George Francis, Medicare Insurance Agent

Answer: 1. What will Medicare do for me?

2. How do I determine which plan is best; Medicare Advantage or Medigap?

Answer: If you were receiving Social Security benefits at least four months before you turn 65, you'll be enrolled in Medicare Parts A and B automatically.

If your automatically enrolled, you'll receive a welcome to Medicare kit before turning 65. It will explain how to decline enrollment if you still working and covered by your employers health plan and do not want to start your Medicare journey upon turning 65.

If you are not receiving Social Security benefits you need to sign up during your Initial Enrollment Period (IEP). This is a 7-month window that begins 3-months before your birth month, the month of your birth and 3 months after your birth month.

Be sure to review how Original Medicare (run by the federal government), Medicare Advantage (run by private insurance companies) and Medicare Supplement (Medigap) works and which best meets your healthcare coverage needs.

George

Answer: The biggest difference between a Medicare Broker and a Medicare Agent is that a broker works for the person looking for Medicare coverage and an agent represents one or more insurance companies.

Brokers and Agents compare Medicare plans to determine which plan best suits and individuals needs, based on price, prescription drug coverage ete.

George

Medicare Advantage Advisor

Answer: Original Medicare with a Part D plan offers flexibility and nationwide access to all doctors and hospitals which accept Medicare.

Some Part D (Stand-along Prescription Drug plan) but not all offer the same flexibility and nationwide access.

George

Medicare Advantage Advisor

Answer: It depends! Medicare enrollment is not mandatory.

Reason - still working and covered by an employer's qualified group health plan with 20 or more employees.

Answer: Overall, yes! The Inflation Reduction Act of 2022 triggered a number of changes to Medicare Part D plans.

Medicare now has the ability to negotiate drug prices directly with manufactures and has capped the dost of certain medications.

Medicare Beneficiaries out of pocket costs are now limited to $2,000 per calendar year.

The dredged donut hole and catastrophic prescription drug coverage stages are eliminated.

George

Medicare Advantage Advisor

Answer: Depends of the needs of the individual!

Medicare Advantage (Part C) is an alternative way of receiving Medicare coverage that combines Original Medicare and Medicare Part D (prescription drug coverage) into a single plan. Medicare Advantage plans are sometimes attractive to beneficiaries because of there extra benefits and lower costs.

Medicare Part D (Stand along prescription plan) typically have separate costs and are combined with Original Medicare.

There isn't a right or best plan, it all comes down to the needs of the individual.

George

Medicare Advantage Advisor

Answer: There are various programs available to cover some but not all premium costs.

Programs resources available to help are:

1. Medicare Saving Programs (MSP), help cover costs associated with Medicare Part A and B. You qualify based on income and/or resources.

2. Low-Income Subsidy or Extra Help (Part D) program, helps cover Part D premiums, deductibles, coinsurance and copays.

3. Medicaid - a government program covering health care costs for individuals with low income, certain children, pregnant people and people with disabilities.

George

Medicare Advantage Advisor

Answer: No, Medicare Part A does not cover outpatient surgery. Part A does cover surgery performed during an overnight hospital stay. Medicare Part B does cover minor outpatient surgery.

Answer: Best time to start looking at Medicare options are:

1. During Annual Enrollment Period

2. A minimum of 3 months prior to turning age 65

3. Prior to moving from one state to another

4. Prior to any expected changes in Medicare/Medicaid status

Answer: Medicare (Parts A, B and C) does cover colonoscopy cost related to inpatient care and outpatient care. Additionally, Medigap also provides some measure of cost coverage.

Answer: A signed Scope of Appointment (SOA) is required by the Center for Medicare & Medicaid Services a minimum of 48 hours prior to any agent discussion about Medicare Options. The SOA assist the agent in narrowing the focus of the conversation about Medicare.

NO, call centers are not exempt from getting a SOA, but there are specific exceptions which can negate this requirement.

Answer: Medigap Plan F does not have an emergency room visit copay for covered services rendered during the ER visit.

Answer: Medicare Supplement plans and Medicare Secondary Insurance does have a number of overlapping benefits (copays, coinsurance and some deductibles).

A Medicare Secondary Insurance plan also covers additional benefits (vision and dental) not covered by Medigap.

Answer: The most complex Medicare issue I've had to assist a client with was getting their Part B reinstated after termination. On its face, it appeared to be an easy task. However, unpacking the reasons for termination, insuring client's eligibility for reinstatement and determining the appropriate Special Election Period (SEP) were not so simple. But through patience and persistence the client objectives of the client were met.

Answer: No, there are no overlapping points provided by the coverage of each. Medicare covers health benefit coverage, while Life Insurance can be used to cover outstanding bills, pay off mortgages, provide an income for beneficiaries and so on.

Answer: 1. Indicate a desire for their best interest.

2. Be professional when explaining benefits.

3. Be patient but firm while helping to calm fears of the unknown.