James Carlson, Medicare Insurance Broker

Answer: Medicare companies expect to be paid within 30-60 days. If difficult to meet timely payment call and request your payment be submitted late. If really difficult you may requst your plan be changed to a less expensive plan. Even supplemdnts could be less expensive.

Answer: it should not be necessary, since your disability income is the same benefit available to a 65 and a younger Medicare client based on SS income benefits.

Answer: Dental inplants are a expensive benefit that are covered potentially if needed due to a medical necessity. This would occur if a accidental incident caused serious damage to a beneficiaries mouth. This benefit would occur with both Med Supp and a Advantage plan.

Answer: Supplements and nutrition are not covered with a Supplement plan. Over the counter products may be covered by Advantage benefits.

Answer: Yes. One type of plan, a Medicare Supplement does not require a referral. Most Advantage plans require referrals.

Answer: A more difficult question. it would depend on the plan, the doctor, the theapy and if the diagnosis is benefited by coverage. If covered by a Medicare Supplement the coveerage would be better clarified. Advantage Plans could have less benefits.

Answer: Depending on what type of insurance you had, and how long you have been covered by the plan will help verify if you would be subject to a penalty.

Answer: Only if you are healthy all of your life. If medical issues occur, expenses will max out year and year again at very high cost compared to a Medicare Supplement plan.

Answer: If you owned a supplement this would not be an issue. With a closed network you will have to

find a new doctor, or follow your current MD to be treated out of network. I you wait until the next year, you can change plans with the old doctor in the new network.

Answer: Medicare part A is guaranteed to all Americans if we have 40 quarters of income with taxes paid.

At 65 we will receive a Part A Medicare card confirming eligibility for Part A without any future cost. You can continue to work and be covered by your spouses plan until you give up or loose that coverage. Then, within 63 days your must apply for Medicare part B and purchase a drug plan and a Medicare insurance plan. Advantage or Supplement are your two choices.

Answer: You are asking a important question. Original Medicare is regular Medicare. There are deductibles, multiple co-pays, some type of expense for all medical services. The best part of original medicare is you know that you control the care and if you can afford the costs of extended expenses you may get by until your older. Then you will want some type of medicare insurance. But at age 65 you legally must have a drug plan. If you pass at 65 you may have significant drug cost at older ages. Good Luck.

Answer: Medicare part A does cover hospital expenses. However to be able to apply for a Medicare Insurance plan both part A and part B are required. If you do not apply for an Advantage or a Supplement plan you are eligible to be insured with Original Medicare with all the deductibles and out of pocket fees.

Answer: The supplement is peace of mind. Here is why. The Plan has no network, go to any doctor who accepts Medicare. One premium that pays for all medical services, no copays option to take plan N which has 20.00 copays, but less expensive. A issue is the need for a separate drug plan. More expense.

Answer: Having medicare and paying premiums are the key to lasting better health. If one cannot pay them help from family members is totally acceptable.

Answer: Medicare is a plan that provides seniors after 65 with medical options to both treat ailments and to provide relief of issues caused by years of prevention. Aging is the issue. It is more likely that seniors will have medical treatment due to disease and lack of preventive treatment earlier in life. Medicare assures that treatment can lead to prevention by allowing beneficiaries to reach out to clinics to receive treatment and help provide a better, healthier life style.

Answer: This is a good question. Most younger beneficiaries would not be concerned. As we all age, the risk of excessive costs and payments grows. What is my risk of some continued OOP fees.

Answer: This law was designed to control costs and minimize the annual cost to drugs to a maximum out of pocket of 2,000. In 2026 the annual out of pocket for drugs will be more. With BC/BS the max payment is $2,100.

Answer: The annual exam is a free service for Advantage and also for a supplement plan.

Other office services with or without a doctor will have copays with Advantage. All medical services are covered and paid with a supplement.

Answer: Five star is the highest value. The rating comes from Medicare. The higher the value, the better the service and the company's ability to pay claims in the future.

Answer: Make the monthly premium payment and the policy will not be any different.

