Babs Atwell, Medicare Insurance Broker

Answer: Be certain to ask your agent or broker what services they offer throughout the year and how they plan to support you as you transition to Medicare. It can be very complicated and confusing and a good agent or broker, such as myself, will give year round support!

Answer: In my professional opinion, there is no "trap" with Medicare Advantage plans. MA plans are not a perfect fit for everyone, however they have definitely been a great fit for those who cannot afford or simply do not want a Medicare Supplement plan. This is why we always recommend working with a local broker who you trust, one who offers plans with many different companies for comparison.

Answer: Yes they do cover preventative screenings. The frequency is determined by the CDC recommendations for the specificity of each test, sex, and age of the beneficiary.

Answer: This question is difficult to answer specifically without a personal consultation. However, the out of pocket max on "covered" prescriptions is $2000. If you have typically spent more than that in previous years, this year will most likely cost you less. This is why we recommend working with a local broker whom you trust to discuss your specific situation and medications.

Answer: In the Medicare billing realm, these terms are interchangeable. However, typically having secondary coverage to Medicare, you will coverage for items and services not normally covered by Medicare. Whereas a true Medicare Supplement will only cover the percentage left over after Medicare has paid their portion, only covering the items and services already covered by traditional Medicare.

Answer: Always look for an agent with high recommendations by friends and family first and foremost. Then make sure they are contracted with the majority of the companies offered in your area to ensure an adequate review. Finally, make sure they are not pushy like a typical sales person. Those types of agents/brokers only have themselves in mind. You want to work with an agent/broker that takes plenty of time to explain everything and answer your questions. As well as someone who offers year round service after enrollment.

Answer: Find a local agent/broker that will take the time to get to know you and your specific needs. A good agent/broker will not be pushy. Ask ALL the questions and if the agent/broker doesn't take the time to help you figure out your best option, then find one who will.

Answer: It depends on other types of coverage you may have. If you do not have a Medicare Supplement to work with your Original Medicare, and you do not have a stand alone dental plan, then the short answer would be Yes. I recommend finding a local agent/broker to sit down with and discuss your current coverages specifically.

Answer: If you are or going to be 65+ at the time of retirement, we recommend setting up an appointment with a local agent/broker at least 4 months prior to retiring. A good agent/broker will walk you through all the steps you will need to take to get everything set up for retirement. If you are not yet or not going to be 65 prior to retirement, we recommend setting up an appointment prior to retirement to discuss other health insurance options that will cover you until your Medicare kicks in at 65.

Answer: Typically, the process needs to start at least 3 months ahead of time. I would recommend finding a good local agent/broker you can trust as soon as possible to help you get the process started. They will be able to advise you on your specific circumstances what you should do.

Answer: I recently had a member who was prescribed an expensive biologic medication for Crohn's disease. Her Medicare Advantage plan had the medication listed as a tier 4, and the insurance company had another plan where the same medication was listed as a tier 2. I had recommended that the member request a tier exception. The company approved the tier exception and reduced her medication to a tier 2 making it affordable for her without switching her plan.

Answer: This is a complex question, and one that I would recommend a personalized consultation with a trusted local agent/broker. Every situation is different, and unique. I have had many clients who have opted to delay as well as many who have opted to enroll in Medicare while continuing to work.

Answer: I explain to all our clients that a Medicare advantage plan typically has no extra monthly premium beyond their part b premium. However there are some exceptions to that as well. Rather than an extra monthly premium, they will typically have copays with a Medicare Advantage plan. Those copays vary depending on the specific plan they would choose. Whereas with a Medicare supplement plan, they would typically have an extra monthly premium beyond their part b premium. However, with a Medicare supplement plan, they MAY have less out of pocket expenses for copays and doctor visits depending on their use. This is why we always recommend a personalized consultation with a trusted local/agent broker to discuss your specific needs.