J Scott Burke, Medicare Insurance Agent
J Scott Burke
Senior Benefits of Evansville
Medicare Agent Licensed in IN, IL and KY
30+ Years of Experience
Contact Details
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Location
Evansville, IN
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Phone
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Website
About Me
I have been a broker/agent since 1996 and I mainly work with seniors on Medicare or soon to be on Medicare. I have co-owned Senior Benefits of Evansville since 2003 and we were co-branded with Deaconess Hospital for many years as the Deaconess Mature Health Center. Many local seniors still remember me as the featured speaker and MGA for all of Deaconess Hospital's monthly Medicare Educational Seminars at Deaconess Gateway and the Deaconess Main Campus from 2008 through 2016.
I am a lifelong resident of Southern Indiana and my wife Jo and I live in Newburgh, Indiana and are active members of the community.
We help Seniors shop and lower the cost of their Medicare Supplements any time of year. Call me any time that you get a rate increase from your insurance company. I offer my clients the ability to meet in person at my office or comparisons and enrollments by phone if they prefer.
Directions to My Office
Q&A with J Scott Burke
Why are hospitals not taking Medicare Advantage plans?
Answer: Some hospitals do take some Medicare advantage plans, but not all of them.
Medicare advantage plans work very differently from original Medicare. Advantage plans have networks which are either HMO networks or PPO networks and you cannot go to just any doctor. You have to make sure that your doctors and your hospitals are in network when you sign up on your plan.
The billing is much different for hospitals and doctors than if you we’re on original Medicare. They have to submit procedures for preapprovals and there is a strong chance that the claims will be declined or have to be submitted several times on advantage plans so some doctors just will not work with certain companies.
There are some advantages to being on an advantage plan, but the network is not one of them.
Can a Medicare Supplement insurer cancel my Medigap policy?
Answer: No Medicare supplement company cannot cancel a policy that is enforce for any reason other than failure to pay the premium.
They could however rescind a policy that is within the first 24 months if they can prove that you did a fraudulent application. A rescission would happen if you were proven to have Lead on your health underwriting questions when you applied for the application. Like if it ask if you had cancer within the past 24 months and you said no when it’s obvious and documented that you did and you knew about it. Or if you said that you were not a smoker and it’s easily approvable that you are a smoker.
Precisions are very rare with Medicare supplements, but they could happen. You always want to answer all health questions completely and honestly.
If an insurance company decided to completely get out of the Medicare supplement business, they would send all the policyholders a letter at least 30 days in advance, and that letter gives you guaranteed issue rights to choose any other Medicare supplement company in your state to continue your coverage with. Your rights are very well protected with Medicare supplement policies.
I'm confused about when I can change my Medicare plan. Can you clarify the different enrollment periods for me?
Answer: If you are already on Medicare and just want to do an annual review, which you should do every year, the period of October 15 through December 7 is the best time to do that if you are on a Medicare Advantage plan or want to start a new Medicare Advantage plan.
This (Oct 15th-December 7th) is also the time that you want to review your Medicare Part D drug plan for the next year.
If you are on Original Medicare and have a Medicare supplement plan (which is usually a Plan G or a Plan N or a Plan F), then you are not affected by any annual enrollment periods. You can change your plan any time of year. Also, it’s important to know that your plan will never end or change on you other than you will have rate increases. Rate increases can happen at any time of year.
If you are on a Medicare supplement plan, many states have a birthday rule which allows you to have special enrollment options if you want to stay on your exact same coverage plan but shop the price to get your rate back down. If you do this within 30 days of your birthday, you can lower your rate and do not have to answer health questions to qualify. Not every state offers this option, but many do.
How much will I have to pay out-of-pocket for therapy?
Answer: If you are on Original Medicare and have a Medicare Supplement such as a Plan G or Plan F, then you will not have to pay anything for any Medicare-approved therapies.
On certain plans, like Plan N, you could have a small co-pay per visit. It would be a maximum of $20 but would usually be less.
Without knowing what type of Medicare coverage you have, we can’t know exactly what your co-pays would be. And if you were on a Medicare alternative, such as a Medicare Advantage plan, you have to look at your schedule of benefits to know if you have co-pays on physical therapy. As each Advantage Plan is different, they are not uniform. Most Medicare Advantage plans would cover physical therapy with a very low or even a zero co-pay for a certain amount of sessions.
What happens if my dad’s income changes? Can his Medicare plan or costs change too?
Answer: Yes. Your Medicare Part B is definitely affected by his income. People who have a higher-than-average income (based on your taxes two years prior) you will pay a much higher rate for your Medicare Part B premiums.
People who have a very very low income will get assistance with their Medicare and can be exempted from paying their Medicare Part B premium at all.
Your father should always have a meeting with his agent if his income substantially changes in either direction.
Even without a change in income, he should be having a short meeting every year with his agent to review any rate increases, coverage changes, and changes in his situation.
What excites you about serving the Medicare population?
Answer: I enjoy helping seniors on Medicare because I have 30 years of experience with it and it’s very confusing to a lot of people. I’ve always been good at taking a complicated subject and making it easier to understand.
And now that I have aged into Medicare myself, I’m meeting a lot of my old friends that I hadn’t seen in years when they’re looking for a local agent.
Do husband and wife each pay their own Medicare premiums, or is there a family plan option?
Answer: Every Medicare supplement plan is an individual plan. That is to eliminate any problems if a couple would divorce or when one spouse would die and the other is still living, their plan continues on.
Many companies do have a premium discount when you are either married or sometimes when you just have another adult living in your household.
Each plan is always billed individually, but you can set up joint billing where they will draft as one bank payment on the same day each month.
Don't you think Medicare should ban all those celebrity Medicare Advantage commercials?
Answer: There should definitely be more truth than advertising with a lot of the television commercials.
But no, I don’t believe that celebrity endorsement should be banned. That would be an overstep. But making it clear that the celebrity is being paid for their endorsement would be a good idea.
And disclosing that Medicare Advantage is different from Original Medicare, and making that clear in the television commercials would be a great improvement.
Why did my Medicare deductible reset in January?
Answer: Medicare Part B deductibles are calendar year deductibles. So they reset every January 1. Once you meet the deductible for the year, it is covered for the remainder of the year.
That’s different than your Part A deductible, which is a per occurrence, and you will have deductibles to meet for different hospital visits throughout the year, which are normally covered for most people by their Medicare supplement plan.