Clarence "Mark" Christiansen, Medicare Insurance Agent
Clarence "Mark" Christiansen
Christiansen Insurance Services
Medicare Agent Licensed in WI, AZ, CA, CO, FL, GA, IL, IN, MI, MN, MO, NC, NM, NY, SC, SD, TN, TX and WA
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Grafton, WI
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Clarence "Mark" Can Help With:
About Me
Wisconsin's # 1 Medicare agent. Independent insurance agent since 1985. Focus on individual Medicare plans including supplements, Medicare Advantage and Part D. Special needs and dual plans, too. "Say Yes to CIS!"
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Q&A with Clarence "Mark" Christiansen
What benefits are there to working with a Medicare Agent near me vs remote/virtual?
Answer: Many people like to get to know who they are dealing with and the best way to do that is in-person. Everyone is different so as an agent, I try to be flexible. The prospect / customer "is the boss!"
Can you describe a time when you helped a client navigate a complex Medicare issue?
Answer: It happens every day! Much of my work involves helping people leave their employer group plan and jumping onto Medicare. There are a couple of forms that need to be filled out, signed and submitted. I am pleased to facilitate in this process.
What’s one Medicare decision that too many people regret later?
Answer: Making sure they have a plan that fits. Medicare is not a one-size-fits-all program so it's important to take the time to speak with an independent agent who can compare and contrast the numerous plan options.
I just got Medicare Part A, and I’m worried about hospital stays. How do I know if my overnight stay will be covered fully?
Answer: The 2025 Medicare Part A deductible is $ 1,676 for the first 60 days of in-patient hospitalization. After that, it gets nasty: $ 419 copay per day for days 61 - 90 then $ 838 per day (that's not a typo!) for in-patient hospital stays for days 91 - 150. Noting that the average hospital stay for seniors ages 65 - 74 is 5.3 days (5.6 days for ages 75 - 84), most people with nothing other than Medicare Part A will be OK with the $ 1,676 deductible. But ... this is all about "what if" and to be on the hook for a monster bill (after 60 days of hospitalization) could be a financially catastrophic event, not to mention the physical issues. Get some insurance! Most Medicare plans have something called a "maximum out-of-pocket," or MOOP to protect yourself against a big hospital bill.
What demographic challenges will Medicare face in the coming years?
Answer: People are living longer due to innovations in healthcare but unfortunately the cost of healthcare is outpacing inflation. As the cost of healthcare increases, so will the cost of Medicare. Medicare Part B premiums jumped 6% from 2024 to 2025 (from $ 174.70 to $ 185 monthly). Retirees on a fixed income need to find a way to stay healthy and properly insure themselves at a reasonable cost.
I just started on Medicare Part D, and I’m confused about whether my new cholesterol medication counts toward my coverage gap. Can you explain?
Answer: There is no coverage gap or dreaded "donut hole" starting 01.01.2025. Medicare Part D members may have high out of pocket costs initially but will be protected by a $ 2,000 annual cap on
your qualifying Rx expenses. So make sure your Part D plan covers your prescription drug list.
If a senior is turning 65 but still working, should they enroll in Medicare or delay it?
Answer: The key questions here are, how good is the senior's employer group plan and what is the cost? Then compare that with the cost of Medicare Part B, typically $ 185 / month, in combination with a Medigap or Advantage plan.
What's one piece of advice you wish every senior knew before picking a Medicare plan?
Answer: My best advice to every senior trying to understand Medicare is they should consult an independent agent who has access to all major health plans in their zip code. There is no cost or obligation to meet with most of us! So you have much to gain and nothing to lose by taking the advice of an expert. I like the DIY / youtube approach many times but not when it comes to Medicare.
How do you educate clients who are completely new to Medicare?
Answer: Every client is different and when it comes to Medicare, there is no one-size-fits all plan.
So I strongly recommend a phone call, needs assessment, then an in-person appointment or a virtual session. Let's start with one of those...
What is the biggest mistake seniors make when enrolling in Medicare?
Answer: The biggest mistake seniors make when enrolling in Medicare is trying to do-it-themselves. I think it's a bad idea, especially considering that a knowledgeable, experienced, independent, licensed Medicare agent is most likely provide Medicare enrollment assistance at no cost or obligation. The technical term we use here is, "no brainer" to talk with an agent.
What do you enjoy most about working with Medicare clients?
