Esther Miller, Medicare Insurance Agent

Answer: I think one trend that is making a big difference is that people in general are paying attention and taking better care of their health overall by doing preventive screening tests and choosing a primary care physician to help manage ongoing conditions. There is better awareness of how healthy living activities including daily movement, health food choices and adequate sleep and taking care of your mental health will improve your overall health.

Answer: Yes, each year Medigapn plans may increase their premiums slightly, or in some cases significantly.

You can, at anytime change from one Medigap Plan to another of equal, greater or lesser coverage for private or service.

Each insurance company has to cover the exact same things with each plan, so changing from a G plan from insurance company 1 to insurance company 2 will be the same, except the premium may be less or the service is better.

Whatever your reason, you just need to make sure you don't have a lapse in coverage so you keep your guaranteed issue status.

Your insurance advisor can help you with this.

Answer: There are two types of Medicare events, educational events designed to answer your general questions about Medicare and sales events that are geared to talk about a specific products.

When signing up to get your general Medicare questions answered, be sure to ask if this is an educational event or sales event.

Also, keep in mind, unless you specifically requested information by phone or email, you should NOT be getting unsolicited phone calls asking you to attend these kinds of events, as this is a violation of Medicare agent regulations or get sales information at Educational Events.

Answer: One thing you should know as an eligible Medicare member is that no Medicare agent will contact you without your permission. First. You give your permission by signing up to ask for more information, or for reaching out on a medicare site.

The medicare site, medicare.gov and 1-800 medicare will give you good information about medicare and your benefits and answer questions that you may have.

All medicare insurance agents are required to have a license, and you can look up that license under the state insurance commissioner's guide. If the person you're talking to does not have a medicare insurance license, then it's probably a scam.

Answer: If you have good benefits through your employer and you pay little or nothing for them, then it may be a good idea to keep your employer's coverage. Until you decide to cut down on work and work part-time only, or if you have other people on your plan, like children who need coverage.

If you're paying for your own insurance on the health work network, you may find that Medicare is a much better bargain for you. And can give you more benefits than individual insurance on the health networks.

The best advice I can give is to. Reach out to a medicare insurance agent to discuss the pros and cons of doing just that.

Answer: Medicare.gov has answers to frequntly asked questions as well as helpful links about costs, enrollment period and an annual book called Medicare and You 2026 version that you can refer to, and you also can do a live chat with a representarive. Social Security is a little more difficult, my best recommendation is to either use their web page ssa.gov or make an in person appointment to tall with a real person. You can always reach out to a Medicare broker like myself as well to help guide you through this process with no cost or obligation.

Answer: There are two ways to budget for future health expenses. The first is by saving your money now by having a Medicare Advantage Plan with low out of pocket costs and a zero or low premium.

The second way is to pay for your future healthcare needs now by psying for a Medigap supplement plan that can cover your future health needs more completely than Medicare Advantage plans. The premiums are higher, but the coverage is greater than a Medicare Advantage Plan can offer.

You can choose one or the other, but not both and you can only get a Medigap plan if you are in good health now or have a guaranteed issue period.

However, the very best way to reduce future health costs is to take care of your health now and take advantage of free Medicare healthcare screenings and fitness and health benefits that come with your plan.

Answer: There are all kinds of situations that are unique when considering Medicare options. Sometimes its just helping a client navigate how to sign up for Medicare if they don't feel confortable using their smart phone or a computer; other times it's making sure their medications are covered, helping them find a new physician or dentist. Requests come all year long and I am happy to help where I can.

Answer: The most common misconception most people have is that Medicare will cover all your Medical needs 100%. This is not true, in most cases. Medicare parts A and B, has co-pays and dedu tables, including a deductible of around $1700 for hospital coverage, and $283 for part B coverage, after that Medicare pays 80% but you will still be responsible for 20% of the bills. This is why you will want to consider the pros and cons of adding either a Medigap Supplent + prescription drug plan or a Meficare Advantage plan that includes prescription drug coverage.

Answer: You may assist your parents if they are eligible, but you can't sign up for them. They must participate if they are able. If they are unable because of medical or mental disability, you may do so if you have been given their Medical Power of Atty to represent them.

Answer: Yes, there are several special situations that can trigger a special election period or your initial enrollment period if you have never had Medicare before. If you suddenly lose your employer coverage you have 63 days to sign up for Medicare coverage. You would sign up for Medicare first through Social Security, and then decide if you want a Medigap Supplement + Prescription drug plan vs. a Medicare Advantage Plan.

This is also true if you move out of your local area or your Medicare plan is discontinued.

