Dutch VanHoesen, Medicare Insurance Broker
About Me
See ALL your Medicare plans/options in 1 meeting. I am paid a standard fee by the carriers so I can remain impartial to your decision. Local Pinellas broker. Annual reviews, remote or in person enrollment. US Navy Vet, Navy Dad, National Social Security Advisor Certified.
Q&A with Dutch VanHoesen
Answer: There is an overwhelming amount of disinformation or misinformation regarding Medicare. Make sure you deal with a broker who has most if not all of the plans available in your area.
Answer: I would say the most common misconceptions about Medicare are the costs involved and when to enroll. There are fines and penalties for late enrollment. Costs may decrease significantly if you qualify for a low income subsidy or Medicaid. Costs increase for high earners.
Answer: Medicare covers vision only when medically necessary such as cataracts. Routine vision, hearing and dental is not covered by Medicare. However many Medicare Advantage plans do include some coverage for vision. There are also ancillary vision discount or savings plans available.
Answer: Medicare will have an historic 80 million beneficiaries by 2030. With fewer paying into the system Medicare will have to make some changes along with Social Security in the coming years.
Answer:
You may utilize a Special Election Period which includes:
Moving to a new plan area.
Enrollment in a 5 star plan.
Losing health insurance.
Weather related disasters.
Annual enrollment. Is October 15th through December 7th. If you miss that enrollment period and you are a current Medicare Advantage member, You have 1 more opportunity to change plans January 1st through March 31st.
So from April 1st through December 31st you are locked into your plan unless you meet a special election period requirement.
Answer: Medicare Advantage plans may be less expensive when you are healthy. Medicare supplements or Medigap may be less expensive if the worst of the worst happens to you. However I can give you examples directly from my clients who have ended up paying more on a Medicare Advantage plan. While you may feel healthy now 85% of our Medical Care comes after age 65.
Answer: The annual enrollment period is Oct 15-Dec 7th. The open enrollment period for those on existing Medicare Advantage plans is Jan 1-Mar 31st.
Answer: I have a client who if she had went with her first choice of a Medigap plan her annual cost would be around $2,400. She decided to take a less expensive route and enrolled in a Medicare Advantage plan. She was diagnosed with a health issue requiring a doctor to administer shots in her eye every quarter for the remainder of her life. This cost is reaching her out of pocket maximum of $5,500 which is more than twice the annual cost of her supplement. In this particular case it would have been more cost effective for her to have been on the Medigap plan costing her $2,400 per year.
Answer:
1. Extra help: if you are low income, you may qualify for the Medicare extra help program. Contact Social Security.
2. Medicare prescription payment program: this is a new Medicare option to spread your drug payments over the course of a year.
3. Generic medication alternatives to your brand name drugs.
4. Patient Assistance programs: most drug manufacturers offer some sort of assistance to help pay for your drugs.
5. Mail Order: this may save you money and may not it all depends on your medications and your prescription drug plan carrier.
Answer: Yes there is an 8-month period between losing your employer coverage to get into a Medicare Advantage plan or prescription drug plan. Cobra coverage does not count as it is not creditable coverage according to Medicare.
Answer: Her friends may endanger your mother. Medicare Advantage may have authorizations, Dr networks, service areas, referrals, Etc. It's easy for any Medicare broker to check her current doctors and see if they are in network for various Medicare Advantage plans.
Answer: Medicare does not cover dental vision or hearing unless medically necessary. Medicare Advantage plans have some coverage for dental, vision and hearing. They typically are not comprehensive benefits but offer mostly preventive coverage. Some plans offer more than others.
Answer: A local broker can help you on an annual basis. He should be able to keep most of your information on a secure file in order to familiarize himself with your needs. Many people change their plans for coverage through the years. Local Brokers are more knowledgeable than someone not from the area. Many plans offer different benefits or cover niches that are not typically published.
Answer:
Original Medicare: Medicare premium $185/mo, $257 deductible + (20% of $20,000 to $40,000 + post care costs)
$5-10K no max out of pocket.
Medigap Plan G: $200-225/mo+
Medicare premium $185/mo, $257 deductible is your max out of pocket for the year
Medicare Advantage: Medicare premium $185/mo (may be reduced by up to $174,70/mo) specialist copay $10-$45+ outpatient hospital copay $100-$300 + post op rehab $20-$40/visit maximum out of pocket could be less than $500. Max out of pocket $1000-$6700.
Answer: Yes. You must have missed the cost of Part B. If you are receiving benefits it is automatically deducted. If not, billed quarterly.
Answer: No, you will simply be re-calculated at the Florida rate. You may however, want to look at the Medicare Advantage plans in Florida as they are some of the most cost effective Medicare Advantage plans in the nation.
Answer: People that are new to Medicare require much more time and explanation regarding how Medicare works and what their options are. People who already have Medicare and are just switching plans usually know what they want however people switching plans do require occasional updates and re-education about how things work.
Answer: Typically you would be eligible for survivor benefits depending on many different variables. You'd be eligible for the $255 death benefit once again providing you meet certain requirements.
Answer: There really is no way to know for sure until you talk to a professional broker or agent. There is just so much information and thought that needs to go into a decision like this. Typically the best time to get into a Medigap plan is within 6 months of your Medicare Part B effective date. After that they will underwrite you and may deny you coverage based on your answers to medical questions.