and recovering.
  • Part B is your medical coverage, taking care of things like doctor visits and preventive services—think of it as your day trips around the area, keeping you in tip-top shape.
  • Part C (also known as Medicare Advantage) bundles Part A and B together with some extra perks, like dental and vision—imagine this as an all-inclusive spa package.
  • Part D is your prescription drug coverage, ensuring you have everything you need, from allergy meds to daily vitamins—like stocking up on brownies before taking a picture with Bigfoot.
chat with Suzie

Who’s Eligible for Medicare?

Now, who gets to enjoy this Medicare experience? If you’re a U.S. citizen or legal resident who’s been living in the country for at least five years and you’re about to turn 65, congratulations—you’re eligible for Medicare! That is correct not everyone can get Medicare, you have to be eligible.

But Suzie knows that life isn’t always a straight path forward. Maybe you’re still working at the local apple orchard, or perhaps you’re basking in semi-retirement, splitting your time between Wenatchee and your cabin in Conconully. If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Parts A and B when you hit 65. Keep an eye on that mailbox. Otherwise, you’ll need to sign up during your Initial Enrollment Period (IEP)—a seven-month window that starts three months before your 65th birthday and ends three months after.

Suzie’s tip: Mark your calendar! Missing this window could mean penalties down the road, like forgetting to RSVP to that big community BBQ and getting stuck at the end of the line and getting the potato salad with raisons.

Suzie Medicare Initial Enrollment, Annual Enrollment or Special Enrollment

How Suzie Makes Medicare Fun

Suzie’s got your back, ensuring you’re not just surviving the Medicare process, but thriving. Picture this: It’s a sunny day in Wenatchee, and Suzie invites you to her office for a Medicare 101 session. She’s got a spread of local snacks—cheese from Walla Walla, apples from Stemilt Growers orchards, and we will skip the wine for the moment because we want to be clear-headed.

She’ll walk you through each part of Medicare, breaking down the insurance lingo into simple, easy-to-digest bites, just like that dutch apple pie you can’t resist. Maybe you’ve heard rumors that Medicare is complicated—like trying to figure out which trail to take on a hike through the Cascades. But with Suzie, it’s more like a leisurely stroll around town, where she points out all the highlights and makes sure you don’t miss a thing.

Need help choosing between Original Medicare and Medicare Advantage? Suzie’s got you covered, like marked-up trail map that shows you the best route based on your needs. She’ll make sure you’re not paying too much, missing out on any benefits, or accidentally wandering off the beaten path into a bears den in Leavenworth.

Wrapping Up the Medicare Adventure

By the end of your chat with Suzie, Medicare will seem less like a daunting mountain and more like a gentle, rolling pasture—beautiful, manageable, and maybe even enjoyable. So, when you’re ready to start your Medicare journey, remember that Suzie from Wenatchee Insurance is there to make it as delightful as a day spent exploring the best of Eastern Washington. Cheers to that!

talk with Suzie
Home Health Medicare Car Dental Prescription insurance corndog

What are the costs associated with medicare prescription Drug Plans?

Posted on by Matt McColm
Medicare prescription plan d talk to Suzie at Wenatchee about Inflation Reduction Act

Unpacking Medicare Part D Costs: A Comical Adventure with Wenatchee Insurance

When it comes to understanding the costs of Medicare Prescription Drug Plans (Part D), it can feel like you’re opening a Walla Walla sweet onion—each layer revealing yet another hidden fee or charge. But don’t worry! Suzie & Wenatchee Insurance is here to make this journey as entertaining as a treasure hunt with a map that only partially makes sense. Let’s embark on this comical adventure together!

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The Entrance Fee: Monthly Premiums

First stop on our treasure hunt: monthly premiums. Think of this as the entry fee to the amusement park. You need it to get in, but the rides are extra.

Sample: “Imagine paying to enter the park, only to find that all the rides have separate fees. Welcome to the world of monthly premiums! Some are like the pricey but thrilling dragon roller coasters, others are more like the budget-friendly but equally fun unicorn merry-go-rounds.”

The First Clue: Annual Deductibles

Next, we encounter the annual deductible. This is the amount you pay out-of-pocket before your insurance plan starts covering costs. It’s like the troll bridge before you can access the treasure mountain.

Sample: “Picture a toll booth on your way to Treasure Island. You have to pay up before you can cross the bridge. Deductibles work the same way. Until you pay, you’re on the mainland, dreaming of buried treasure.”

insurance deductibles are important to the policy

The Treasure Map: Formularies

As we delve deeper, we find the formulary—a list of covered medications. Think of it as Big X on the treasure map. If your medication isn’t on the list, it’s like looking for treasure in the wrong place.

Sample: “Navigating the formulary is like following a pirate’s map. If your meds aren’t listed, it’s like trying to dig for gold in a child’s sandbox—frustrating. Always check the map (formulary) before setting sail.”

