George Ibanez, Medicare Insurance Broker

Answer: Your doctor probably coded the test as a Physical instead of coding it as a wellness check and that is why you got a bill from the doctor.

The AWV is a yearly check-in with your primary care provider to create or update a personalized prevention plan, while a physical exam is a more comprehensive evaluation that includes a hands-on examination and may involve diagnostic tests

Answer: The only way to verify the benefits is to call an independent broker and never call a TV commercial since they are all call centers and they are not going to offer you the plan that is best for you since most of them only sell one plan and the call center agents are generally very poorly trained.

Best place to call is Medigap Agency Group with all season agents that represent multiple companies 888-801-9097

Answer: The reason that they can afford it is because although you will have a $0 monthly premium payment is because Medicare reimburses the insurance companies for your treatment, however, keep in mind that all Medicare Advantage plans have copays for many of the services that you will receive and you will be personally responsible for the copays which in some cases may be very large.

Answer: Medicare A and B are great, however, they have large deductibles, and you would be responsible for 20% of the bill with no cap which will potentially bankrupt you if you have a major medical expense.

I have seen medical bills over 500K and you definitely do not want to be responsible for 20% of a large bill, so my recommendation would be to get a Medicare supplement to take care of the 20% that Medicare will not cover for you.

Answer: Maximum out of pocket expense is a term used for Medicare Advantage plans as it relates to your share of responsibility for the services provided, and once you reach the maximum out of pocket expense the plan pays 100% of covered medical services.

Your premium and prescription drug costs don't count towards the MOOP.

Answer: Yes, you can change your Medigap plan at any time during the year, and go with whoever you like. There are no special election periods, you just simply need to qualify from an underwriting stand point and you can go to any insurance carrier that you like.

Answer: Medicare planning is a very complex subject that should be discussed with a professional broker that has access to Medicare supplement plans as well as Medicare advantage plans since everyone's needs are very different.

I would advise that you select an independent broker rather than going to an insurance company direct since the insurance company will not give you multiple options with other companies other than themselves and they may not have the plan that suits you best.

Always check with a broker!

Answer: This is a very specific question, which you should consult with your agent since there are so many plans and your agent should be able to look at the Evidence of coverage from your plan in order to give you an accurate answer.

Answer: Medicare covers medically necessary blood tests which include diagnostic tests ordered by a doctor to help diagnose illnesses, as well as preventive screenings, however routine or annual blood work may not be covered.

Answer: You need a traditional Medicare supplement with Medicare being your primary and your supplement being your secondary coverage.

Call me if you have additional questions or if you need a supplement to 888-801-9097

George

Answer: Going directly to a carrier is a big mistake since carriers can only offer you their own products and you would be limiting yourself to only one quote, many rate increases over time, and no solution to lower your rate when you have a rate increase.

Also the rates will be the same as going through a broker , but you will not get any of the personalized service and you will not be able to have someone dedicated to you that understands what you need.

Answer: Networks, limited doctors and pre-approvals seem to be the biggest issues with Medicare Advantage plans.

Answer: Medicare has gone up very little over the last 10 years, however Medicare supplements have been going up in price at a rapid pace and it seems like insurance companies are losing money due to unsustainable claims from Covid and unfortunately I don't see the prices coming down.

Answer: In my opinion Plan N is the best overall option for Medicare supplement plans and although you have a $20 copay for doctor visits, it offers overall the best value compared to plan G or plan N unless you are going to the doctor multiple times per month.

Answer: The answer is not so simple, but basically if your employer is providing and you are enrolled on your employers plan, it will depend on 2 things.

1-Are you happy with your employers plan?

2-Is your employers plan good?

3-Is your employers plan expensive?

If you are happy with your employers plan, and you don't want to leave the plan till you stop working, then you do not have to do anything, however, in most cases Medicare with a supplement offers much better coverage and cheaper than most employer plans and it has lower deductibles and lower copays and in some cases no copays at all.

Answer: It will help you relief the sting of having to pay for expensive medicines all at once and it will help you breakdown the expense into monthly payments rather than paying all upfront.

Answer: The new $2000 MOP expense limits your exposure and the maximum amount that you will pay for your drugs for the year.

Answer: If you go in an advantage plan and you get sick , you may not be able to go into a Medicare supplement at a later time and you may be stuck with an advantage plan that you may not like.

Answer: Backdating is not allowed, and you would have to speak to Medicare if you missed the enrollment and enroll in the next enrollment date available or apply for a special enrollment period.

Answer: Medicare supplements are not regionalized when it comes to benefits, and the benefits are the s same no matter where you go in the USA, but Advantage plans differ from region to region.

Answer: You will need to call your insurance company and find out what specific benefits they offer for durable medical equipment since they are all different.

Answer: Medicare supplements include international coverage, however, it is limited and I would recommend to purchase travel insurance to be on the safe side.

Answer: If you move to a new state and you have a Medicare supplement plan, you must notify your agent so that they can adjust your rates to the proper rates to the state that you moved to, however if you have a Medicare Advantage plan you will have to call your agent to enroll you in a new plan for the state that you move to since Medicare Advantage plan are different in every state and every county.

Answer: Medicare covers very limited amount of home health care, and this could include some help for limited periods of time after hospitalizations, but it is not a permanent solution.

Answer: You will automatically get Medicare , but you need to make sure that you get Medicare A and Medicare B activated.

Answer: Medicare advantage plans are very restrictive when it comes to the doctors that you can use as well as the hospitals that you can use and pre-approvals for procedures and I do not think that they will ever replace traditional Medicare with a Medicare supplement or Medigap plan since Medicare supplement plans are far superior in every way.

Answer: Scope of appointments are required by Medicare in order to discuss Medicare plans and this is a normal procedure and nobody is exempt from doing this form.

Call centers are required to do the same as anyone else.

Answer: Technology works well however there are so many factors that technology will not address that there is no replacement for an experienced agent.

There is no substitute for a well trained, and experienced Medicare insurance advisor.

Answer: Picking the wrong plan could be a long term bad decision, so going into Medicare knowing the difference in the plans could be a game changer for some people.

Answer: I like to help people that go into Medicare without knowing their option and help them navigate through the complexities of Medicare.

Answer: It all depends on what type of plans that you have and what type of plan your friend has, since not all plans offer Silver sneakers.

I will be glad to look into it if I know a little more about the plan that you have, and I can even suggest which plans will pay for Silver sneakers for you.

Please call me at 479-485-3989