Alan "AL" Minthorn, Medicare Insurance Broker

Answer: My best advice would be talk to your fellow senior neighbors and identify a good local agent/broker representing most or all available insurance companies. Call centers and carrier agents are often hundreds of miles away and do not understand local providers, nor hear issues customers have with one plan over another in your backyard.

Answer: Most common misconception about Medicare - they cover everything! Know your A, B, C, and Ds of Medicare.

Answer: For about 90% of customers in markets with a minimum of a dozen advantage plans, they’ll be fine on these products. In more rural markets, those with high maintenance chronic conditions, or those living in three more locations yearly - a Med Supp may be a better choice.

Answer: If you are still working, have creditable employer health and prescription insurance, meaning it is as least as good as Medicare (HR should know this), then enroll in Medicare Part A ONLY. It has zero cost, provided you've worked 10 years and paid into Medicare.

Approx. 3 months before you are ready to retire and selected an end date of employment (end of month is easier), enroll in Medicare Part B (for 1st of month following this end date). After receiving your revised Medicare Card showing Part A & B dates, have a local agent assist in educating and selecting the appropriate plan(s) to begin without a gap in coverage.

Answer: First, make sure you have the plan providing lowest cost coverage for your formulary needs. Next make sure you use preferred plan pharmacies. Create a price sheet comparing plan co-pays/coinsurance vs Single Care, GoodRx, CostPlusDrugs, or other discount programs. I have one blood pressure med I pay approx. 23% for 90 days versus plan pricing.

Note: If you use a non-plan option, have your prescriber note that on your chart for audit purposes.

Some tablets can be split in half, others not - you may be able to pay a similar price for double strength tablet and half it. Just make sure your doctor knows and approves for your needs.

Answer: MOOP’s apply to Part A & B cost sharing - it is the maximum you should pay in total cost shares before the plan covers 100% of Part A & B costs the remainder of year. Greater than 90% hit their MOOP via chemo or other Part B medications, or radiation treatments.

Answer: Medicare’s cost sharing is independent of your contributions through payroll deductions, or premiums paid. Specialist visits are expensive due to their expertise you’re accessing. You might review your current plan options with a good agent to see what other options may be available.

Answer: In my case, I have spent 16 years developing, refining, and learning everything I can about the Medicare program, senior insurance products, and options I can offer my customers. It’s all I do. No home, auto, life, or other insurance products to dilute my time and expertise.

Answer: I recommend 12-14 weeks prior to your birth month visiting the Social Security website and looking for the “Apply for Medicare” radio button. Do not procrastinate. The process typically takes a minimum of 4-6 weeks. During that time - you’ll get NO updates; then about 30 days later, you’ll get a brief email saying you’ve moved to the next step - within two weeks you’ll have your Medicare Card and about 3-4 letters.

Answer: Most Medicare Advantage plan Dental Benefits are limited at best. Some reimburse, others use a national dental insurer, yet, others, are “internal” dental products under that carrier’s portfolio of products. A good agent can offer suggestions of local plans meeting your dental needs and balancing those with your medical/Rx needs.

Answer: The best advice I give my customers - do not listen to your friends, family, or others not licensed in my business. Most do not disclose all their medical and pharmacy details, rarely know their insurance and your insurance plan nuances, and do not have the experience to make those generalizations and comparisons. I fix their bad advice more than bless it.

Answer: First you may not be comparing apples to apples; without knowing their income, plan details, etc, you are likely not comparing like plans. Some states allow “rating” insurance by zip codes, others gender, tobacco use, and age. Some use all of these. Agent’s can sort the details and risks making sure you needs are being met.

Answer: Consult with a licensed agent or call Medicare to review possible options. There are multiple election periods annually. You may qualify for a Special Election Period depending on “why” you missed your Open Enrollment Period.

Answer: I had a client call a TV ad 800 number during Annual Enrollment in a moment of emotional weakness having just lost their spouse. They were assured all their docs and drugs were covered by that new “TV giveback plan.” They had 13 docs and 23 drugs. Ten docs were out of network on the giveback plan; the cost sharing for the 23 drugs was over $10,000 more than their current plan.

They called feeling shame and embarrassment for succumbing to the fast talking agent at their low point emotionally. I KNEW I COULD “FIX” IT. It took hours to reverse the damage caused by the fast talking TV call center agent. As it was still AEP, it was easily reversed with a few days to spare. But still caused the customer a lot of worry over the several weeks of processing time.