Jack Mayer, Medicare Insurance 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

Answer: Medicare will not cover dental, vision and hearing. It is an ancillary benefit offered by insurance carriers who offer Medicare Advantage Plans. Medicare was only intended to help with Hospital and Medical care. My guess is that if these perks were added on to Medicare, a Federal Program it would drive cost through the roof.

Answer: Part A Hospital by itself is not enough to take care of the hospital bills. Medicare Hospital Part A has huge gaps and frankly with out a health plan, a supplement or medigap plan to cover the deductible and daily co-pays, by itself will add up quickly and it would not be advised to go with just Medicare Part A without a health plan to cover the gaps.

Answer: Check with SSA and see if you can qualify for some help through a low income subsidies program or LIS

Answer: I would not suggest going with out expert advise, a well qualified agent will be your guide, listen to your story, help you make sense of everything and then find the best outcome for your personal insurance needs. With a Medicare Advantage client, the agent will make sure your doctors and specialist are in network and that your medications are covered on that plan. It's not one size fits all, there are variable factors. When it comes to Medigap insurance there are different options and its best to go over all that with an expert. The goal is to get it done right the first time...one and done.