The policy is not effected by your financial issues, as long as premiums are paid.

Answer: If the surgery is after the effective date, the policy will pay the total cost of the operation.

You have to schedule the surgery after the effective date.

Answer: You will continue to need your Medicare policy and will have to pay the premium. If you own a

Advantage plan, the premium can be deducted from Social Security. If you have a Medicare Supplement plan, you will have to continue to pay out of pocket. One idea would be to set aside a fixed amount of money invested for income, and use the income and principal if needed to keep the policy in force.

Answer: Medicare plans are vital to the health and welfare of senior Americans. The large cost of implementing and managing services make it very difficult for a private company with limited assets to be able to continue paying the ever increasing benefits of Medicare plans. It will not be privatized.

Answer: I agree, Medicare Advantage plans are applied for when agents do not inform prospects about the Medicare Supplement plans. Also TV ads and insurance companies promotion of Advantage plans help beneficiaries to believe the only option is an Advantage plan.

Answer: The annual out of pocket limit for all drug purchases is $2,000. The donut hole is not a factor.

The annual deductible applies toward the oop max.

Answer: Emergency care in a hospital will normally be covered. There is no major hospital coverage with Medicare. Therefore it is advisable to purchase a policy for traveling outside of the USA.

Answer: Yes! There are penalties for not enrolling at age 65 in both medical and the drug plans.

Thes can be life time penalties that raise your cost of care.

Answer: I am more in favor of original Medicare. I know every doctor will see me and I can travel or move and maintain my plan. I am not tired to a network.

Answer: Health care is and will be expensive. Be prepared and purchase the best plan that is affordable and makes having care and treatment easy.

Answer: With Advantage plans an individual can have premiums paid from their monthly check.

This is more convenient and assures there will not be a lapse.

Answer: This may be due to not earning 40 quarters. You may be a high earner and are paying an excess premium due to higher income.

Answer: First is the network. Second is the risk of having to pay the max oop annually due to a serious medical condition. 3rd, the plan is controlled by the insurance plan, not medicare.

Due to network limitations, proper care may not be available. Many more disadvantages that a supplement plan would cover.

Answer: There are many reasons to start medicare even when continuing to work. Les cost, more benefits, less costly drugs.

Answer: Medicare should allow agents not have to review and test annually. We should have reviews less often. Renew every 3-5 years.

Answer: Making a decision without real good understanding of their options. If they choose a Advantage plan, they may not ever be able to apply for a Medicare Supplement Plan.

Answer: The deductible is included in the 2K max. More important, when expensive and hard to get meds are prescribed, the more costly plan is likely to pay.

Answer: All beneficiaries know they will not have to pay more. Willing to save the larger cost of the past. There is also a option to pay over a 12 month period at a average cost..

Answer: Deal with a qualified and verified agent like Medicare Hub agents. Remind clients that at age 65 many companies will be trying to earn their business. Be careful.

Answer: They love knowing the oop cost can be met if the cost exceeds $2,000. this also gives them good reason to be sure the drug plan is the best for them.

Answer: We can call the carrier or the hearing aid company. This will give the client confidence in me.

it is also an opportunity to help the client understand that the benefit is really a small amount of the total cost.

Answer: They answer a outside call and get caught by an agent selling plans that will not work in the state of residence.

Answer: This is a challenge. I love the sales process and knowing my knowledge will help to protect the client by making them feel the understand the choices well enough to be willing to pay the monthly premimum.

Answer: If not sure you have the best plan, I would verify the current plan vs some new options. I would explain that some plans may not have wide network, while other plan may better cover your needs. Should you keep it is your decision.

Answer: You are welcome to call for better clarification. I can send information about both drug and medical coverage.

Answer: I explain that all the info received is confusing. I will clearly explain your options and be sure you understand the difference between Advantage and Medicare Supplement plants.

Answer: Contact Medicare and enroll in parts B so you can receive a new Medicare card.

Once you have your card we can discuss options that will meet your needs. Thank you for contacting me.