David Bell, Medicare Insurance Agent

Answer: In a word, relationships. I love the relief my customers have as I help them understand thier options, costs and the benefits available. The time I spend with you builds a long term relationship and I value those friendships, that trust. I truly treat my customers like aunts and uncles and want them to have the best coverage and experience possible.

Answer: Free is a catchy marketing word. Many have no monthly premium so in that sence, yes. If we are looking at overall cost (premiums, co-pays, deductible etc...) then no. Advantage plans will have co-payments for things like doctors office visits, tests, radiology, the emergency room and the hospital, but they are set co-payments that are usually very reasonable. Additionally, there is an out of pocket maximum, so you know your worst case senerio. Note that few people reach the out of pocket maximum, so it is not really an annual cost. In comparison, Medicare supplement G only has you pay a Deductible ($254 in 2025) for services, so many people with supplements feel that visits, tests and hospital stays are "free" but fail to account for the monthly premium they pay no matter if they use the plan or not. In comparison, Medicare Advantage will come out well ahead in years with fewer medical procedures. As good years usually well outnumber the bad, Medicare Advantage usually wins.

Answer: Since 2004, as Medicare Advantage has evolved, we have seen more and more extra benefits added to the plans. Dental, vision, hearing, gym memberships and over-the-counter credits are the most notable. All money spent by the plans to care for their members. Additionally, they are well accepted by doctors and facilities.

Answer: Medicare changed very little in it's first forty years and that is a bad sign in any program or product. Demand for better service and a better product drives competition between the companies that provide Medicare Advantage plans. This competition makes for a better product for all Medicare recipients that are part of the Medicare Advantage program.

Answer: It's a good idea to make sure things get done, especially with deadlines and enrollment windows. If they miss things it could have life long financial effects. Kids should be involved at least a little. As your parents get older, they may have trouble remembering how things work. Be kind and help them navigate. I will always be kind to your parents.

Answer: It depends. If your deductible and co-payments will be near the $2000 maximum, and they would come up in the first few months, yes it would help. To be clear, it doesn't save any money, it just lets you spread the payments out.

Answer: If you are undergoing current, major treatment such as dialysis, chemotherapy, transplant or joint replacement, a supplement may be the better choice as premiums may be less than the comparitive out of pocket costs. Also if treatments or procedures will be well away from where you live there may be network issues if your Medicare Advantage options are HMO's. If you are in this situation, discuss the pro's and con's of both plans with your agent so they can best advise you. There are also places the Medicare Advantage plans are not available so for some there may not be a choice.

Answer: You usually get Medicare once you have been disabled for 24 months. If for some reason you have not, then you should get it at 65. If you have not heard from Medicare six weeks before the month you turn 65, you should contact Social Security.

Answer: Mostly, yes they are. They benefit you as you can meet the agent, ask questions and gather information. They are not supposed to have a sales pitch attached, or even any obligation for follow up contact. However, as polite human beings, many feel obligated to follow through and set up a meeting. To be fair, most presenters are salespeople, and we can't help but sell.

As an agent with 30 years behind me, I always have preferred one on one meetings. I have always felt they are far more personal and efficient for the customer. Skip the seminar and go see an agent.

Answer: Thank you for taking care of your dad. Know that every medication filled, every doctor visit, etc... will trigger a claim that will make it's way to you in the form of an EOB or Explanation of Benefits. Usually they are sent in batches of a week to a month as the claims are processed. The important thing to look for is the patient responsibility, usually the far right side. As you get bills from the providers you can match them up and know what you need to pay. I usually suggest setting up the companies online portal. They can help you organize and seach EOB's, find in-network providers and understand benefits better. You can choose to not have paper EOB's with most carriers. Save those trees. Sorry, I can't help with stacks of other junk mail you'll be sifting through.

Answer: Due to the gaps in original Medicare A & B, it is important to have either a Medigap plan or Medicare Advantage. Is it right for you? Do some comparison of the options with an agent that knows both plans. Medigap is a better choice if you have current treatments like chemotherapy, need major surgery in the near future or if the Advantage plan options in your area are limited. Medigap also makes doctor choice much easier as there are no networks.

