Tony Merwin, Medicare Insurance Agent

Answer: Hard to truly explain why someone would fail to explain that, but ultimately it falls on the agent who helped you with the enrollment. Currently we're not within an eligible enrollment period to make a change to something more appropriate but you could easily add a low cost dental plan to help you through the remainder of the year until you can review your plan options for next year.

Answer: Ultimately depends on the carrier. Not all insurance carriers deal directly with consumers. But even when they do, you'll be receiving biased advise for that one insurance carrier versus say an independent agent who can compare your situation across multiple carriers. Regardless if you enroll in something directly with the carrier or through an agent, the cost and benefits are identical. So if it were me, I'd rather work with someone who can offer me unbiased advice across a myriad of options.

Answer: These are reserve days available to you in the event you go beyond 90 days consecutively in a hospital stay benefit period. These reserve days are only used when you spend more than 90 days straight in a hospital.

Answer: It means that the coverage offers benefits comparable to or better than what Medicare offers. This primarily applies when choosing whether or not you should delay your coverage for Parts B & D of Medicare to maintain Group insurance coverage.

Answer: Ultimately it depends on a few variables which come down to cost, benefits and experience.

How much are you contributing to your employer group plan each month? How good is the coverage? Have you had a good experience.

I tell most clients that if you're spending more than $350-400 per month on your group plan then you should at least investigate what going full Medicare would look like and compare. Costs will vary by state but in most cases I've been able to provide much better coverage for roughly that same cost (including your Part B Premium).

Answer: Most likely, yes. However it may depend on how or when you enrolled in your Plan G. If you took the policy out during your Open Enrollment period with Guaranteed Acceptance then, yes. If otherwise then it's possible they could enforce a 6 month wait period for pre-existing conditions, but still unlikely. Generally a Medicare supplement carrier would not even issue the policy if they know you have a pending surgery verfiied by health underwriting.

Answer: No. When you're enrolled in a Medicare Advantage plan, original Medicare is no longer handling your claims. The provider you visit must be in network or you will be responsible for possibly the total cost depending if you have an HMO or PPO plan. With an HMO you must always be in network except for emergencies. With a PPO plan you can visit our ot newwork providers under 3 conditions: #1 that provider accepts Medicare. #2 that provider is willing to accept the terms and conditions of your PPO. And #3 that provider is accepting new patients.

Answer: In short, yes. You’ll need to fulfill your deductible but otherwise you’re covered including time spent in a skilled nursing facility to rehabilitate.

Answer: I’m sure there are plenty of us here who can. Feel free to post any questions or look us up on the site for more info.

Answer: Min some cases, certain products are only accessible through an agent or broker. The primary reason is for the expertise and ability to shop the landscape of options. For products you could go direct to the company on, there is no difference in cost or benefits to you when using an agent to help facilitate.

Answer: More and more doctors are accepting them now, but generally it comes down to payment, and ease of doing business.

Answer: You must enroll in Part B unless you have qualifying employer insurance and are working. Aside from that it comes down to comparing cost and quality of coverage.

Answer: They certainly do. Star Ratings are comprised of a few factors with the heaviest weight given to quality of network and evidence of improved health outcomes.

Answer: It often depends on state of residence but I generally believe Plan N offers greater value in comparison with other Medigap plans. You have minimal additional exposures in comparison to Plan G that contradict the additional premium cost. The vast majority of my clients are on Plan N and very happy.

Answer: Just requires you to manually enroll in Medicare versus an automatic enrollment had you already been drawing SSI. No other effects.

Answer: In short, Medicare Advantage plans are a privatized, network version of Medicare. Instead of Medicare directly handling any medical claims you have, a private insurance company will handle them.

Medicare Advantage plans, by law, must offer at least the same benefits and coverage that Original Medicare offers, but many will offer more as a type of "all-in-one" plan whre you have one card for all services, Hospitals, Doctors, Dental, Vision, Prescriptions, etc.

Finally where Original Medicare provides access to all Medicare accepting providers nationwide, a Medicare Advantage plan will have a network of providers you must utilize to receive optimal coverage.