Christy Jones, Medicare Insurance Broker

Answer: You can enroll in a Medicare Advantage plan that includes those benefits or you can purchase a separate Dental/Vision/Hearing plan with your Medicare Supplement plan. Some Medicare Supplement companies offer discounted dental and vision benefits.

Answer: Some ads say ‘Grocery Benefit’ and ‘Get what you deserve’. Those extra benefits are typically for people who have Enhanced Medicaid. (If you don’t have Medicaid then you won’t qualify for those benefits, but it gets the phone ringing!) Once you call the number on the advertisement, your information is sold to many different Agents and your phone never stops ringing. I show beneficiaries the various plans available to them, go over the differences in all of the companies and plans, and see if they qualify for Medicaid. Based on their qualifications, health needs, finances and other things, I am able to make realistic plan recommendations.

Answer: Apply for Part A and Part B immediately if you haven’t already. A&B covers 80% of medical costs, then talk to a Broker to see what your options are to get the additional 20% covered. Choose an Independent Broker who can present all of the plans available. Also, choose a Broker that you like and trust that will be available to you when you have questions in the future.

Answer: Possibly. Talk with a Broker who can present other Medicare options that are available to you based on your primary residence. There might be plans that are less expensive monthly that will also cover you when you travel.

Answer: Sit down with an independent Broker who is well versed in both Medicare Supplements as well as Medicare Advantage plans. Their service doesn’t cost you anything and can be very helpful when making those decisions.

Answer: There are many mistakes that can be made, but I think the biggest mistake that I see people make is not enrolling a couple months ahead of when they need coverage. Sometimes, it can take 60+ days to get your Part B in place.

Answer: Medicare Advantage plans are county specific and available in the county of your primary residence. Each county has different plans available. (Medicare Supplements are state specific.). There are many differences in coverage and ‘extra benefits’ like Dental/Vision/and Hearing. Original Medicare doesn’t cover those things and Medicare Advantage plans sometimes (not always) have those additional benefits.

Answer: Get with a Broker that can help you apply for various programs based on your income. (You can also go to Social Security and Health & Welfare to see if you qualify.). Some programs will cover your Medicare premiums, but you have to qualify for them. Some qualifications are based on your income and financial situation.

Answer: I go over both types of plans and we talk about all of the differences between them. We discuss their current health needs as well as the cost differences between the two types of plans. How will they use their plan? How much do they want to spend on a plan? I have clients on both Medicare Supplements as well as Medicare Advantage plans, and my goal is to have a happy client.

Answer: They need to know ALL of their Medicare plan options and what each plan covers as

well as the costs. A Broker should have experience with both and examples to share to help the Client make an informed decision as to what they feel is best for them.

Answer: Ozempic is covered by your prescription plan, as long as it’s on the formulary. Check your formulary whether on your Medicare Advantage plan or your stand alone prescription drug plan if you are on Original Medicare.

Answer: The coverage gap went away for 2025. There is now a $2000 max for prescriptions. As long as your cholesterol medicine is on your prescription drug plan formulary it will count towards the $2000 max. If your prescriptions were to reach/exceed $2000, your prescription

cost over $2000 would be zero dollars for the rest of the calendar year.

Answer: If you miss your sign up window for Part B you’ll need to wait and sign up for Part B during the General Election Period, from January 1st-March 31st. If you miss your initial election period to sign up for a Prescription Drug Plan (Part D), you will need to wait until the Annual Enrollment Period from October 15th-December 7th. Late enrollment in Part B as well as Part D will result in lifetime late enrollment penalties.

Answer: As long as you have ‘credible coverage’ (for example, coverage with an employer group plan) you will not be penalized for delaying your Medicare enrollment.

Answer: Special needs plans are Medicare Advantage plans. They are designed for people who have specific health conditions or needs. There are special needs plans specifically designed for people who have Medicaid. There are also chronic special needs plans designed for people who have specific chronic conditions..

