Heather Johnson, Medicare Insurance Agent

Answer: Congratulations on getting married! Getting married, young, old; or not; has no impact on your Medicare. Part A is the amount that you paid in through your FICA taxes. Part B is based on your adjusted gross income the last two years. In other words, it is based on you and your working life.

Answer: Whomever you spoke with did not do their due diligence. There are certain plans that do require prior authorization but that was the case with your employer plan as well. The authorization requirements do vary plan to plan and when you made the switch, you should have been informed.

Answer: I can definitely understand the confusion! There are certain plans that do allow extra benefits, such as grocery spending, every month but not everyone qualifies, so they should not be making empty promises just to get in your door.

Answer: Folks regret choosing a Medicare Advantage plan over Original Medicare due to the network boundaries. Original Medicare is nationwide whereas Advantage is established by networks: both HMO and PPO.

Answer: Some of the biggest red flags that you should look for include:

1) Do they represent a specific carrier, like United Healthcare or Aetna or the like?

Those that represent only one carrier can not scrutinize benefits ensuring you get the best plan, year after year.

2) Do they attempt to sell you something the very first time they see you without a decent interview?

They do not have the necessary detail to your specific situation to fairly assess the best plan for you.

3) Are they pushy and overbearing or are they considerate and thoughtful?

If they come across pushy, they are only after one thing... the sale. If they are thoughtful they are considering the big picture for your entire retirement.

Answer: I find that the biggest mistake seniors make when enrolling in Medicare is that they do not seek out professional advice. There are a variety of impacts that retirement can have on quality of life, so seeking a licensed professional is the prudent thing to do.

Answer: Income very much influences the price that your Part B will cost. The higher your adjusted gross income from two years previous, the higher the cost of your Part B premium.

Answer: It is up to each facility as to whether they accept various Medicare plans. In Northwest Missouri, all of the major hospitals accept them.

Answer: Premiums are the costs per month to have the coverage; similar to the money that was taken out of your paycheck to pay for your coverage in your younger years.

Deductibles are the out-of-pocket expenses that must be met before coverage can begin.

Copays are the amount of money you pay when you visit a provider - be it a doctor, hospital, or pharmacy.

The copays do not count towards the deductible but the remainder of the bill will. Once the deductible is met, the policy pays the agreed upon percentage.

Answer: The best time of the year to start looking at Medicare options depends on a variety of factors: 1)your age - are you just now coming into the Medicare eligibility period.

2) If not, are you currently on Medicare Advantage or Original Medicare? Medicare Advantage has open enrollment periods so the best time to look at the available options are the two months leading up to October 15th so if changes are made, they can be made during Annual Election Period.

3) If you have recently switched from Original Medicare to Medicare Advantage in the state of Missouri, you have one full year to switch back so at any time during that first year we can examine the options.

Answer: The Part D plans are required to cover several drugs in each category of illness, diabetes etc. If a generic isn't available for a name-brand drug, Part D can still deny the coverage.

Answer: I sit with each client and ensure they receive all benefits that they are entitled to. For the ones that qualify for the extra benefits, the money gets loaded onto their medicare ID by the Centers for Medicaid and Medicare so that they can take them to the store and use them. Simply present your ID to the cashier and they will help you, much like a debit card!

Answer: Working with a Medicare agent removes the guesswork and ensures that you find the best plan at the best price. Knowing whether Original Medicare or Medicare Advantage is the correct path and if the plan you have discovered is the correct one takes an expert eye.