The Hidden Charges: Co-pays and Co-insurance

Along our adventure, we can stumble upon co-pays and co-insurance—those sneaky hidden charges that pop up when you least expect them. Co-pays are fixed amounts you pay for medications, like the fee for the funhouse. Co-insurance is a percentage of the cost, like splitting the bill for the bumper cars.

Sample: “Co-pays are like knowing the cost of the funhouse upfront—predictable and straightforward. Co-insurance, on the other hand, is like agreeing to pay a percentage of your friends’ bumper car rides—unexpected and potentially pricey.”

The Final Prize: Catastrophic Coverage

Finally, we reach the ultimate prize: catastrophic coverage. Once you’ve spent a certain amount, your costs drastically decrease. It’s like finding the buried treasure after a long, arduous journey.

Sample: “Catastrophic coverage is the X marking the spot on your treasure map. After navigating premiums, deductibles, and co-pays, you finally strike gold with lower costs and peace of mind.”

Wenatchee Insurance: Your Treasure Hunt Guide

Navigating the costs of Medicare Part D plans doesn’t have to feel like a solo quest through uncharted waters. With Suzie and Wenatchee Insurance as your trusty adventure guide, you’ll find the fastest routes, avoid the pitfalls, and maybe even have a few laughs along the way.

Whether you’re a swashbuckling adventurer or a cautious explorer, let Wenatchee Insurance help you uncover the treasures of Medicare Part D plans. Because with the right guide, the journey is just as rewarding as the destination.

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What Is The Difference Between Orginal Medicare And Medicare Advantage?

Posted on by Matt McColm
Medicare Advantage Prescriptions talk to Suzie at Wenatchee Insurance

When it comes to choosing between Original Medicare and Medicare Advantage, it’s kind of like deciding between a road trip along Highway 97 or hopping on a Greyhound bus tour through Eastern Washington. Both will get you where you need to go, but the experience can be quite different.

Original Medicare, the trusty old Ford wood paneled Station wagon of the Medicare world, offers Parts A and B. It’s like cruising along the Columbia with the windows down 55 miles an hour —simple with no air conditioning. You get hospital coverage with Part A and medical insurance with Part B, but you’re pretty much on your own for extras like dental, vision, or hearing aids. (Yes, Medicare does not cover everything). And just like a road trip, if you want snacks or souvenirs (prescription drugs), you’ll have to plan ahead and get yourself a Part D plan. If you skip Plan D at the start of your Medicare trip then you may have a late enrollment penalty.  

Now, Medicare Advantage (Part C) is the private bus tour with the tinted windows. Suzie from Wenatchee Insurance can guide you through the process like your seasoned tour guide. Medicare Advantage plans are offered by private companies and bundle Parts A, B, and usually D together, plus extra perks like gym memberships (perfect for keeping fit while exploring the Cascades or checking out the local wineries). Suzie can help you pick a plan that stops at all your favorite sights, whether that’s routine checkups or specialty care.

So, whether you’re a solo adventurer or prefer the all-inclusive package, Suzie has you covered. Just give her a call, and she’ll help you figure out which route is best for your Medicare journey.

health or medicare enrollment suzie makes it easier

Topics: health insurance, Medicare, Medicare Advantage, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,

What medications are covered under medicare prescription Drug Plans?

Posted on by Matt McColm
prescriptions cost money a medicare plan d can save medicare prescription

Understanding Medicare Part D Coverage: A Hilarious Adventure with Wenatchee Insurance

Navigating which medications are covered under Medicare Prescription Drug Plans (Part D) can feel like deciphering an ancient scroll written in hieroglyphics. But fear not! Suzie & Wenatchee Insurance is here to turn this daunting task into a hilarious adventure that’s as enlightening as it is entertaining.

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The Treasure Map: The Formulary

The formulary is your treasure map, showing you which medications are covered by your plan. Each plan has its own formulary, which can vary widely. It’s like a map with X’s marking the spots where your gold (meds) is hidden.

Sample: “Imagine being a pirate with a treasure map. Each X marks a spot where your treasure (medication) is hidden. Some maps are better than others, so choose wisely!”

The X Marks the Spot: Tiers of Medications

Medications in the formulary are divided into tiers, with each tier representing different levels of cost. Think of it as a hierarchy in a medieval kingdom.

Sample: “Tier 1 is the peasant tier—affordable and plentiful. Tier 2 is the knight tier—costs a bit more but offers more benefits. Tier 3 and beyond are the noble and royal tiers—high costs for high benefits. Choose your allegiance!”

health or medicare enrollment suzie makes it easier

The Scroll: Reading the Formulary

Understanding the formulary is like reading an ancient scroll. You’ll see medication names, tiers, and restrictions like prior authorization or step therapy.

