Turning 65?

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Mission

Mission Statement

"TO CARE, SIMPLIFY, EDUCATE AND PROVIDE OPTIONS FOR MEDICARE BENEFICIARIES"

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  • Understand

    Understand

    Understand

    We Help Patients understand the various parts of Medicare: Part A, B, C, and Part D.

  • Learn

    Learn

    Learn

    We Help Patients learn the differences between an HMO, PPO, and Supplements.

  • Save

    Save

    Save

    We Help Patients save by reducing the cost of their medications (LIS).

Who We Are

Who is SBHIS?

Insurance

South Bay Health & Insurance Services, Inc also known as SBHIS, is an insurance agency that specializes in helping people with Medicare or Medi-Cal or both; find the plan that best suit their needs.

Medicare

SBHIS is highly specialized in Medicare because we ONLY represent Medicare Part D, Medicare Advantage, and Medicare Supplement Plans. Our clients have or will soon have Medicare.

Coverage

At SBHIS we believe that having the right coverage to go along with Medicare is one of the most important decisions a Medicare eligible has to make.

Beneficiary

SBHIS believes every Medicare beneficiary should be educated on their coverage options in order to make informed decisions.

Agents

SBHIS agents are highly trained professionals dedicated to helping Medicare beneficiaries. Having the heart to serve and educate our members is at the forefront of our mission.

Honor

At SBHIS we are honored to be entrusted with assisting and guiding members through such important decisions. We always look forward to helping our members find coverage that makes sense that best suit their needs.

15+ California Locations
1000+ Active Members
30+ Current Agents
10+ Awards Winnings

Medicare 101

We know Medicare!

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD). Although Medicare has a lot of moving parts Medicare Parts A and B are the formation of Original Medicare...

Medicare Part A (Hospital Insurance)

Part A includes basic functions of insurance such as inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Keep in mind Part A may require a monthly premium for those who haven’t paid into social security for at least 10 years.

Medicare Part B (Medical Insurance)

Part B helps to cover medically necessary doctor’s expenses, outpatient care, and preventative services like seasonal flu shots and other vaccines. Part B does come with a monthly premium that can be deducted from a social security check every month.

Am I eligible?

Before you can enroll into a Medicare plan you must first make sure you’re eligible.

Most people are automatically eligible if they are 65 years or older and either themselves or a spouse has worked for the past 10 years while paying into social security. You may also be eligible if you’re already getting benefits from social security or the Railroad Retirement Board. People are also eligible under 65 if they have ESRD or other certain disabilities.

When Can I enroll?

Initial Enrollment period. If you are turning 65 and have received your Medicare Card you have 7 months to choose a Medicare Advantage Plan. Your Initial Enrollment Period will begin 3 months before the month of your 65th birthday, the month of your birthday, and 3 months after your 65th birthday.

Open Enrollment Period (OEP)

Every year from October 15th- December 7th you can renew, review, and enroll into a plan of your choosing.

Special Enrollment Period (SEP)

A special enrollment period is a period outside of open enrollment in which you can get coverage due to qualifying life events. You may qualify for special enrollment if you lose your Medi-Cal eligibility, move out of the area, miss a deadline, lose your current coverage, your plan changes its contract with Medicare and other special situations.

For more information about Medicare, please go to the website at www.medicare.gov or call Medicare at 1-800-Medicare.

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Medicare Part C (Medicare Advantage Plans)...

Medicare Advantage Plans are health plans offered by private insurance companies that contract with the government to provide Medicare Parts A and B, as well as extra benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans also offer prescription drug coverage.

  • Health Maintenance Organization (HMO)

    In most HMOs, you must choose a Primary Care Physician (PCP) and use in-network providers. In this type of plan you are traditionally required to obtain an authorization prior to receiving specialty services.

  • Preferred Provider Organization (PPO)

    In a PPO you have the option of accessing services both in-network and out-of-network. However, the cost shared by the beneficiary and the provider will be higher for out-of-network providers.

  • Special Need Plans (SNP)

    These types of plans are designed to service groups and limit enrollment for people with Medicare that meet specific qualifications:

    • Chronic Special Need Plans (C-SNP)
    • Dual Special Need Plans (D-SNP)
    • Institutional Special Need Plans (I-SNP)
  • When Can I Enroll?

    Initial Enrollment period
    If you are turning 65 and have received your Medicare Card you have 7 months to choose a Medicare Advantage Plan. Your Initial Enrollment Period will begin 3 months before the month of your 65th birthday, and 3 months after your 65th birthday.

  • Open Enrollment period (OEP)

    Every year from October 15th – December 7th you can renew, review, and enroll into a Stand Alone PDP or a MAPD that includes a PDP.

    For more information about Medicare, please go to the website at www.medicare.gov or call Medicare at 1-800-Medicare.

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Medicare Part D (prescription drug coverage)...

Part D is a supplement to original Medicare (Parts A & B) by providing additional prescription drug coverage. They can be attached to regular Parts A and B, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Prescription drug coverage may also be included by Medicare Advantage Plans and follow same rules Medicare Prescription Drug Plans.

  • Am I eligible for Medicare Part D?

    In order to qualify for a Medicare Part D you must meet the following criteria:

    • You must have Medicare Part A (Hospital) & Medicare Part B (Medical)
    • You must live in a zip code covered by the Medicare Advantage Plan
    • You must not have End Stage Renal Disease (ESRD)
  • When Can I Enroll?

    Initial Enrollment period
    If you are turning 65 and have received your Medicare Card you have 7 months to choose a Medicare Advantage Plan. Your Initial Enrollment Period will begin 3 months before the month of your 65th birthday, and 3 months after your 65th birthday.

  • Open Enrollment period (OEP)

    Every year from October 15th- December 7th you can renew, review, and enroll into a Stand Alone PDP or an MAPD that includes a PDP. Medicare supplement Plans, also known as Medigap, are designed to fill in the coverage gaps of Original Medicare. Most of them will cover Medicare Co-Insurance, and deductibles. Medigap plans are also provided by private insurance companies who are contracted through the government.

  • For more information about Medicare, please go to the website at www.medicare.gov or call Medicare at 1-800-Medicare.

Read More...

Medicare supplement Plans, also known as Medigap, are designed to fill in the coverage gaps of Original Medicare. Most of them will cover Medicare Co-Insurance, and deductibles. Medigap plans are also provided by private insurance companies who are contracted through the government...

  • Some things you should know about Medigap

    • You must have Medicare Part A and Part B.
    • If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
    • You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
    • A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
    • You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
  • When Can I Enroll?

    Initial Enrollment period
    The best time to enroll in Medigap is during your Open Enrollment Period. This period lasts six months and begins the first day of the month in which you are 65 or older and enrolled in Medicare Part B. So if you turn 65 on April 3 but don’t join Medicare B until May 25, your Medigap Open Enrollment Period will start on June 1, which is the first day of the month in which you are both 65 and enrolled in Part B.

  • For more information about Medigap, please go to the website at www.medicare.gov or call Medicare at 1-800-Medicare.

Read More...

Still confused about choosing the right plan?

Having the right plan, making the right choice and confirming that it remains the one that makes the most sense for you, year after year, is our specialty.

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or Call 1-888-988-8072 | TTY: 711 (M-F: 8AM - 6PM)

SBHIS represent various Medicare Advantage Plans (MA), Medicare Supplement (Medigap), and Prescription Drug Plans (PDPs) with Medicare contracts. Calling this number will connect you to a licensed agent: 1-888-988-8072 | TTY: 711 (M-F: 8AM - 6PM).

**Privacy is our policy. We will never spam or sell your personal information.

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