If plan to retire, and have not had Medicare before, then you can plan in advance and then you will have up to 6 months to sign up for a Medicare Supplement Plan or 7 months ( three months before your birthdate, the month of your birthdate ane three months after your birthdate to sign up for a Medicare Advantage Plan or Prescription Drug plan.

Answer: It depends on why you wanted a Medigap plans. If you wanted a plan that would offer the most coverage in the event of a big event, then no you did not make a mistake. However, if you are more concerned with your monthly budget and your Medigap premiums are a hardship, you can do one of two things: 1. Shop for a more competitive price. Unlike MAPD and prescription drug plans, you can change Medigap plans anytime during the year. 2. You can try a Medicare Advantage Plan during the annual enrollment season Oct 15 thru Dec 7th for the following year. If you like Medicare Advantage better, you can stay with it,but if you don't you still have guaranteed issue and can go back to a Medigap plan within the first year.

Answer: Medicare A and B when it first became available did not cover all the issues that happen with aging including vision care, dental care, and prescription drug coverage. All these elements needed to be added separately and Medicare Supplement (Medigap) insurance only covers the gaps in Medicare part A (Hospital) coverage and Medicare Part B (Doctor coverage).

Medicare Advantage plans were designed to cover these other services along with Medicare Part A, B and D (prescription drug coverage) in one comprehensive and convenient package and are similar to the comprehensive health insurance coverage many people have through work.

One other advantage of Medicare Advantage Plans, is they change from year to year offering newer and sometimes better benefits than Medicare alone. Since CMS oversees Medicare plans and Medicare insurance, we have the assurance that if there is a bad player, they will be shut down or sanctioned. The Medicare Advantage Star Rating System helps consumers determine the overall client (patient and physician) satisfaction with the various plans.

Answer: In some cases, Medicare will cover genetic testing where there is a proven history of cancer risk in your family. Your family physician or an oncologist may order this test, it is not a test you can self-order. Having this information will tell you if you have the genetic markers that make you more susceptible to getting cancer which can help you determine on going testing where needed for prevention.

Answer: Medicare Suppliments are good in that they are able to provide additional coverage for Medicare Part A hospital coverage and Medicare Part B doctor coverage to minimize out of pocket expenses to just $257.00 for the Part B deductible. But they do so at a price, as policies for a G plan average between $240 to $260 per month. This is in addition to paying for the Medicare Part B monthly premiums of $185.00 per month, a monthly fee for a Part D prescription drug plan and an average cost of $60 to $75 per month for a dental plan. These monthly costs do add up and can put these kind of plans out of reach for those with fixed budgets. Advantage plans on the other hand, can start as low as zero premium, vision, dental coverage for a lower monthly fee. The trade off? You may have to pay more out of pocket for a big health event, as max out-of-pocket costs can be up to $6000 or more annually.

Answer: Every Medicare Advantage Plan is updated during the Annual Enrollment Season for the next year. OCT 15 thru DEC 7th. This is a perfect time to shop and compare with your agent to get the best plan that has the coverage you want, including the doctors you are currently seeing.

Answer: Your Medicare Supplement coverage doesn't change, but the premiums may go up over time, so you'll occasionally want to review those costs with your Medicare agent,to see if there is a more competitive rate.

Answer: As a traveler, you'll only the emergency travel benefits of either a Advantage Plan or a Medicare Supplement Plan (also called Medigap Plan), while you are on vacation for either urgent care or emergency room care for up to 6 months with the Medicare Travel benefit. Each plan is different, so you'll have to check on how much they will cover and for how long.

For long extended stays oversees, greater than 6 months, you may need to purchase a separate travel insurance for routine healthcare or self-pay for services. It will depend on where you are located and whether you have dual-citizenship there.

If you are going to be returning to the US, you'll want to continue to pay your Medicare Part B premiums and have Medicare Part D prescription drug plan, and don't let your policies lapse so you won't have to pay penalties for being without part B or Part D insurance while you are gone or lose your Medigap Insurance coverage.

Answer: Each year Medicare publishes a book for new enrollees and for existing enrollees called Medicare and You which outlines what is covered in Medicare Advantage Plans (also called C plans) and Medigap Plans which are also called Medicare Supplements. This book is available to order or download from the Medicare.gov website and has that information in it.

While there is a lot of information in this book, it's also good to contact a local licensed Medicare Insurance agent to help you sort through these options once you are eligible for Medicare insurance, or if you need to change your insurance or have a Special Enrollment Period, like a moving from one area to another, as you could be eligible for a 2nd guaranteed enrollment period for Medicare Supplements.