Best time to buy one? When you are healthy. You get a "no questions asked" entry to any Medigap when you are first elegible for medicare, so that is the best time and the easiest time. In the future you have to answer elegiblilty questions and can be turned down for things like heart conditions, diabetes, cancer etc.... Medicare Advantage asks no health questions, but you are restricted to an annual open enrollment period (10/15-12/7 each year).

Answer: Plan N makes you Part B deductible ($254 per year in 2025) your responsibility. It depends if you have had other outpatient services that would have required the deductible already. So the most it would cost is $254 in 2025 but it may cost nothing.

Answer: Your age makes a difference. You should do some research so you can budget and make a good decision.

If you are over 65 and still on employer coverage you should really compare costs. Premiums are sometimes about the same, sometimes less. Premiums are only part of the picture. Your out of pocket costs under medicare plans are significantly less than almost any employer plan, so that usually makes the decision. If your spouse is still under 65 and/or you have dependent children still on the employer plan, they can usually stay on the plan, even without you. Your HR department should know if that is an option.

If you are under 65, reserch costs so you can budget, talk to an agent and make a plan, then sit tight until three months before your birthday. Then check in with Social Security to make sure both Parts A & B will be ready for you. It is supposed to be "automatic," but make sure you'r enot the "one that wasn't." When you get your Medicare card callyour agent and get your Medigap and Part D or Medicare Advantatge plan started for the first of the month you turn 65. If you're not taking Social Security you'll need to make payment arrangements for your Part B premium.

Answer: There are a couple of ways to get dental and vision coverage.

Most Medicare Advantage plans have dental and vision coverage built in or have an option to add the coverage for an additional premium. But this is not the only way.

If you have a Medicare Supplement plan (like G or N), you can buy a separate policy for dental and vision from the same company or a different company.

Talk to your agent to find the best option for you. Be aware of waiting periods and make sure your dentist is in the plan's network.

Answer: Probably not. Premiums are long term, co-pays are short term. The cost of Medicare Supplement premiums are often thousands per year and will always go up. You will always pay them, whether you use the plan or not. On the other hand,you will only have copays when you use the services, and servies are often not long term. Part B medications like chemotherapy often have a 20% copayment but it is short term. Durrable Medical Equipment like an oxygen concentrator would also be 20% and is probably long term, but it's about $30 per month.

When you join a Medicare Advantage plan with low premiums, I always suggest using your new savings on the cost of your prior health plan to build yourself a little savings account. If you have $2,000-4,000 saved, you will never worry about copayments. Planning and budget make all the difference.

If you are really worried about the copays, talk to your agent about options to move to a Supplement. If you are healthy it is usually not a problem. There are also guaranteed acceptance plans if you are not healthy.

Answer: Medicare supplement plans do surchage for tabacco use, build (height/weight) and health factors. Original Medicare and Medicare Advantage do not. It would take a major change to the Medicare system that probably won't happen.

Answer: It's 2025 now. $2,000 max out of pocket and they will let you make equal monthly payments of $166.66. Be aware that to use that option, you need to ask your Part D provider for it in advance.

Answer: It does under Part D. There is generally no cost. Talk to your doctor and get a prescription. They will take it from there.

Answer: They use taxes from two years ago (so 2023's taxes for 2025), so you have time to prepare. The brackets change every year and they are tiered so if you just go over a little the penalty is is about $1,200 for the year. Work with your tax advisor if you will be near the current year's levels to reduce you income through things like charitable giving and other tax deductions. Balance the deduction spending against the expected penalty. To be honest, it's a great problem to have. Good work on the savings.

Answer: HMO, PPO, POS, PFFS. I don't think it's a "trick." All plans have some restriction in who you can see.

HMO- besides the rare exception, you have to see the providers on thier list or there is no coverage.

PPO- the plan has a list of providers that are in-network but you can see the provider of your choice. If they are not in the network, you pay a higher co-pay. Sometimes much higher (this may be the "trick")

POS- is an HMO with an out-of-network option. It is slightly different than a PPO in that the "in-network list" is often smaller and you often need a referral to see out-of-network providers

PFFS- you can see any provider as long as they are contracted with Medicare.

Always review the provider list for plans you are considering. Most people don't want to chnage doctors so be sure yours is on the list. Don't bank on an exception.