Answer: Helping Medicare clients select the most suitable plan for their individual needs then learning how happy the clients were with the decisions they made is the single most gratifying outcome I have ever enjoyed.
How can I make sure I'm not overpaying for my Medicare plan, and are there any tools or resources you recommend?
Answer: I would strongly recommend that you speak with a licensed, independent Medicare agent with access to all of the major plans in your zip code. An experienced Medicare agent will easily be able to help you and there should be no cost or obligation.
I have multiple medications; how can I ensure my Medicare Part D plan covers them all without breaking the bank?
Answer: medicare.gov has a public website allowing you to input your Rx list including name of drug, milligrams and dosage. Then key in your pharmacy preference to see which Medicare Part D plan will give you the best bang for your buck.
When my husband dies, do I get his Social Security and mine?
Answer: You can't receive both your full benefit and your husband's survivor benefit at the same time. If your survivor benefit is higher than your own benefit, you can switch to the survivor benefit. However, the Social Security Administration will give you the higher of the two amounts, but not both.
I'm turning 65 next month; what are the first steps I should take regarding Medicare enrollment?
Answer: Go to ssa.gov, log in or register (then log in), click apply for benefits and apply for Medicare Parts A and B. When you get your Medicare card in the mail, contact your friendly independent, Medicare agent who can help you pick a suitable Medicare plan, either a supplement (Medigap) plus a Part D plan or Medicare Advantage (Part C) plan with embedded Part D benefits.
What happens if I am already retired and collecting Social Security when I turn 65?
Answer: In this case, you will be auto-enrolled in Medicare. When you get your red, white and blue Medicare card in the mail, pick a Medicare supplement plan plus a Part D Rx plan or an MAPD plan. Your independent Medicare agent can help with this.
How can I verify if a Medicare Advantage plan’s advertised benefits are legit?
Answer: CMS, Centers for Medicare Services, overseas the Medicare Part C Advantage program. By law, Medicare Advantage plans must be at least as good as Medicare, which is to say that all plans are better than original Medicare. CMS will shut down any plan advertising benefits that are not real. "They've got your back!"
Do I have to answer health questions when switching from one Supplemental/Medigap plan to another?
Answer: Medicare supplement plans are subject to Underwriting and you will need to be in reasonably good health when you are outside of your guaranteed issue period which will be when first enrolling in Medicare or within several months after leaving an employer group health plan.
What is the biggest disadvantage of the Medicare Advantage plans?
Answer: The biggest disadvantage of the Medicare Advantage plans is the negative publicity surrounding the insurance, the negative sentiment and fake news making Medicare Advantage seem like a bad idea. As an independent Medicare agent for the past 18 years and a Medicare Advantage member for the past 5 years, I have no regrets and if I could do it all over again, would stick with Medicare Advantage. OK, there are plusses and minuses with Medicare Advantage but the program is overseen by the Federal Government. That's CMS, the Centers for Medicare Services. By law, Medicare Advantage must be "at least as good as" original Medicare. Medicare Advantage members are protected by an out of pocket maximum so that's probably the best thing about the program. On the flip side, many doctors don't like Medicare Advantage because it's more work for them. Some procedures require prior authorizations so the additional paperwork is not popular among the medical profession. But, I have yet to hear of a medically necessary procedure that has been denied by any Medicare Advantage plan.
I'm worried about the 'donut hole' in my Part D plan. How do I manage my medication costs once I enter it?
Answer: Don't worry! The dreaded "donut hole" has been discontinued effective January 1, 2025. So you can not longer enter the donut hole. However, Medicare pays less to the insurance companies this year for your prescriptions so most Part D plans now have higher deductibles which will be offset by a $ 2,000 annual limit on the full price of a member's covered Rx costs, so members with expensive name brand drugs will be protected by the new rules. Be careful on this and make sure that all of your prescriptions are in fact covered by your Part D plan.
Does Medicare Advantage cover acupuncture or alternative therapies in some plans?
Answer: Yes, some Medicare Advantage plans cover acupuncture and in order to find out if alternate therapies are covered, this too is plan dependent. Here in Wisconsin, an independent agent like myself has access to Medicare plans from UHC, Humana, Aetna, Network Health, Quartz Health Plans, Molina and Wellcare so it's always wise to check with an experienced, Medicare agent to learn about specific plan benefits.
How do I appeal a decision by Medicare or my plan if they deny coverage for a procedure or medication I need?
