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Congratulations!
You have taken the first step toward understanding your Medicare options! Whether you're new to Medicare or reviewing your existing plan, this page will help you know exactly what to expect before our appointment. Our goal is to make your Medicare experience simple, compliant, and informative - while helping you feel confident about your choices.
Below, you'll find a clear breakdown of what happens during the Medicare process - from your first conversation to enrollment - along with a glossary of key terms you'll hear along the way.
Don't worry if it feels like a lot right now; we'll walk through it together during your appointment.
Why Medicare Appointments Are Recorded
Medicare requires certain phone and virtual appointments to be recorded to protect both you and your agent. These recordings ensure transparency, accuracy, and compliance with federal regulations. They serve as proof that all plan information was presented clearly, honestly, and without pressure — giving you peace of mind and helping prevent misunderstandings later.
You can call (323)973-2724 to speak with John Ortiz about Medicare.
For New to Medicare Beneficiaries
As you begin your Medicare journey, here's what to expect. Each step ensures clarity, compliance, and personalized support. When a conversation must be recorded - it will be recorded and stored for 10 years (as required by law).
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Initial Contact (Lead Generation)
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Source: Referral, Website, Lead Vendor, Seminar, or Ad.
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All marketing must be CMS-compliant. Recorded if by phone.
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Discovery (Education)
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We'll explain Original Medicare, Medicare Advantage, Prescription Drug Plans, and Supplements. Recorded if virtual or phone.
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Scope of Appointment (SOA)
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Completed before discussing any plan benefits. May be verbal, electronic, or written. Recorded if virtual or phone.
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Plan Comparison (Recommendation)
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We review carriers, benefits, and premiums to find the right fit. Recorded.
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Enrollment (Application)
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We assist with your enrollment form. Recorded if virtual or phone.
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Post-Enrollment Support
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We help with ID cards, provider networks, and prescription updates. Administrative only - recording not required.
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For Renewal Medicare Beneficiaries
If you are already enrolled in Medicare, we make your annual review simple and secure.
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Annual Review
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We review your current plan and discuss 2026 changes. Recorded if plan details are discussed.
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Plan Comparison
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We compare your existing plan to new options in your county. Recorded if plan-level details are recorded.
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Decision & Enrollment
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If switching or reviewing by phone, the call is recorded. In-person appointments are documented with an SOA.
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Post-Enrollment Support
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We help with ID cards, provider networks, and prescription updates. Administrative only - recording not required.
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Understanding Medicare Terms
Before you dive into your Medicare options, it's important to understand the language of Medicare. Many people find the terminology confusing - and that's completely normal.
Knowing these terms helps you feel more confident, make informed decisions, and follow along easily during our discussion.
The more familiar you are with these definitions, the smoother your Medicare journey will be.
Medicare Glossary
This glossary was created to help Medicare beneficiaries in Southern California prepare for their Discovery Appointment with John Ortiz of Insure Your Success. Understanding these key terms can make your Medicare discussion easier and more empowering.
A
Annual Enrollment Period (AEP): Oct 15–Dec 7: the yearly window to change Medicare Advantage or Part D plans.
C
Chronic Condition Special Needs Plan (C-SNP): A Medicare Advantage plan for individuals with specific chronic conditions.
Coinsurance: A percentage you pay for a service after the deductible is met.
Copayment (Copay): A fixed dollar amount you pay for a specific service or medication.
D
Deductible: What you pay out of pocket before coverage begins.
Dual Eligible: Someone who qualifies for both Medicare and Medi-Cal.
E
Enrollment Period: Specific times when you can enroll in, change, or drop Medicare coverage.
Extra Help (Low-Income Subsidy): Assists lower-income individuals with prescription drug costs.
H
HICAP (Health Insurance Counseling & Advocacy Program): California’s free, unbiased counseling service for Medicare beneficiaries.
I
Initial Enrollment Period (IEP): Your first chance to enroll in Medicare around your 65th birthday.
M
Medi-Cal: California’s version of Medicaid, helping low-income individuals with healthcare costs.
Medicare: A federal health insurance program for people 65 & older, and for certain younger individuals with disabilities.
Medicare Part A: Covers inpatient hospital care, skilled nursing facilities, hospice, and some home health care.
Medicare Part B: Covers doctor visits, outpatient care, preventive services, and durable medical equipment.
Medicare Advantage Part C: A private plan that replaces Original Medicare and often includes drug coverage.
Medicare Part D: A standalone prescription drug plan offered by private insurers.
Medicare Supplement (Medigap): Helps pay costs not covered by Original Medicare, like copays and deductibles.
N
Network: The group of doctors, hospitals, and pharmacies covered by your Medicare Advantage plan.
O
Open Enrollment Period (OEP): Jan 1–Mar 31: allows switching Medicare Advantage plans or returning to Original Medicare.
Original Medicare: The traditional government program consisting of Part A (Hospital Insurance) and Part B (Medical Insurance).
Out-of-Pocket Maximum or Maximum Out-of-Pocket (MOOP): The most you’ll pay in a year before your plan covers 100% of costs.
P
Premium: The monthly amount you pay for Medicare coverage.
Prescription Drug Formulary: A list of covered medications organized by cost tiers.
Primary Care Physician (PCP): Your main doctor who coordinates care and referrals.
Prior Authorization: Approval required from your plan before certain services or prescriptions are covered.
S
Scope of Appointment (SOA): A required form that lists which Medicare products will be discussed during your appointment.
Special Enrollment Period (SEP): A time outside standard periods when coverage changes are allowed due to qualifying events.
Specialist: A doctor who focuses on a specific field, like cardiology or orthopedics.
Star Rating: Medicare’s 1–5 star quality rating for plan performance.
T
Tier: A level that determines how much you pay for a medication; lower tiers usually cost less.
Additional Medicare Terms will be added to this Glossary as experience dictates.
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Get in Touch
Have Questions? Let's Talk.
Medicare can feel complicated, but you don’t have to navigate it alone.
Whether you’re new to Medicare or reviewing your current plan, our team is here to guide you with clarity and care.
Reach out to us three ways:
1. Use the form to send us a message
2. Email us at john@insureyoursuccess.com
3. Call our recorded line: (323) 973 - 2724
Let's start a conversation today.
