Jack Mayer, Medicare Insurance Agent
Jack Mayer
Bill Proctor & Associates
Medicare Agent Licensed in CA
Contact Details
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Location
Palm Springs, CA
About Me
Hi! My name is Jack, to those who are Medicare Eligible, that may be looking to make a change or perhaps you are coming on to Medicare for the very first time and you need someone who can assist you, I can help! I'm committed to finding the most suitable health plan that aligns with your unique health care needs. Our insurance agency in Palm Springs is the oldest health insurance agency in this area and we are a group of insurance professionals that work together by providing excellent service and follow-up service to our clients. I also specialize in final expense plans to those who have yet to take care of the potential expenses associated with end-of-life arrangements.
Q&A with Jack Mayer
What do you like most about being a Medicare agent?
Answer: Simply put, since 1984 I've been actively helping Medicare enrollees who need someone to guide them through the Medicare landscape and their health care choices. I love what I do because I add value to the lives of those I work with. I am blessed to be able meet so many nice people throughout my professional career.
Are Medicare Advantage plans really "free," or is that just clever marketing?
Answer: Most Medicare Advantage Plans have no monthly premiums however there are deductibles, co-pays and co-insurance so it is important to understand that with Medicare Advantage Plans there will be some out of pocket or share of cost. Medicare Advantage Plans are Network plans so if the policyholder stays in Network their is minimal out of pocket.
Why are hospitals not taking Medicare Advantage plans?
Answer: Each year the insurance carriers that offer Medicare Advantage Plans re-negotiate contracts with providers and hospitals under CMS rulings and if the deadline is not met for one reason or another, it is possible to lose those providers and hospitals. I have some information and can expand on that if interested. The main thing is to go with a flagship carrier that has huge networks such as United Healthcare for example. Just a note of confidence, 9 our of 10 people stay with UHC once they enroll.
I just moved from New York to Florida and have Original Medicare with a New York Medigap plan. Do I need to change my coverage?
Answer: No need to change because Med Supps or Medigap plans are not network based plans like Medicare Advantage Plans are and therefore you go to any provider or hospital anywhere that accepts Medicare.
How does Medicare handle coverage for experimental treatments or clinical trials?
Answer: If Medicare covers it and these clinical trials are available in your area network then it's covered by your health plan, your chances of getting that covered are greater when you have the flexibility that a Medigap plan offers.
Why might Original Medicare with a Part D plan be better than a Medicare Advantage plan for frequent travelers?
Answer: Original Medicare can be used in all 50 states, as well as in the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the Virgin Islands. The same isn’t true for Medicare Advantage plans. These plans have defined service areas and may not cover out-of-state care, with the exception of emergency and urgent care situations.
My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?
Answer: For 2025 you will have an annual deductible of $590.00 then your maximum out of pocket will be $2000 but in most cases its much less because you are credited at times beyond the cost of the prescription.
How can I save money on my Medicare Supplement?
Answer: Talk to me in person to go over the landscape because you have choices to keep cost down by choosing the right Medigap plan that fits your lifestyle, budget and needs.
What's a common trick in Medicare marketing that hides restrictions on doctor choices?
Answer: I think for the most part it really comes down to the carrier, the available plans in your area that have the largest network of providers and going with a flagship carrier like United Healthcare for example. Also, Medicare Advantage PPO plans can offer less restrictions because there is no referral needed by your Primary Care Physician but the PPO plans are still network based and you will have more out of pocket! On the flip side a Medigap plan has no network and you are free to see any doctor, provider anywhere that accepts Medicare.
I picked a Medicare Advantage plan because of the dental and now I found out it only covers cleanings. Why didn't anyone tell me this upfront?
Answer: Depends on the plan you choose but for the most part most carriers will offer a maximum annual benefit of $1500 on all procedures however depending on the procedure, you will still have out of pocket expenses. With a Medicare Advantage plan you can pick up a second stand alone Dental plan to cover the lion share but these plans are very limited on what they will allow for implants. Some of my friends go to Mexico and pay much less without insurance.
I'm turning 65 in three months but still working with employer coverage. Do I need to sign up for Medicare right now or can I wait?
Answer: You can wait with no penalty until you decide to go off the group. You will have Part A hospital but you get the Part B once you decide to go off the group plan and apply for Part B with Social Security or the Dept of SSI You have 8 months to make the transition before you are penalized
My Medicare Advantage plan listed my doctor, but now they say he's out of network. How is that even allowed?
Answer: The in Network providers and hospitals renegotiate contracts with carriers overseen by CMS Centers of Medicare & Medicaid Services each year and sometimes deadlines and negotiations are not met especially in some of the small rural areas where the networks are small. You will need to contact your carrier and request a new primary care physician. Also, you can check other carriers to see if your doctor is in their networks and switch during the Annual enrollment period October 15 - December 7th.