How Via Benefits Works — Health Coverage Simplified (2024)

This article provides an overview of Via Benefits and the Via Benefits Medicare enrollment process.

As trusted advisors to over two million Medicare-eligible participants, Via Benefits Insurance Services offers assistance as you enroll in new individual Medicare coverage. Once you understand your Medicare coverage options, you're ready to start reviewing the plans available in your area.

Who We Are

Via Benefits is a personalized service to help you find, evaluate, and enroll in coverage that fits your needs and budget. We work for you and your eligible spouse or dependent. Via Benefits isn’t an insurance carrier. We’re the largest and oldest private Medicare marketplace, operating since 2004. We work with leading national and regional insurance carriers to ensure you can choose from quality plans available in your area. Because we offer a range of options, you may find coverage better than your current plan at a lower cost.

The Via Benefits Process

With personalized support, outstanding online tools, and quality plan options, Via Benefits provides assistance to prepare, review and enroll in an individual Medicare plan that meets your health needs, covers your prescription drugs, and works within your budget. Our service is provided at no cost to you.

Prepare

We need your Medicare Part A and Part B effective dates to enroll you in a Medicare plan. Go to ssa.gov to sign up for Medicare online if you haven’t done so already. You can also contact the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778).

Sign Up with Via Benefits and Create Your Via Benefits Profile. To create your profile, gather and enter the following information to help you find and choose the right plan:

  • Your Medicare number

  • Prescription information – names, dosages, the frequency you take medication, and the pharmacies you use

  • Provider information – for plans that have a provider network, names and addresses for all the doctors, hospitals, and outpatient facilities you wish to continue using

When you create a Via Benefits profile, you can review your plan options and even enroll on the website. When you select Shop and Comparefrom the Menu, it allows you to view and compare Medicare-related insurance plans available in your area and sort them by price, plan type, insurance carrier, and other factors. Using the information in your profile, you can access personalized cost estimates. This includes entering your providers and your prescriptions.

Shop for Plans

Now that you've created your Via Benefits profile, it’s time to shop for plans. You can contact us at 1-866-2824 (TTY: 711) to speak with a Via Benefits licensed benefit advisor who will ask you some questions to learn your needs, help you evaluate plans based on your needs, and answer any of your questions. We take the time you need to make a confident choice.

If you’re already familiar with Medicare and know what you need, sign into Via Benefits and select Shop for Plans to shop and enroll in plans. Reviewing your plan options helps you make an informed and confident choice during enrollment.

Plans renew automatically. If you want to keep the same plan, no action is needed. Read Renewing Your Plans for Next Year for more information.

Watch a Pre-Recorded Educational Medicare Webinar or Join a Live Webinar to learn more about how Medicare works and what choices you need to make as you turn 65 or retire.

Enroll

Once you’ve reviewed your options, either by speaking with a benefit advisor or using the website, you're all set to enroll. If you’re looking for coverage during Medicare’s Open Enrollment Period, October 15 through December 7, be aware coverage options for the following year are usually available in mid-October. For example, plans and rates for 2024 are available in mid-October 2023.

Enroll Using the Via Benefits Website

If you find a plan you know you want, consider enrolling on the website. It’s easy, and most plans allow you to enroll on the websitewithout needing to speak to anyone at Via Benefits.

Not yet Medicare-eligible but interested in reviewing your plan options now? Without signing in or creating aprofile, select See Plans on the landing page. On the Prepare to Shoppage, enter your ZIP Code and select Show me plans now.

Enroll Over the Phone

Unsure if enrolling on the website is your best option? Consider scheduling a call to enroll up to three months before you retire or turn 65. You can schedule a call on the website or by calling us. If you'd rather not make an appointment, you can call us at your convenience. During your call, a Via Benefits licensed benefit advisor* walks you through your coverage options, helps you determine which plans meet your medical and financial needs, and completes your enrollment application. The call takes about 90 minutes per person to complete. If you're also enrolling a Medicare-eligible spouse or dependent, you're both welcome to enroll at the same time, or make separate enrollment appointments.

When you purchase a health plan through Via Benefits, we become your advocate for the lifetime of your enrollment. If your needs change, or you move, you can contact us to determine if your plan is still right for you. We’re available and happy to assist you with changes

How Via Benefits is Compensated

Individual benefit advisors are compensated the same whether you pick a Medicare Advantage plan or Medicare Supplement (Medigap) plus a Prescription Drug Plan and regardless of which carrier you choose. For other kinds of products, the compensation they receive may vary based on the kind of product you purchase, but doesn't change based on carrier.