Answer: Medicare is designed to provide care for cdisabled adults under 65 and older adults from age 65 on throughout their lifetime regardless of where they live.

While there is some support for skilled living facilities ( up to 100 days), there is not a,provision for ongoing nursing home coats. Residential care costs are not covered after the first 100 days.

For that you will need to use other resources, which include savings, selling a home or if necessary, relying on Medicaid to help sustain the costs for ongoing care.

Medicare will still cover your Medical costs for physicians, specialists or hospitalizations or hospice care.

Answer: I am a Medicare Insurance agent specialist, not a financial advisor. Your best advise would come from speaking directly to Social Security or your own licensed financial advisor who can tell you the pros and cons of when to start collecting your Social Security.

Answer: There are many Medicare Advantage plans that have a zero premium, but you'll want to compare the benefits you are getting as some have a lower maximum out of pocket costs, while others have more ancillary benefits like dental, vision or additional chiropractor care. Other plans will cover your medications better. Medicare Supplements, while they cost more money than most Advantage Plans, will cover your medical costs more comprehensively and if you have chronic health conditions and need healthcare frequently, this actually might be your best option. You need to compare all these factors to find the plan that will truly be the best value, rather than just the cheapest.

Answer: You will not get in any trouble for reported suspected fraud or billing errors to Medicare.

If you believe this is an honest billing error, contact the billing agent first to try and get it corrected. You can also contact your agent for assistance in determining if an actual billing error occurred.

If you do suspect either fraud or wastefulness, you can contact Medicare directly at 1 800 Medicare. Your complaint is completely confidential.

Answer: Yes and no. You have to stop contributing to these plans when you reach 65 and you can't use them for Medicare Supplement (Medigap) premiums, however you use the tax-free distributions for Medicare Part B premiums, Medicare Part D prescription drug coverage premiums or Medicare Advantage premiums or the co-pays you may have to pay for your insurance costs.

Answer: If you are all ready collecting SSI benefits, you can get Medicare benefits as soon as 24 months after you have started to collect SSI benefits, you do not have to be 65 years old. Just go to SSA.gov to sign up for Medicare or call 1 800 Medicare to help guide you through the process. Note: Your local licensed Medicare insurance agent can also help guide you through these steps.

Answer: It depends. If you have credible health insurance through your employer, the answer is no as long as you keep your healthcare coverage and you are also entitled to Medicare Part A hospital coverage in addition to your work insurance. If you currently don't have any employer sponsored insurance or only catastrophic insurance, then yes you will want to sign as soon you are eligible for both A and B coverage and talk to a Medicare Health Insurance agent.

Answer: Yes, it's a good idea to get in touch h with a local licensed agent.

You may have questions whether you need to make any changes to your existing Supplement or prescription drug plan and if you have an an Advantage plan you have a SEP special enrollment period to change to a new state plan or even a Medigap supplement under guaranteed issue.

Your local agent can help you find providers, and knows the local doctors and hospitals near your new home.

Answer: Your primary care physician may need to make the referral before its approved by your plan, especially if you have a HMO plan vs a PPO or HMO-POS plan where you can select specialists on your own instead of through your primary care provider. The other situation is the specialist you selected may not be in network. Again with HMO plans you always need to stay in network. With a PPO plan, you can choose a specialist who is not in network, but you will pay significantly more if you do. Check either with your agent or the customer service to find out what your options are to resolve this issue.

Answer: Nor asking enough questions! Never assume what works for a friend or neighbor will work for you. While you may get a good idea if your friends are satisfied with their healthcare plan, by working with an agent, you'll be able to compare all your options and find the plan that is best suited to your needs and budget.

Answer: Medicare is funded through the workforce for future generations which is why it is very important that every person working is contributing to this program. We have many workers in the US who are either self-employed or undocumented who are not contributing, that gap needs to be fixed by having a legal path to citizenship for those workers who will also benefit from Medicare when they retire.

Answer: The most common misunderstanding is that Medicare pays 100% of your medical costs. While there are many free preventative tests and services available, there are deductibles and Medicare in general, only pays 80% of allowed services, which is why most people choose to have a Medicare Supplement or Medicare Advantage Plan to get additional coverage.

Answer: I first listen and ask questions to understand their Medicare needs. The next step is to match them with more than just one option, so they have choices and the plan fits within their budget and health needs.

Answer: I have 10 years experience and also know the local hospitals, clinics and providers in Washington State. I'm also here locally to answer your questions about your policy throughout the year.