Carol Thompson, Medicare Insurance Broker

Answer: I enjoy educating clients on the confusion of Medicare and it gives me such fulfillment to help seniors or the disabled community get what they well deserve.

Answer: I prefer to not use the word “free” but rather “at no cost or zero co-pay”. Since plans can vary from state to state or county to county. However, there is always the Part B cost.

Answer: There may be no premium cost with most plans however there is Part B cost.

Part B stands for outpatient services such as bloodwork, dr. visits, imaging and many more that may require co-payments or co-Insurance.

Answer: I enjoy educating my clients so they will have a better understanding or a peace of mind as it can be very confusing and overwhelming.

Establishing a rapport and trust is most important and overall I loved serving the community.

Answer: Knowing that there is more than one kind of Medicare, there is different costs and that plans can and may change from year to year.

Answer: Yes, most of my clients rely on the OTC benefits monthly or quarterly.

Some carriers offer cards where you can purchase items in retail stores and some give you an option to set up a profile on their website site to order online or to call in the OTC 3rd party program to place an order monthly or quarterly.

Answer: I have heard a little about that In the news -media but I’m not very familiar on whether there will be a crisis.

Answer: The Biggest mistake is to not get assistance or guidance from an agent.

An agent can educate and assist you on the different options by preparing a NEADS analysis.

Going on original Medicare can lead to financial burdens.

Answer: One option would be to contact the pharmaceutical company who manufactures the medications for any grants or discount programs.

The client could look into State Pharmaceutical programs as well as discounts with prescription drug cards such as Good Rx & Clever Rx.

As an agent I can assist a client to see if they may qualify for Medicare Savings Programs.

Answer: Yes - usually lost of employer coverage is a SEP options, however I always check thoroughly with each carrier.

Answer: There is mental health coverage but it is not fully covered; it other words there will be some cost sharing.

Answer: You can contact the Social Security Administration to see if you are eligible and if there will be a late penalty fee.

Answer: I would say it can be challenging and not frustrating; is the client providing you with the correct and all the information needed to help them select the best plan.

Answer: Yes definitely; different states have different service areas and plans can vary. You will need to change your plan according to the new area you will be living in.

Answer: There is Open(Annual) Enrollment Period from Oct 15 through Dec 7 and Open enrollment from Jan 1 to March 31st.

If there is 5 Stars plans in your coverage area you can be moved to that plan or if there is a life changing event or catastrophic event.

Answer: Well if the agent is near you then you can meet them In person rather than remote/virtual.

I do both as I’m licensed in multiple states and attain referrals or recommendations.

Answer: You could be getting billed for your Part B premium. This premium amount can vary each year and it depends on the plan you are on.

Answer: That depends on your finances; Medicare Advantage can lessened your cost in medical bills as you will not be paying 20% cost sharing on most things.

Answer: If you have a HSA established prior to enrolling In a Medicare plan - you can use those funds to pay for Medicare premiums. However, once you are enrolled in Medicare you cannot contribute to a HSA account.

Answer: Yes there are preventative screenings covered by Medicare. I would recommend to verify the screening is covered prior to the screening.

Answer: Yes a scope of appointment is required prior to discussing Medicare plans & prescription drug (Part D) plans per CMS. The SOA - A gives the agent permission to discuss plans with the potential client/beneficiary.

Call centers usually have to record the call and have the client call into an inbound call.

Answer: There is a 7 months window when turning 65 that allows you time to sign up for Medicare unless you have creditable coverage through an employer. If you do not attain coverage through an employer-retirement or directly through Medicare you can have lifetime insurance and penalties.

Answer: It is part of the Medicare Savings Programs. Also known as as LIS - low income subsidy. You apply to see if you qualify through your local DCF or an agent can help you apply.

Answer: Medicare Advantage has a provider network where it may be not cover out of network charges or if out of network there may be a higher charge.

Medigap or AKA - Medicare supplement allows you to see any Dr or go to any hospital as long as they accept Medicare. Regardless on whether you are in or out of network.

Answer: Yes Medicare will usually notify you by mail if you are already collecting social

Security. If you are not getting social

Security than you will need to apply for Medicare. An agent can assist with applying.

Answer: You can have an agent assist in seeking if your specialist is in the network; if they are not then An agent can recommend another specialist to you that is in the network.

The specialist can submit a request to your plan requesting that your care is medically necessary to see if the carrier will accept.

Answer: Have an agent look up the formulary of all of your medications for you or you could call into member services of your plan To verify the cost.

Answer: Often times seniors can be dropped by a plan because of a change of income - lifestyle change or no longer live in the service area.

If you are on a chronic special needs plan - you need to be sure your primary dr signs off that you have that chronic condition - verification chronic condition form. As an agent I verify with the carrier prior to the deadline for my clients.

Answer: Plans can change from year to year. It’s advisable or recommended to have an agent to verify this for you by letting your agent know of any medications changes.