Answer: Unfortunately, there are many agents that will tell people they can get free groceries when they don’t actually qualify for that benefit. It is helpful to let people know that there is a benefit like that available but they don’t tell you that you must qualify for that particular plan. Most of the time plans with a with a grocery benefit are for people that have low income and qualify for Medicaid.

Answer: Original Medicare does not cover cataract surgery because Medicare doesn’t cover vision. If someone is on a Medicare Advantage plan, most MA plans have vision coverage. In that case, the member will have a co-pay for outpatient surgery when having cataract surgery.

Answer: There are many reasons that somebody would want to switch their Medicare plan. Coat/monthly premium might be one thing that might make somebody change their Medicare Supplement or Medicare Advantage plan. Prescription coverage/the formulary might be another reason a Medicare recipient might look around/compare/see what's available to them according to their prescription needs. You should review your Medicare plan or standalone prescription plan every year. When you compare the various plans available in your area, you can make sure that your plan still meets your needs for coverage as well as your needs financially. A 3rd reason to compare your plan annually might be whether or not your doctor accepts your plan.

Answer: I need more information to answer this completely. Do you only have Original Medicare (Part A & Part B) that covers 80%? (Then you are responsible for the other 20% including deductibles.) Do you have a Medicare Supplement in addition to Part A & Part B, that helps cover the other 20%? If you have a Medicare Supplement plan, what Plan do you have? Various plans cover costs and co-pays differently. (You might pay for a Plan F, Plan G, Plan N, Plan L, Plan K, etc.)

Medicare Advantage plans also have various costs, coverage structures and copays, so I’m not sure of you would be better off having gone with a Medicare Advantage plan. Medicare Advantage plans are county specific according to your Primary residence.

Answer: Original Medicare (Part A and Part B) covers 80% of your Medicare covered hospital and doctor bills. A Medicare Supplement plan helps cover the other 20%. When you ONLY have original Medicare (Part A and Part B), your financial risk is having to come up with 20% of all of the Medicare bills you might incur.

Answer: Medicare advantage plans are not only state specific but also county specific. If you move out of state or from one county to another, your current plan may not be available in your new state and/or county.

Answer: Every hospital has their own network of plans that they accept. Private hospitals are no different. Some plans are in network with various hospitals and some plans are out of network.

Answer: Yes annual notice of change paperwork is mailed out at the end of September every year. Brokers are allowed to discuss those changes no earlier than October 1.

Answer: Medigap insurers may cancel plans based on lack of payment for premium and sometimes if you move out of an area that they service.

Answer: Annual Notice of Change paperwork is mailed out at the end of September. Brokers are allowed to talk about those changes no earlier than October 1st of each year. If a person would like to change plans, the Annual Enrollment Period begins October 15th.

Answer: I will meet with Clients in person or via phone appointment. I will review Medicare basics and will let them know what their options are according to their specific state and county. We will review the various types of medicare plans. We will also talk about provider networks, their prescriptions, and what their personal health needs are.

Answer: Some companies are already using AI to review claims. AI is so new that there are a lot of questions as to its efficiency with the various claims. It’s important for Medicare beneficiaries to look at each claim and advocate for their needs.

Answer: As a former educator, I enjoy educating people about Medicare and their plan options. My favorite thing about being a Medicare agent is taking care of my Clients. My Clients end up being like family. Helping them navigate through health issues and situations that can be very stressful, gives me a deep satisfaction and purpose.

Answer: When someone has a change in coverage, they qualify for a Special Election Period’ so they can make a change outside of the annual enrollment periods. Find a Broker and get the coverage you need.

Answer: There are many financial issues that affect someone’s eligibility/premiums with Medicare. Some beneficiaries automatically qualify for Medicare if they’ve been on disability for 24 months. Some beneficiaries can get lower prescription and premium costs (called Low Income Subsidies) based on a lower income. Some beneficiaries have an increase in the Medicare premiums if they have a higher income. This is called an ‘Income Related Monthly Adjustment Amount’, or IRMAA.