Andrea Smith, Medicare Insurance Broker
Andrea Smith
Medicare Broker Licensed in CA
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Salida, CA
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About Me
Medicare can be confusing. You don’t have to figure it out alone.
Already on Medicare? If you’ve received your Annual Notice of Change (ANOC) and have questions, don’t like the changes you see, or want to explore new plan options this Annual Enrollment Period, give me a call.
New to Medicare? Whether you’re turning 65, retiring, or leaving employer coverage, I can help make the process easier to understand.
I’m Andrea Smith, a Medicare Advisor and licensed Medicare Insurance Broker based in California’s Central Valley, helping clients throughout California understand their Medicare options.
My services are free and personalized to you. I take the time to understand your doctors, prescriptions, budget, and healthcare needs so we can explore options that fit your situation.
Medicare Annual Enrollment (AEP) runs October 15–December 7. This is your annual opportunity to review your coverage and make changes for the coming year if another option better fits your needs.
This is a busy time of year, and appointment times can fill up quickly. Contact me today to reserve your free, personalized Medicare consultation.
Q&A with Andrea Smith
I just received an inheritance. Will it raise my Medicare premiums, and for how long?
Answer: It will....in two years! The amount you pay for your Medicare Part B (The Doctor and outpatient services) is based on what your income was two years ago. Not what you make today, not what you think you will make next year. They look at what your income was two years prior to assess how much you will pay today. So your inheritance, depending on how large it is, might bump you into the next payment level... so in two years from now you could be paying more!
I live in Cook County. How do I know which Medicare Advantage plan covers my doctors and prescriptions?
Answer: This is where an agent comes in very handy. Call up your agent. Have a conversation about YOU. Your doctors, prescriptions, budget and lifestyle. It is the agents job to do the legwork and present you with a few viable plan options that will meet your needs and that should include Medicare Advantage plan options that cover both your doctors and prescriptions.
I have a Humana Medicare Advantage plan in Illinois. How do I know if my plan will still be available next year?
Answer: Around this time of year, you will be receiving an Annual Notice of Change (ANOC) letter from Humana. Do not throw this piece of Medicare mail away! Your ANOC will let you know what changes to expect for your plan for 2027. If the plan is being terminated, you should be notified in the ANOC. If you do not receive or misplace your ANOC, you can call your Medicare agent or Humana member services after October 1st and they can update you on your plans status for 2027.
I spend part of the year outside Illinois. Will my Medicare Advantage plan still cover me when I’m away?
Answer: It depends. If you are using the out of State coverage for an emergency situation; the answer is yes it will cover emergencies. If you want to go see a doctor for a routine type visit, then the answer is unfortunately no. If you want a plan that will travel with you, you would need to enroll in a Medicare Supplement plan.
Can I be turned down for a Medicare Supplement plan because of a pre-existing condition?
Answer: It depends. When you are first entering into Medicare there is a 6 month window of time where you have Guaranteed Issue rights; meaning- if you sign up you are automatically accepted no questions asked. Outside of that golden window you will likely have to answer health screening questions and depending on what your answers are you can have your rate increased or even be denied coverage. There are unique scenarios which trigger other Guaranteed Issue windows for you, but typically if you miss that initial 6 months you will have to answer those heath assessment questions. If you have missed your Guaranteed Issue window and are unsure of what to do, give me a call we can look into your specific situation together and go over your options.
Where can I attend a free Medicare education workshop near me?
Answer: Many Medicare Agents and Brokers offer local community Medicare education workshops year round. During the Annual Enrollment Period (Oct 15-Dec7) every year you can find a ton in your community. A lot of these workshops around the Annual Enrollment Period have an educational portion on how Medicare works and will showcase a couple of Medicare plans.
What does Medicare cover?
Answer: "Original Medicare", the "barebones Medicare" that we payed for through Medicare taxes being taken out of our paychecks during our working years, and typically get when we turn 65, -THAT Medicare consists of only two parts. Part A- covers the Hospital and Part B- covers the Doctor and out patient services. Thats it. Part A (Hospital) + Part B (Doctor) = Original Medicare.
Original Medicare covers a lot but not all of your needs. To find out everything that Medicare covers you can go to www.medicare.gov to find exactly what is covered.
I think its more important to point out what is NOT covered.
Original Medicare does NOT include prescription drug coverage. You will be penalized without drug coverage.
The biggest thing, in my opinion, that Original Medicare DOES NOT provide is a Maximum-out-of-pocket limit. After your deductibles are met Original Medicare will cover 80% of your Medicare covered costs. You will be left with footing 20% of the bill. So if that bill is $100,000 you better have your $20,000 ready to pay your share. A medical bill for $1,000,000? Do you have $200,000 to spare? Does anyone?
As a solution to these issues people usually get extra coverage beyond Original Medicare in the form of Stand-alone Prescription Drug Plans, Medicare Supplements or Medicare Advantage Plans. These options help prevent penalties for not having creditable coverage, and help shield your pocket book from large Medical bills.
What are the reasons why I should work with a Medicare agent?
Answer: I think the two biggest reasons to work with a Medicare agent or Broker are to save you time and to have someone in your corner when dealing with a large insurance company.
As a broker, I can take the leg work out of finding the plan that fits you best. I take into consideration your doctors, your prescriptions, your budget and your lifestyle. Instead of spending the weekend or a few weekends becoming a pseudo Medicare expert you can spend your time doing literally ANYTHING more interesting than reading Medicare paperwork. In my experience even after a self imposed Medicare deep dive, many people come to me after for advice when second guessing their decisions. Save yourself the time and headache and find someone who does this every day to help guide you through your options.
A broker can also help work alongside you when issues come up with your insurance company. For example I had a client that was not able to get a piece of durable medical equipment. She had spent a month dealing with member services before calling me. When she finally did call me I was able to escalate this issue inside the company which lead to a quick resolution of this issue. Whether you are dealing with a billing issue or having a hard time dealing with member services, my clients know that they can call on me to help them get their issues resolved faster.
My doctor mentioned something about Medicare not covering my procedure. How do I find out for sure before I get stuck with a bill?
Answer: You can go to Medicare.gov and find out what is covered. I hope that helps!
https://www.medicare.gov/coverage