Armand Smith, Medicare Insurance Broker

Answer: You will always have copays for specialist and primary care if your plan has those copays as well as copays for many out patient procedures.

I recommend purchasing a hospital indemnity plan to help off set those hospital copays. These plans are very reasonable in cost.

Answer: It is my understanding your Medigap insurer cannot terminate your policy unless it gets cancelled for non payment of premium.

Medigap insurers can raise your premium every year as they see fit but still have to keep you insured no matter what your health condition.

Answer: No that cannot. Medicare cannot drop you for health reasons and Medicare Advantage must comply by medicare rules.

Answer: I do not think it will effect coverage. Nursing homes are only covered for 100 days.. I would advise anyone to buy a short term coverage plan that covers LTC for up to a year and also look in to some hybrid ltc plans.

Answer: Always best to go to the online directory and check the doctors the carrier is contracted with. Also look at the doctors website and also call the doctors office to verify.

Staying on a medicare supplement, though can be more expensive premium wise is a safe way to know any doctor that takes medicare will take your supplement.

Always weight the pros and cons in my opinion.

Answer: This is a normal procedure, so that the customer understands we are discussing medicare options.

As far as call centers go, yes they are required to have you agree to a scope. It is a voice signature they can collect over the phone. However, there are some call centers that are very loose with the rules. If they are calling you unsolicited, then don't talk with them and don't give them permission to help you.

Also agents or call centers should not solicit you without your permission but the call centers seem to try to work around this.

Answer: When medical equipment is required I recommend working with the supplier to submit the invoices for medicare. Many times Medicare will come back asking for a letter from the Doctor.

Answer: Medicare usually covers if the doctor requires it otherwise it is not covered every year. Also some carriers have wellness riders which may cover it every year. Best to check out the company you are thinking of working with.

Answer: A medicare Broker may represent several Medicare carriers and policies and know the difference between them.

A medicare agent usually represents one company from what I have seen.

Answer: People ofton think Medicare is free, they do not realize we all have to pay a premium for Part B which went up this year to $205 a month plus it you buy a supplement to medicare for the portion medicare does not pay then that is a premium as well.

Also all doctors to not take medicare or do all specialty hospitals.

Answer: If a person has dementia the advisor usually works with someone that has been picked to help the person with these enrollments.

Answer: Many weight loss drugs are covered if you have Diabetes and ofton if not. The plan may deny they drug but the doctor can write and exception. Good communication with the insurance company and the doctor is important.

Be sure to check the various plans for the medications you take.

Answer: Every open enrollment Oct 15 to Dec 7th. Also Jan to March 31 is a special enrollment if you are not happy with the plan you chose you may do a one time change to another.

Also if you are on a Supplement and change to medicare advantage but within 12 months realize you made a mistake or are not happy with it you can change back to a supplement without underwriting.

Answer: If you miss your window to sign up you can sign up for a supplement anytime, if you miss your window you may be charged a penalty for not having credible drug coverage . As for Medicare Advantage you will have to wait until the next open enrollment opportunity.

Answer: With a Medicare Supplement you will rarely see a medical invoice you have an amount due except for an items that maybe is not covered or the provider charged more then allowed.

With Medicare Advantage you will have copays you may received invoices for a well as services that the doctor charged more then medicare allowed or were not covered by medicare.

Answer: This is why is is important to read the summary of benefits, and the agent should of reviewed this with you.

Many Medicare Advantage plans only cover preventative which is usually stated in the benefits summary.

For full dental coverage, which many plans cover , such as the one I have, the Summary of Benefits will say Comprehensive Dental.

Answer: https://www.medicare.gov/publications/11037-medicare-coverage-outside-the-united-states.pdf

See the link above this is directly from Medicare. It is best that you read the 3 pages of this link which is from Medicare.gov

It explains nicely what is covered if in a foreign hosptial.

Answer: In my opinion not weighing the pros and cons of enrolling in a medicare supplement or going on Medicare Advantage. Look at all the differences in regards to your situation. Look at the out of pocket cost for both.

Make sure your doctors are in network if you go on Medicare Advantage

Answer: If drowning in bills contact medicare of the providers to review the bills and possibly have your agent assist in this. The medications should most likely just be copays at the pharmacy. Review all medical bills to make sure they are correct. A good agent will help assist if you need help.

Being a care giver is hard work, do not be afraid to ask for help from family, your agent or even an outside claims consultant.

Answer: Unfortunately this does happen. Your choices as far as I know are to find a new specialist and or on open enrollment find a plan that has your specialist in it.

Answer: It will work if they are on a medicare supplement and the hospital takes medicare. If they are in an HMO or PPO medicare advantage plan check to see if the hospital is in the network , some plans to pay a benefit of out of network.

Answer: As an agent I discuss both options , review what is going on with the insured and they can decide which option is best for them. Medicare Supplements give you freedom to go to any medical provider that takes medicare as well as many that do not take Medicare Advantage such as Mayo Clinic in Arizona will now take a supplement but not Medicare Advantage.

Medicare Advantage pays a larger commission to the agent which is one reason you see so many call centers calling people at home to discuss it as well as ads on TV. Remember if you did not give an agent or call center permission to contact you then they are in violation.

Answer: As a medicare agent working in insurance and medicare for over 30 years I gather the information needed for you to make an informed decision for yourself.

I never push a individual into any one plan. Having helped many friends and relatives with medicare I understand each person is different some a medicare supplement is the best choice others prefer medicare advantage.

Also will show Veterans which carriers have the best options for them.

Call , text of email me anytime.

Armand Smith, CIC

Senior Health Solutions and Benefits

Veteran