Gabrielle Sones, Medicare Insurance Broker

Answer: Typically, with an HMO plan you must stay within your network unless it's a life-threatening emergency for coverage. If you are on an HMO without any out of network coverage you will pay out of pocket for those costs.

Answer: Hello, it's Gabrielle, your go-to insurance girl. One of the biggest questions I get is which is better: Medicare Advantage or Medicare Supplement? Honestly, it depends on you, your lifestyle, your health, and your budget. Let me break it down, starting with a Medicare Supplement.

A Medicare Supplement works in conjunction with your Original Medicare. Your Original Medicare is going to be your Part A and Part B. A lot of people like to choose this route because with Original Medicare, you don't need a referral for a specialist. There's not an HMO or PPO network to worry about. As long as you go to any facility or doctor that accepts Original Medicare, you're going to be okay. The only thing you would have to purchase separately is a prescription drug plan, or Part D, because that's not included with your Supplement, along with a separate dental and vision plan if that's something you need or want. The only downside to a Medicare Supplement option is that it could be a little bit more on the pricier end monthly.

Now, with a Medicare Advantage plan, also called Part C, you will have all your benefits bundled together through a carrier. So, your hospital, your medical, and usually your prescription drugs are all in one. Depending on the plan, some of these plans have extra benefits like dental, vision, gym memberships, and over-the-counter benefits. However, they do have a network that you need to stay within for certain providers and facilities, as well as service areas. One upside to these plans is that they can be a little bit less monthly.

So, which option do I recommend? I don't recommend just one. I recommend what's best for you. Some people love the flexibility of Original Medicare with a Supplement, and others just love the simplicity and extra benefits of a Medicare Advantage plan. That's why I'm here to help you compare side by side and choose what fits your life.

Answer: No, both options are good for the right person. Your broker should be performing a through Ough needs analysis to determine which route is best for you. A Medicare advantage plan is great but just make sure you also have some ancillary protection to protect you from your bigger copays and max out of pocket.

Answer: You will need to review with a broker beforehand because you may or may not need to make changes to your current plan.

Answer: Depending on your plan you should have a benefit for Skilled nursing facility and or home health care. I would speak to your carrier. I would also work with a broker to see what kind of additional protection you can add onto your coverage for these specific situations to help protect you more than what Medicare offers.

Answer: I would call your carrier first before treatment to just be prepared. If it's experimental or considered experimental, it may not be covered. I would speak to both your physicians billing office and your plan.

Answer: Most of the star ratings are a compilation of reviews received through the community. The higher the star rating the happier the members of the plan.

Answer: No, you can apply for Medicare once you're done working without penalty as long as you had credible coverage through your employer. I would still work with your current health plan and a broker to evaluate both options to see which is best for your needs and budget.

Answer: Pros of having an agent/broker near you would be that you can meet in person. Most will have a local office or a public space that you can privately meet. This way you can physically see the material and it might make more sense. If over the phone, you can ask for a virtual option this way they can screen share with you, and you can see the material that way.

Answer: I'm not sure. Medicare is very fluid and there has been a lot of changes in the last couple of years and changes that are upcoming for this year. My best advice is to work with a trusted broker this way you'll be able to stay ahead of the changes and your broker will help you make a plan when necessary.

Answer: Many different ways. You can look to build cash value, build cash value for children/grandchildren. It also is a way of financial end planning, like making sure there is enough funds to pay off mortgages, car loans, credit cards, etc when you pass and not leave that to a family member.

Answer: I would check with your Dr and contact member services with your plan. There could be a coding issue on the Dr's end or something on the carrier's end.

Answer: No, it's not mandatory, but it's still advised to go ahead and enroll when you are eligible. If you decide to enroll later on there could me penalties.

Answer: You may qualify for some of your spouse's benefits, but you may not receive both your retirement benefits and his/her benefits at the same time.

Answer: The best way to do this is by utilizing a broker. As a broker we have access to technology that allows us to enter medications and filter plans by cost, pharmacy, etc. I'd be happy to help!