Sample: “Deciphering the formulary is like reading an ancient scroll. Some words are clear, others require a magnifying glass and a translator. But don’t worry, we’re here to help!”

The Gatekeeper: Prior Authorization

Some medications require prior authorization, meaning your doctor needs to get approval before the plan covers the medication. It’s like asking the castle gatekeeper for permission to enter.

Sample: “Prior authorization is like asking the castle gatekeeper if you can enter. Sometimes they’ll wave you through, other times they’ll demand to see your credentials (doctor’s approval).”

The Quest: Step Therapy

Step therapy is a process where you must try cheaper medications before the plan covers more expensive ones. It’s a quest where you must complete tasks to progress.

Sample: “Step therapy is like a knight’s quest. You must complete the first task (try a cheaper med) before moving on to the next challenge (getting the expensive med covered).”

The Allies: Preferred Pharmacies

Some plans have preferred pharmacies where you can get your medications at lower costs. It’s like finding friendly allies in different towns during your journey.

Sample: “Preferred pharmacies are your allies in various towns. They offer you safe haven (lower costs) and help you on your quest (managing your meds).”

The Dragon: The Donut Hole

Ah, the donut hole—the fearsome dragon guarding the treasure. It’s a coverage gap where you pay more out-of-pocket for your medications. But with the right plan, you can slay the dragon and move forward.

Sample: “The donut hole is the dragon in your story—scary and expensive. But fear not, brave knight! With Wenatchee Insurance’s guidance, you can slay the dragon and continue your quest.”

calling suzie for medicare or health insurance help

The Ultimate Prize: Catastrophic Coverage

Finally, after navigating the formulary, prior authorization, step therapy, and the donut hole, you reach catastrophic coverage. It’s the ultimate prize where your costs decrease dramatically.

Sample: “Catastrophic coverage is the Holy Grail of your quest. After facing all the challenges, you find your costs reduced and your treasure (meds) more affordable. Victory!”

Wenatchee Insurance: Your Quest Companion

Understanding which medications are covered under Medicare Prescription Plan doesn’t have to be a solo quest through treacherous lands. With Wenatchee Insurance as your trusty companion, you’ll have a guide, map, and ally to help you every step of the way.

So, if you’re ready to embark on this epic adventure, let Wenatchee Insurance lead the way. Together, we’ll turn the daunting task of understanding Part D coverage into a thrilling, victorious quest.

talk with Suzie
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How Do I avoid Late Enrollment Penalty for Medicare?

Posted on by Matt McColm
Medicare and Medicare Advantage help with suzie avoid late enrollment penalty

Avoiding Medicare late enrollment penalty is like making sure you’re not stuck in traffic on the George Sellar Bridge trying to pick up your kid at the mall—you want to plan so you don’t miss out (or have an upset kid!). The secret sauce is to sign up for Medicare on time, during your Initial Enrollment Period (IEP).

The Initial Enrollment Period is three months before your 65 Birthday, your Birth month, and then three months after your birthday. Seven months can seem like a long time but yes, we have encountered a fair number of people who have missed their IEP.

Suzie from Wenatchee Insurance is like your pocket navigator, guiding you to avoid any wrong turns. If you miss your IEP and don’t have other creditable coverage, you could face penalties when you enroll. The penalties do not go away and grow the longer you delay coverage.  

Late Enrollment Penalty Example

For example, for Part B, the late enrollment penalty is an extra 10% added to your monthly premium for each full 12-month period you were eligible for but didn’t sign up.

But here’s the fun part—Suzie trained to understand the shortcuts. Maybe you have employer coverage or are covered under a spouse’s plan? In these cases, you might qualify for a Special Enrollment Period (SEP), which is like getting a personal police escort across the bridge to make it on time.

health or medicare enrollment suzie makes it easier

Suzie can also help you figure out if delaying Medicare makes sense for your situation. Just like knowing when you can grab a coffee and when you need to get going, having Suzie’s advice will ensure you’re on time and on budget. For some people, it makes sense to start their Medicare Part A Coverage while others may want to delay their Part B.

Suzie with Wenatchee Insurance has been helping people in Washington State navigate the twists and turns of Medicare for over a decade. If you have been a long-time resident, you may have encountered her when she was a Pharmacy Technician in Wenatchee. She has people who have set appointments years in advance to do the change from healthcare to Medicare.

set appointment with Suzie
Home Health Medicare Car Dental Prescription insurance corndog

Topics: health insurance, Medicare, Medicare Advantage, wenatchee insurance, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,

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Suzie Health Solutions

Health & Medicare

For nearly a decade we have assisted with Health & Medicare Solutions. We are proud to be selected by the Washington Healthplanfinder to be one of ten Enrollment Centers located in Washington State.

We work with all ages and charge no fees.

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