Answer: To appeal a decision by original Medicare, contact Medicare. If your Part D plan is denying prescription drug coverage, have will need to request that your doctor file for a "formulary exception" with your insurance. If the insurance company decision is to deny the requested exception, you need to feel an appeal with your insurance. The recommended plan of action for an insurance company's denial of coverage for a specific procedure is you need to contact your insurance company and file an appeal of the denial. Your independent Medicare health insurance agent (who sold you the plan) most assuredly should be able to help you.
I'm on a fixed income and struggling to afford my medications. What's this Extra Help program I've heard about for Medicare Part D?
Answer: In 2025, single tax filers making up to $ 1,976 monthly gross income with no more than $ 17,600 in assets (couples: $ 2,665 / $ 35,130) should qualify for Extra Help for Medicare Part D also referred to as LIS (Low Income Subsidy). To apply for help, go to ssa.gov/extra help, call Social Security at 800.772.1213, or call your local SS office. Walk in traffic is not recommended.
I’ve got a Medicare Advantage plan, and I’m curious if my upcoming eye surgery is fully covered or if I’ll owe extra out of pocket.
Answer: This depends on the nature of the procedure. Medically necessary cataract surgeries are for the most part covered by all Medicare Advantage plans and you will typically pay your plan's outpatient surgery amount or copay. If you need cataract surgery on both eyes, expect to pay an additional copay for the second eye. There is a very nice, "enhanced," multifocal procedure which is not an approved benefit by Medicare and this is likely not covered by any Advantage plan. Expect to pay $ 5,000 per eye for the privilege of not needing reading glasses! If your upcoming eye surgery is other-than-cataract, ask you doctor to secure a Prior Authorization from your plan before going ahead with the work.
I don’t understand how my friend pays nothing for their plan and I pay over $200—are these plans just totally random by ZIP code?
Answer: The plans are not random. If your friend pays nothing for his Medicare plan, this is highly likely to be a Medicare Advantage plan featuring deductibles, copays and coinsurance depending on the plan. Most advantage plans feature a $ 0-dollar copay to see your primary doctor but will have a $30-to-$ 50 dollar copay to see a specialist and there will be additional costs depending on what's going on. Now if you are paying over $ 200 for your plan, you may have a very high-benefit Advantage plan but it is more likely that you have a Medicare supplement plan and this is a different animal. Medicare supplement plan F pays after Medicare leaving you with no medical bills for health services for Medicare-approved services (or no bills after a 2025 $ 256 outpatient deductible if you have a supplement Plan G). Talk to your independent insurance agent about all this otherwise get your license and help me explain this stuff!
What are the red flags I should look for when interviewing agents? I want to make sure I'm not just getting sold to but genuinely advised.
Answer: Experience matters. Ask your agent how long they've been in business? What percent of their business is Medicare (important!). Have your agent provide you with the names of the states where they're licensed and list the Medicare plans they are licensed / appointed to sell in your resident zip code.
Can Medicare pay for my groceries?
Answer: Great question. Most Medicare Advantage DUAL plans for folks with Medicare and Medicaid have a monthly healthy grocery benefit so no cigarettes, alcohol or non-food products. There are a couple of Medicare Advantage plans which may help with groceries for people with A and B Medicare so you don't necessarily have to be on Medicaid to participate but check with your independent agent to find out which plans help with groceries and if you qualify for the added benefit.
Why are people unhappy with Medicare Advantage plans?
Answer: Did you know that approximately 50% of the Medicare population has Medicare Advantage? Popularity for this type of coverage is surging. Still, Medicare Advantage is not for everyone and there aren't too many things that we're all happy about. I think it's a lack of understanding that causes displeasure with Medicare Advantage. As a Medicare Advantage member myself for the past 5 years and having sold these products for 18 years, I am 100% happy with Medicare Advantage considering the thousands of dollars I have saved by using Part C. So what's the problem with Medicare Advantage? Have you talked with your agent and gained a full understanding of Medicare Advantage and how it works? Medicare Advantage plans, many of which feature $ 0 (zero) monthly plan premiums, have deductibles, copays and coinsurance depending on the plan. All Medicare Advantage members are protected by an out of pocket maximum which varies depending on plan and service area. This is in exchange for higher premiums associated with traditional Medi-gap or Medicare supplement plans. It's important to take the time to learn about these products before making an enrollment decision.