Elayne Cotton, Medicare Insurance Agent

About Me

Hey there, my name is Elayne, and I am your local Medicare advisor and agent. I specialize in Medicare and am devoted to helping you find the best plan that matches your specific needs and financial situation. I will take care of the daunting task of comparing plans from well-known national and local companies for you. Even better, my services are completely free! Contact me today to explore your Medicare options, and be sure to mention that you found me on Medicare Agents Hub!

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Q&A with Elayne Cotton

What do you like most about being a Medicare agent?

Answer: My career background revolved around education. So, educating seniors, as I am one myself, is my number one priority when discussing the Medicare program and completing a Needs Analysis so that the plans I will be presenting to the beneficiary are meeting all of their concerns (i.e., doctors in network, prescriptions covered, and/or ancillary benefits).

What's the trade-off between a Medicare Advantage PPO and HMO when it comes to flexibility?

Answer: Flexibility is the key word to this answer. PPO and HMO plans are similar in that they all have co-pays for services. However, the PPO is a much larger network of providers with no referrals needed. The HMO plans will often have lower co-pays but the network of providers is more restricted.

What are Medicare’s coverage options for mental health apps or virtual therapy platforms for seniors with depression or anxiety?

Answer: One's coverage will depend on whether they are on the Original Medicare (Parts A & B), or a Medicare Advantage Plan (Part C). Both options will offer mental health coverage. However, the MA plans will include other options like the telehealth apps, group or single therapy sessions or other supplemental mental health services. These services can vary between plans.

How to know if a Medicare agent is legitimate?

Answer: A legitimate Medicare agent will be morally compliant at all times with all the rules and guidelines that are set in place by the federal agency, Center for Medicare & Medicaid Services. They will be properly licensed in all states where they offer services. They will be properly approved and accredited by the carriers whom they are representing.

I've been dreading hitting the donut hole each year. How will its elimination in 2025 change what I pay throughout the year?

Answer: The donut hole is no longer a problem - it's been eliminated! And the maximum out of pocket for medications is capped at $2,000.

Additionally, for the first time, the beneficiary can spread out the payments for the year with a capped monthly cost, instead of paying the pharmacy the full price when the medicines are purchase.

What's the difference between a Medicare broker and a Medicare agent?

Answer: A Medicare broker agent will offer multiple carriers (i.e., Humana, Cigna, United Healthcare) whereas a Medicare agent will work for a carrier (i.e., Humana). {The carrier(s) listed above are for example purposes only. There are 100s of medicare carriers.)

My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?

Answer: in 2025, the maximum out of pocket cost for prescription drugs is capped at $2,000. It is a change that will primarily benefit individuals who are taking a lot of medicines and/or are taking very high cost medicines. This Medicare drug cost change did eliminate the donut hole.

If a senior is turning 65 but still working, should they enroll in Medicare or delay it?

Answer: Short answer, Yes. You can enroll in Part A as long as the employment is providing your health insurance.

If you are working, and do not have health insurance, then you should definitely enroll in Part A. The initial enrollment period for a senior turning 65 consists of seven months: three months before the birth month, the birth month, and three months after the birth month.

Enrolling in Part A can work with employer insurance.

If you are working, and do have health insurance, then you can delay the enrollment into Part B until you decide to retire.

How can I get dental and vision coverage with Medicare?

Answer: To have dental and vision coverage with Medicare, you need to be enrolled in both Parts A & B and have a Part C health plan that includes dental and vision. Alternative, you can purchase a standalone dental, vision or a combination of both through any number of insurance carriers.

What's one Medicare decision that too many people regret later?

Answer: The one that I'm most familiar with is from an individual who is very healthy and not taking any medications. They think because they don't take prescription drugs that they don't need to purchase a Part D stand-alone prescription drug plan.

Unless they have been educated on the rules around Part D, they become subject to a lifetime penalty due to not enrolling into Part D when they were first eligible.