Donald Heath, Medicare Insurance Agent
Donald Heath
Brightstar Insurance Services
Medicare Agent Licensed in CA, AZ, CO, NM, NV, TX and WA
Contact Details
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Location
San Buenaventura, CA
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LinkedIn
Donald Can Help With:
About Me
25 years helping clients as their trusted advisor on Medicare supplements, Medicare Advantage plans and Part D drug coverage. My services are free and I can offer all carriers!
Q&A with Donald Heath
What do you like most about being a Medicare agent?
Answer: I really like knowing that I am helping clients navigate a confusing landscape of choices. I am very good at explaining how the plans work and helping them arrive at a selection that they understand and want.
Are Medicare Advantage plans really "free," or is that just clever marketing?
Answer: They are never free. Many plans are zero premium but they all have co-pays and co-insurance for certain services. They do, however, all have a annual max out of pocket to limit annual costs for the subscriber. The key point to know is that you are assigning your Original Medicare benefits to a private Insurance carrier...Humana, UHC, etc. The reason they are zero premium is because Medicare pays them a monthly fee to manage your health care. There are cases where this type of plan may not be a good fit.
How do you stay up to date with changes in Medicare policies and plan options each year?
Answer: Every year I have to re-certify with Medicare. This is a multi-hour process of study and then a final exam which must have a 90% score to remain certified by Medicare to be an agent that can sell Medicare products. Additionally, each carrier I represent (about 12-15 each year) has their own compliance study and tests to certify knowledge to sell their plans each year. These also have to be completed with a 85-90% score. I complete all this over a 1-2 week period each year to be compliant for Medicare Annual Enrollment which runs from Oct 1-Dec 7.
I picked a Medicare Advantage plan last year, and I'm not sure if my hearing aids are covered. How do I figure this out?
Answer: Look at your Summary of Benefits. It should list all your coverage details. If you can't put your hands on it, call the customer service number on your ID card to have them send another. Good to keep it handy for reference.
What's the best way for seniors to protect themselves from Medicare-related scams?
Answer: Have a trusted Medicare professional to call or go to the www.medicare.gov website to look up info. If you get an unsolicited call from someone wanting to talk to you about Medicare plans, ask them for their name and state ins License number. Since this is not allowed under Medicare rules, they will probably hang up real fast. The penalty for not having permission to call you could result in them losing their license.
I have Medicare Advantage with a PPO, and I'm curious if my annual wellness visit is free or if I'll owe something for it.
Answer: The annual wellness visit in no charge under Medicare rules on MAPD plans in network. Even if you are out of network, and the provider accepts your plan, the annual wellness visit will be no cost.
I'm confused about the different tiers in Medicare Part D plans. How do they affect what I pay for my medications?
Answer: The part D Medicare drug plan tiers in 2025 run from Tier 1- preferred generics to Tier 2- non preferred generics to Tier 3- preferred brand name to Tier 4- non preferred brand name to (sometimes) Tier 5- specialty or compounded meds.
Tier 1 and 2 are typically not subject to the annual part D drug deductible of $590 in 2025. Part D medication costs are capped at $2000 for the calendar year including the $590 deductible and all co-pays and co-insurance. This is new for 2025 under the Inflation Reduction Act passed in 2022.