*Our licensed benefit advisors specialize in health insurance for retirees. They go through annual training and certification to ensure they can help you make an informed and confident decision.

How Via Benefits Works — Health Coverage Simplified (2024)

FAQs

What is via benefits and how does it work? ›

Via Benefits is a personalized service to help you find, evaluate, and enroll in coverage that fits your needs and budget. We work for you and your eligible spouse or dependent. Via Benefits isn't an insurance carrier. We're the largest and oldest private Medicare marketplace, operating since 2004.

Is Via benefits real? ›

Via Benefits is not an insurance company; it is a resource that gives you access to a state-of-the-art Medicare exchange (sometimes referred to as a marketplace) containing a wide assortment of plans from more than 100 of the largest and most popular national and regional health insurance companies.

How does health insurance work summary? ›

Each month, you make a payment to a health insurer, such as Medicare or your insurance company. Some employers chip in for this payment. In return, your insurer covers all or some of your medical costs, as long as you follow the insurer's rules.

What is the explanation of benefits in health insurance? ›

An explanation of benefits (EOB) shows you the total charges for your visit. An explanation of benefits isn't a bill. It helps you understand how much your health plan covers, and what you'll pay when you get a bill from your provider.

How do I claim payments via benefits? ›

Use the Via Benefits Accounts mobile app, the website, or a Reimbursem*nt Request Form to submit reimbursem*nt requests. Submitting your requests on the mobile app or on the website is the fastest and most secure way to have your reimbursem*nts processed. You also save time and postage.

What happens to via benefits when someone dies in Medicare? ›

Please be aware, that after 24 months from the date of the benefit recipient's death, the HRA will automatically close and funds will forfeit. To utilize the remaining balance, submit a claim on the deceased's behalf, or qualified dependent. The HRA will be considered closed once the balance has been exhausted.

Does Via Benefits reimburse Medicare premiums? ›

A Recurring Premium Reimbursem*nt request needs to be submitted once each calendar year to be reimbursed monthly. You can also submit for a one-time reimbursem*nt of quarterly Medicare Part B payments.

How do I check my Via benefits balance? ›

Download the Via Benefits Accounts mobile app to easily view your available balance, upload receipts, and view the statuses of your expenses. Download the app or sign into my.viabenefits.com/funds. This guide has important information on how to manage your reimbursem*nt account.

Are VIA benefits taxable? ›

The purpose of the Plan is to reimburse eligible retirees for certain medical expenses which are not otherwise reimbursed. Reimbursem*nts for eligible medical expenses paid by the Plan generally are excludable from the participant's taxable income.

How does medical insurance work for dummies? ›

Health insurance works by having you pay a monthly premium to maintain your coverage. In return, the insurance company helps cover the costs of your medical care.

Which is the best health insurance in the USA? ›

Compare the Best Health Insurance Providers
CompanyAvailability
Blue Cross Blue Shield Best Overall36 states
Kaiser Permanente Highest Quality Plans8 states and the District of Columbia
Oscar Best Health Management Programs18 states
Aetna CVS Health Best for Same-Day Care12 states

What is the purpose of the summary of benefits coverage? ›

The SBC is a snapshot of a health plan's costs, benefits, covered health care services, and other features that are important to consumers. SBCs also explain health plans' unique features like cost sharing rules and include significant limits and exceptions to coverage in easy-to- understand terms.

What are the disadvantages of health insurance? ›

Disadvantages of private health insurance

Many individual policies can cost several hundred dollars a month, and family coverage can be even higher. And even the more comprehensive policies come with deductibles and copays that insureds must meet before their coverage kicks in.

What is the difference between insurance coverage and benefits? ›

Coverage is the amount of financial protection you get from insurance. Benefits are the health services your plan covers.

Is health insurance worth it? ›

Health insurance can help reduce your risk of racking up medical debt. Only a handful of states enforce financial penalties if you don't have health insurance but it's still wise to have the financial protection.

How does a benefit allowance work? ›

What Is a Benefit Allowance? A benefit allowance is money that a company or government agency provides to an employee for a specific purpose, such as transportation, healthcare costs, or a flexible spending account. Benefit allowances administered to employees can be distributed through regular payroll.

Can I use my Via benefits card at the ATM? ›

You can't use your Benefits Card at an ATM machine or to get cash back when making a purchase at a store.

Does Via Benefits reimburse for Medicare premiums? ›

This account is administered by Via Benefits, and funds can be used to reimburse your Medicare plan premiums or other out-of-pocket healthcare costs. Click here to learn more about this program.

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