Answer: It should cover it but I would reach out to your plan to Verify the coverage. The billing department of your insurance company can help you with this.

Answer: You can but it may create confusions. Never hurts to get a 2nd opinion. Most of my clients are referrals by other clients or know me. Therefore the trust is already established.

Answer: Yes on Some plans but not too many cover acupuncture.

They will cover some

Chiropractic, physical and speech therapies.

Answer: One decision that people regret later is to NOT consult with an insurance consultant. As plans can change from year to year; your agent can guide you on whether your plan will be the best plan based upon on your needs. Having an agent guide to you is a FREE service.

I hear often from beneficiaries that they did not know their Dr was no longer taking their plan or why did my medication cost change.

Plans and contracts can change yearly.

Answer: In 2025- once your cost shared amount has reached $2000- there is no cost to you. In 25’ there is also a payment plan that you can opt in with your insurance carrier to stretch out the cost of you medications throughout the year.

Answer: It would be more expensive if you acquire stand alone plans with Original Medicare or Medicare Supplement. Medicare advantage plans offer dental, hearing and vision as part c.

Answer: I have additional & specific questions I ask the new to Medicare clients. Those questions determine the next step in preparations.

Answer: The regulations are quite strict as is. I would

Say the tell telemarketing calls need to be gotten under control. My clients get tired of receiving multiple calls Per Day from those who want to promise them something/a plan that they do not qualify for.

Answer: Yes Medicare can cover wearable medical devices. Most of these devices are considered Durable medical devices.

Answer: Medicare is a type of health insurance and is separate from life Insurance. Life insurance is not the same as Medicare insurance.

Answer: The annual wellness visit is a review of your personalized prevention plan of services which entails a health risk assessment. It also includes discussion and scheduling of screenings and immunizations. These are preventative care services provided at $0 Cost as long as you have Medicare part B.

Answer: That Medicare is all of the same of which it is not. As there is original Medicare, Medicare Supplements (medigap) and Medicare Advantage plans.

Answer: It depends on your needs and your finances. If you are a healthy person and you live in a service area that offers medicare Adv plans then I would recommend as such. Depends on your needs mostly.

Answer: The ratings are there to share the opinions of other Medicare beneficiaries/ members of their experience regarding plans.

Answer: Deciding on whether what plans to go with depends on your personal needs. It is important to consult with a licensed broker for guidance on what will best suit your needs.

Answer: That depends on whether your current pcp participates and or is contracted to accept Medicare advantage plans. As an agent I always check to see if a pcp is in the networks of Medicare advantage plans.

Answer: The cost off Part B, co- payments, co- insurance and cost sharing of plans. Rates can go up each year as plan can change.

Answer: Due to getting social security-SSDI- Medicare will see you in the system so that you will need not to apply for Medicare. However, your social security amount can change now so you will

Need to contact social security admin on any changes as well as ask about your Medicare eligibility status.

Answer: Yes you can be denied for a Medicare Supp. plan. Having certain preexisting conditions can cause you to be denied

On the contrary, Medicare advantage plans do not deny beneficiaries due to preexisting conditions

Answer: The cost shared is 80 % (Medicare pays) 20% (you pay). So will be responsible to pay 20% of most medical expenses.

Answer: Having a family member help on making the medical insurance decisions. Often times and is recommended to have a child or family member become your POA - power of Attorney or medical directive.

Answer: I would say not to listen to neither. If you want an opinion then get a professional opinion from an insurance broker/agentand it’s Free!

The role of an insurance broker is as such: each and every year we have to be tested for the changes of Medicare laws/ guidelines and go through training to know the changes of the plans as they can change yearly. Seek professional help- often times

I have saved people quite a bit per year.

Answer: On a simple note. Once you have reached the $2000 threshold that is cost shared by you and your plan & pharmacy, then most of the time you do not have to pay anymore for cost of meds for the remainder of the year.

Answer: 24/7 nursing hotline is one of the services that people may not aware of.

Some of the extra benefits could be over the counter (OTC) that you would normally pay for out of pocket. Like Tylenol, cold meds, band aids, etc.

Answer: Be sure to have applied for Medicare Part B.

You must be entitled to Part A and have Part B to enroll into Medicare.

Answer: Explain the different types and how they work. What you can expect to pay and the the differences in Original Medicare, Medicare Supp (Medigap) and Medicare Advantage with Part C.

Answer: Is to meet with a Medicare insurance broker. They can break it down to a better understanding so that you will be able to make a more accurate decision.

Answer: There are specific times of the year for open enrollment. Unless you have a change in life and of which is a special enrollment period. Also- if there is a 5 stars rating plan available you can enroll throughout the year. Please consult with an agent they can better assist you.

Answer: There are a long list of preventative services that are available to you. Your pcp will assist you with those tests.

Answer: As of Jan 1, 2025, the donut hole does not exist any longer. There is a TROOP of $2000 and once cost shared between you and pharmacy reaches the $2000 there should not be any cost to you.