Alexander Valencia, Medicare Insurance Agent
Alexander Valencia
Segpro Insurance Agency
Bilingual English & Español
Medicare Agent Licensed in CA, IL, NJ and NY
6+ Years of Experience
Contact Details
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Location
Tracy, CA
Alexander Can Help With:
About Me
Hi! My name is Alexander, and I am your dedicated Medicare consultant and agent. My focus is on Medicare, and I am committed to assisting you in finding the most suitable plan that aligns with your unique needs and budgetary constraints. I will tackle the challenge of sifting through plans from nationally and locally recognized companies, so you don't have to. What's more, my services are entirely free! I am fluent in Spanish and Portuguese as well. Reach out to me today to explore your Medicare insurance options and be sure to mention that you discovered me on Medicare Agents Hub!
Q&A with Alexander Valencia
How can insurance companies afford to offer Advantage plans with $0 monthly premiums?
Answer: Government subsidies, The government pays a set amount to health insurance companies to offer Medicare Advantage plans to beneficiaries. Some of this funding is used to offer plans with no monthly premium and extra benefits to help members.
When is the best time of the year to start looking at Medicare options?
Answer: If you are signing up for the 1st time, the Initial Enrollment Period (IEP), which is typically around your 65th birthday. If you are already receiving Medicare benefits, the Annual Enrollment Period (AEP) runs from October 15 to December 7 each year, where you can review and enroll in your Part D Prescription drug plans. It's important to review your Medicare options even up to 9 months in advance of your 65th birthday to ensure you have the best coverage and avoid any potential penalties.
Is Original Medicare or Medicare Advantage better? Why do you recommend one over the other?
Answer: Hi there, choosing between Original Medicare and Medicare Advantage depends on your health needs, budget, and personal preferences. Here are some factors that may help you choose one over the other:
1. Original Medicare: Offers a wide provider network, allowing you to see any doctor that accepts Medicare. It does not have maximum-of-pocket costs, which can be beneficial for those who may not need extensive coverage.
2. Medicare Advantage: May offer additional benefits such as dental, vision, and hearing coverage, which can be appealing for those who want comprehensive health coverage. However, it may have a higher monthly premium. It has a maximum out-of-pocket cost, which can be beneficial for those with higher cost medical needs.
The choice between Original Medicare and Medicare Advantage should be based on a careful assessment of your health needs, financial situation, and personal preferences. It is advisable to consult a Medicare expert to help you arrive at a more informed decision.
What do I need to do if I didn't take Medicare at 65 and am now retiring?
Answer: 1. You will have a Special Enrollment Period (SEP) to enroll in Medicare, which starts when you stop working or lose your health insurance.
2. If you don't sign up for Medicare when you turn 65, you may incur a late enrollment penalty, if you did not have creditable coverage at the time you were eligible to initially enroll (IEP)
If a patient had surgery with more than a 3 day stay in the hospital and needed to recover from the surgery before starting rehab, can the rehab stay be delayed by up to 90 days pending recovery?
Answer: Yes, the rehab stay can be delayed up to 90 days pending recovery from the surgery, provided that the delay is medically necessary. Medicare 3-day rule requires a medically necessary inpatient hospital stay of at least three consecutive days before Medicare will cover skilled nursing facility. If the delay exceeds 30 days, it must be deemed medically inappropriate to begin rehab sooner to remain covered.
I'm on Original Medicare with no supplement, and I'm wondering how much I'd pay if I need an ambulance ride to the hospital tomorrow.
Answer: You will have a charge of the Part B deductible first which as of 2025 will be $257 and then 20% of the charge of the ambulance company charge in your area (state/city) you live.
For Medicare Part D, why would someone pick a plan with a high total cost?
Answer: Choosing a Medicare Part D plan with a high cost can be beneficial for several reasons:
1. Specific Medication Coverage: Plans with higher costs often offer better formularies, favorable for expensive brand-name or specialty drugs, which could be essential for enrollees with chronic conditions.
2. Lower Out-of-Pocket Costs: For frequent medication users, a plan with a higher premium but lower copays, coinsurance, and deductibles can save money over the year.
3. No or Low Deductible: Some higher-cost plans waive the Part D deductible.
4. Pharmacy Network Flexibility: Plans that charge more but offer broader pharmacy networks
What are the reasons why I should work with a Medicare agent?
Answer: Medicare is a very complex subject, with many different aspects involved. You want to make sure you are working with an expert that will help you make a more informed decision, taking into account all the different angles of it. It is no different than working with an expert on any other important decision in your life
What happens if I delay Medicare Part A enrollment because I'm still on my spouse's employer plan?
Answer: Hi there, you can delay your Medicare Part A enrollment if the employer has more than 20 employees and it is creditable coverage. If that is the case, you will not incur a penalty if you are entitled to premium-free Part A