Cynthia Allen, Medicare Insurance Agent
About Me
We specialize in Medicare so that individuals turning 65 can better understand their options.
Medicare Made Simple:
If you find Medicare is a little confusing, you are not alone, there are a lot of choices but we are here to help simplify it for you. We are independent agents who are certified in Medicare, and who represent many different insurance companies but will always give you unbiased information as to what your options are.
You deserve a Medicare Plan that not only supports your continued good health but also your peace of mind. Essentially, meet your health needs and budget.
If you would like to have a free consultation, please call me. There is no obligation.
Look forward to talking with you and the best to you on your 65th Birthday!
Serving clients in California, Pennsylvania, Virginia, Georgia, Idaho, Texas and more.
Q&A with Cynthia Allen
Can Medicare pay for my groceries?
Answer: Medicare does not pay for groceries. However, there are some Medicare Advantage Plans
That offer a health food benefit or grocery allowance. You have to qualify by being a part of a Medicare Advantage plan that offers this benefit, — example would be a Special Needs Plan which is for individuals with chronic conditions. If you qualify you will receive a pre-paid card with an allowance that ranges from 25 to 200 dollars. The plan does specify where you can buy food and which items you can purchase.
Who can help me figure out this Medicare "maze and alphabet soup" it's so confusing.
Answer: One of the best ways to figure it out is to have a Medicare Agent help you because they have been trained in the knowledge and will help make it less confusing and help narrow down information for you so that you make a good decision for your Medicare plan. If people try to figure it out on their own I think it would be difficult because you don’t have all the access to plans and the knowledge an agent has acquired.
Also, there is no charge for a Medicare Agents service, if you would like to talk about your options you could call me or any other agent of your choice.
What's the best way to avoid surprise bills for lab tests under Medicare Advantage?
Answer: To avoid any surprise lab bills you need to know what your plan covers which you can get that information through your plan’s Summary of Benefits. If you do not have that you should contact your plan to get a copy of it so you always have it on hand. Also, if after you have gone through the summary of benefits and you are not sure if a test is covered, then contact your plan for verification. In addition, talk to your doctor to make sure the tests being ordered are in-network.
If possible, get a good faith estimate of the costs before the tests are performed.
If you should receive a surprise bill, check for its accuracy, and if the bill seems incorrect or includes an out-of-network charge, you can dispute the bill by calling your plan and filing a grievance…they will explain the process.
There is a “No Surprise Act’ in effect which does provide additional safeguards, particularly for certain out-of-network care in emergency situations and at in-network facilities.
This Act requires providers and facilities to give you certain information about balance billing protection and out-of-network care costs.
I want to get a shingles vaccine. Will Medicare cover this preventive service?
Answer: Medicare Part D - which is your prescription drug plan will pay for the shingles shot. However, if you have a Medicare Advantage plan you will need to check with that plan to make sure it is covered. Part D covers all adult vaccines that the Advisory Committee on Immunization Practices recommends.
I've been paying into Medicare for years, and I'm not sure why my specialist visits still cost me so much. What am I missing here?
Answer: Costs in Medicare go up every year so if you have a medicare advantage plan those specialists costs are going to increase also and you will need to pay a co-pay or co-insurance that was more than the year before, it does not matter how much you have paid into medicare — it is the same for everyone. If you were to have a Medicare Supplement plan you would more than likely just need to cover the Part B deductible which is $257.00 for 2025, and then not have to pay anything further once that is met. Keeping in mind that Medicare Supplement plans have a premium every month but no other out of pocket expense except the Part B deductible. You can also look into other Medicare Advantage plans to see if your out of pocket costs could be less.
Please note that if you have had a medicare advantage plan for years and wanted to switch to a medicare supplement you will more than likely have to pass underwriting…therefore insurance companies could deny you or charge a higher premium.
I picked a Medicare Advantage plan because of the dental and now I found out it only covers cleanings. Why didn't anyone tell me this upfront?
Answer: Of course I do not know who you spoke with, but if you did speak with someone like an agent they should have gone over what the dental plan covered via the Summary of Benefits. As agents we know that all plans are not the same and that we need to review the summary to determine whether you will have comprehensive coverage or only preventative services which only includes cleanings, exams and X-rays. More comprehensive coverage should include fillings, root canals, dentures, etc. All plans vary and with most dental plans you will more than likely have out-of-pocket costs such as a deductible, copays or coinsurance.
If you want more dental coverage you can certainly change your Medicare Advantage plan to something that is more beneficial to you during the Annual Enrollment Period which starts October 15th and runs till December 7, 2025, which is only 3 months away.
Does Medicare cover emergency care if I'm traveling in a U.S. territory like Puerto Rico?
Answer: Yes, Medicare generally covers emergency care for individuals traveling in Puerto Rico, as it is considered a U.S. territory. Original Medicare (Part A and Part B) provides coverage for services like hospital care and doctor visits in all 50 states and U.S. territories.
Here's a more detailed explanation:
Original Medicare (Part A and Part B):
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If you have Original Medicare, you are covered for emergency care and other necessary medical services when traveling in Puerto Rico, just as you would be in any other part of the United States.
Medicare Advantage:
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If you have a Medicare Advantage plan, it's crucial to check with your specific plan regarding their coverage for emergency care in Puerto Rico. Some plans may offer additional benefits for emergency and urgent care services during foreign travel, but it's best to verify the details with your plan provider.
Foreign Travel Emergencies:
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While Medicare generally doesn't cover care received outside the U.S. (except in specific, limited circumstances like being closer to a foreign hospital in a medical emergency than the nearest U.S. hospital), Puerto Rico, as a U.S. territory, is an exception.
Medigap:
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Some Medigap plans (like C, D, F, G, M, and N) may offer some coverage for foreign travel emergencies, but they often come with deductibles and co-insurance requirements.
Why do some clients ignore your advice and end up in bad Medicare plans-what makes them resistant?
Answer: I would think that because some people feel that they can figure it out for themselves or they just don’t trust the agent has their best interest at hand, they decide to go their own route. As a result, sometimes the plan they have chosen, while not knowing information that primarily agents know, they might experience a plan they thought would be the best for them but turns out not to be….there really aren't any “bad plans” — but agents help with selecting plans that accommodate a person’s needs. That said, I make sure that the client knows all their choices and gear towards the least out of pocket costs but also getting what they need in coverage.
What do I need to do if I didn't take Medicare at 65 and am now retiring?
Answer: If you have had creditable medical coverage, i.e. a medical plan from your employer, then you would need a letter from your employer stating that you have had coverage along with the starting date of coverage and when it will end. You will need that to sign up for Medicare Part A and B within 8 months of you leaving your employment to avoid any penalties. You would need to contact Social Security if you plan on taking those benefits, and then you could have the Part B premium taking out of Social Security as an option. It all depends upon when you want to take social security. You can go to medicare.gov to find out information or contact an agent to help explain things further to you which is best since every situation can be different.
I need help at home after my surgery. Will Medicare cover a home health aide or am I on my own?
Answer: Go onto google and search - does medicare cover home health care after surgery and it will bring up the information that you need,