Calvin Fritz, Medicare Insurance Broker
Calvin Fritz
Chapter
Medicare Broker Licensed in MO, AL, AR, AZ, CA, CO, FL, IA, IN, KS, KY, LA, ME, NC, NM, NV, OH, OK, PA, SC, TN, TX, VT, WA and WV
Contact Details
-
Location
Joplin, MO
About Me
Hi! My name is Calvin, and I am your dedicated Medicare consultant and agent. I have over a decade of experience dealing with Medicare. 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! Reach out to me at 816-608-6307 today to explore your Medicare insurance options and be sure to mention that you discovered me on Medicare Agents Hub!
Q&A with Calvin Fritz
What's the most important question I should be asking about Medicare that I probably haven't thought of yet?
Answer: How will my current health needs and medications be covered under the different Medicare plans?
Medicare has multiple parts (A, B, C, and D), and understanding how each part covers your specific needs—especially if you have ongoing health conditions or take regular medications—can save you a lot of time, money, and stress.
Are Medicare Advantage plans really "free," or is that just clever marketing?
Answer: The idea that Medicare Advantage plans are “free” is generally more of a marketing strategy than a literal truth. While many Medicare Advantage plans have low or even $0 premiums, this doesn’t mean they are free in the overall sense.
Out-of-Pocket Costs: Even if the premium is $0, there are still costs like co-pays, deductibles, and co-insurance for doctor visits, hospital stays, prescription drugs, and other services. The out-of-pocket costs can add up, depending on the plan and the services you use.
Network Limitations: Many Medicare Advantage plans are HMO or PPO plans, meaning they have network restrictions. You might have to stay within a network of doctors and hospitals, and if you go outside that network, you'll pay more or your care may not be covered at all.
Why do some people regret choosing a Medicare Advantage plan over Original Medicare?
Answer: The main reasons are:
Limited provider network, higher out of pocket costs, referrals and authorizations, plan changes year to year, traveling in and out of state.
Because these issues often only become apparent after someone enrolls, many people don’t realize the limitations until they need care that isn’t covered or are faced with high out-of-pocket costs. It's essential to compare all your options carefully to ensure the plan you choose aligns with your health needs and preferences.
I picked a Medicare Advantage plan based on the low premium, but now I'm facing high copays. Did I make a mistake?
Answer: It sounds like you're experiencing one of the potential downsides of Medicare Advantage plans, where low premiums can be offset by high copays and other out-of-pocket costs. This can definitely feel like a mistake, especially if you expected more predictable costs.
Think Long-Term. Medicare Advantage plans can work well for some people, but if you expect to need frequent care or have specific providers in mind, it might be worth reconsidering whether Original Medicare with supplemental coverage might have been a better option. The key is finding a balance between premium, copays, and your healthcare needs.
I've been on my employer's health plan but am retiring soon. What should I consider when moving to Medicare?
Answer: When transitioning from your employer's health plan to Medicare, consider your eligibility for Medicare Part A and Part B, potential special enrollment periods, COBRA options, and the costs and benefits of Medicare compared to your employer's plan.
I'm on Medicare but recently declared bankruptcy due to medical bills. How will this affect my coverage and options going forward?
Answer: While bankruptcy can be a challenging experience, it shouldn't directly affect your Medicare coverage. Medicare is a federal program, and being on Medicare isn't contingent on your financial situation, including bankruptcy.
If I start dialysis, how does that change my Medicare eligibility or coverage?
Answer: If you're under 65 and have end-stage renal disease (ESRD), which requires dialysis or a kidney transplant, you’ll become eligible for Medicare when you begin dialysis. This applies regardless of age, and you don’t need to wait until you're 65 to apply.
If you're over 65 and already on Medicare, there’s no change to your eligibility for Medicare; your coverage will continue as normal. However, starting dialysis might mean that you’ll need to adjust your plan choices to accommodate the new medical needs.
Why is the new $2,000 out-of-pocket maximum for drug costs important?
Answer: The new $2,000 out-of-pocket maximum for drug costs is important because it provides significant financial relief and protection for Medicare Part D beneficiaries. Here’s why it matters:
1. Caps Drug Spending for Seniors
Before this cap, there was no limit on how much someone could spend on prescription drugs under Medicare Part D in a year. Some patients—especially those with chronic or serious illnesses like cancer or multiple sclerosis—could end up paying tens of thousands of dollars annually for their medications.
With the $2,000 cap:
Once a person has paid $2,000 out-of-pocket in a year for covered drugs, they owe nothing more for the rest of that year.
This makes drug costs predictable and manageable.
2. Protects Vulnerable Populations
Older adults and people with disabilities often live on fixed incomes. High drug costs can force people to:
Skip doses
Not fill prescriptions
Cut back on essentials like food or utilities
The new cap reduces this risk by limiting how much they can be asked to pay.
3. Part of Broader Drug Pricing Reform
This cap is part of the Inflation Reduction Act (IRA), which also includes:
Allowing Medicare to negotiate drug prices
Penalties for drug companies that raise prices faster than inflation
Together, these reforms aim to lower prescription drug prices overall and increase affordability and access.
4. Implementation Timeline
The $2,000 cap goes into effect in 2025, giving time for Part D plans and pharmacies to prepare systems and communicate with patients.
In summary:
This change marks a historic shift in Medicare by giving beneficiaries clear financial protection against runaway drug costs, which improves health equity and access to needed medications.
My doctor wants me to get several preventive screenings. Will Medicare cover all of these at once?
Answer: Yes, Medicare allows multiple preventive screenings in the same year, depending on:
The specific screening
The recommended frequency (some are every year, others every 2+ years)
Whether you meet eligibility criteria for each test
Example:
You could potentially receive a mammogram, diabetes screening, and an annual wellness visit all in the same calendar year—and all could be covered at no cost.
Exceptions & Notes
Some screenings (like colonoscopies with polyp removal) might lead to coinsurance or costs if something is found during the test.
If your doctor orders tests not classified as preventive or performed more frequently than Medicare allows, you may have to pay.
What should I look for in a Medicare plan if I travel frequently both domestically and internationally?
Answer: 1. Nationwide Coverage
Choose a plan that allows you to get care anywhere in the U.S.
Original Medicare (Part A & B):
You can see any doctor or hospital that accepts Medicare—nationwide.
Great for domestic travel.
Medicare Advantage (Part C):
Many plans have networks (HMOs or PPOs).
Look for:
PPO plans (more flexibility to see out-of-network providers)
Plans with nationwide networks or travel benefits
Confirm how coverage works outside your home area.
2. International Travel Coverage
Original Medicare typically does NOT cover care outside the U.S., except in very limited situations. To get global coverage:
Option 1: Medigap (Medicare Supplement)
Plans F, G, and N offer some foreign travel emergency coverage:
Covers 80% of emergency care abroad (up to plan limits)
Limited to the first 60 days of a trip
$250 annual deductible; $50,000 lifetime limit