James ONeal, Medicare Insurance Broker
James ONeal
O'Neal Insurance Group
Medicare Broker Licensed in IL, AL, AR, AZ, CA, DC, FL, GA, IN, KS, KY, LA, MI, MN, MO, MS, MT, NC, NM, NV, NY, OH, OR, PA, SC, TN, TX, UT, VA, WA and WI
26+ Years of Experience
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Chicago, IL
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About Me
For over the last 35 years, The O'Neal Insurance Group has helped thousands find the lowest rates and the best Medicare Advantage and Medicare Supplemental plans to protect themselves and their families by providing free guidance and education on how to compare plans and enroll in Health Insurance Coverage that meets or exceeds their needs.
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My Google Reviews
17 Total Reviews (5.0)
February 15, 2025
Great company with the best rates!
September 9, 2024
Just finished a call with an agent in Gulfport, MS, and I’m thoroughly impressed. They walked me through all the Medicare Advantage plans and helped me choose a PPO plan from Anthem that suits my needs. The entire process was quick and stress-free!
September 6, 2024
I was a bit overwhelmed with Medicare options, but the agent in Ocean Springs, MS, made it all so easy to understand. They got me on a great plan with Wellcare, and I’m very satisfied with the coverage.
September 4, 2024
The process of finding the right plan was so easy thanks to O'Neal Insurance Group. The agent in Slidell, LA, was professional and made everything clear. I’m so glad I chose them to help me.
September 4, 2024
My experience with O'Neal Insurance Group was excellent! The agent in Moline, IL, was incredibly helpful in walking me through all my Medicare options. I felt confident in my decision thanks to them.
Q&A with James ONeal
What do you like most about being a Medicare agent?
Answer: Being a Medicare agent is incredibly rewarding, primarily because it allows me to help Medicare beneficiaries/seniors navigate their healthcare options, ensuring they receive the best care.
One of my most memorable moments was when I assisted a client overwhelmed by their Medicare plan's complexities.
After patiently guiding them through their choices, they expressed immense gratitude for the clarity and support I provided.
Knowing that I can make a significant difference in someone’s life—especially for those who may feel lost in the system—is what I love most about this role.
It’s not just about selling insurance; it’s about empowering Medicare beneficiaries to make informed decisions that enhance their quality of life.
I signed up for a Medicare Advantage HMO, and I'm wondering if I can see a cardiologist out of network without paying everything myself.
Answer: Generally, Medicare Advantage HMO plans require you to see doctors and other healthcare providers within their network to receive covered services, except for emergencies and urgent care situations.
If you see a cardiologist who is not in your HMO's network, you may have to pay the full cost of the visit yourself.
I'm turning 65 next month and the amount of Medicare mail I'm getting is overwhelming. How do I sort through all this?
Answer: It's completely normal to feel overwhelmed by the amount of mail you receive as you approach Medicare eligibility. Insurance companies are eager to reach potential customers, and the volume of mail can be significant.
Understand the Different Types of Medicare Mail:
Official Medicare Information (from CMS): This is the most crucial mail to pay attention to.
It includes things like your Medicare card, the "Medicare & You" handbook, and important notices about enrollment periods, benefits, and costs.
Marketing from Medicare Advantage and Part D Plans: These are plans offered by private insurance companies that work with Medicare.
You'll likely receive a lot of promotional material from these companies trying to convince you to enroll in their plans.
Mail from Third-Party Brokers: These companies or agents represent multiple insurance plans and may send you information or solicitations.
I thought I signed up for both Part A and B when I got my Social Security, but now I'm getting bills for Part B. Did I miss something during the enrollment period?
Answer: Here's why:
Automatic Enrollment:
If you were already receiving Social Security benefits at least 4 months before turning 65, you would have been automatically enrolled in premium-free Part A and Part B. However, those in Puerto Rico are only automatically enrolled in Part A.
Part B is Not Always Automatic:
Even if you were automatically enrolled in Part A, you may have needed to actively enroll in Part B separately, or you may have chosen to decline Part B coverage initially.
Late Enrollment Penalty:
If you didn't enroll in Part B when you were first eligible and are now enrolling, you might be subject to a late enrollment penalty. This penalty is an increase to your monthly premium for as long as you have Part B.
How do you educate clients who are completely new to Medicare?
Answer: To effectively educate clients new to Medicare, it's crucial to simplify the complex system, explain the different parts of Medicare, and guide them through the enrollment process.
Focus on using clear, jargon-free language, providing personalized information based on their needs, and offering resources for continued learning.
What happens to my Medicare coverage if I move to a U.S. territory like Guam or the Virgin Islands?
Answer: If you have Original Medicare (Parts A & B), your coverage extends to U.S. territories like Guam and the U.S. Virgin Islands.
This means you can receive care from any provider or facility that accepts Medicare in those territories.
I'm considering genetic testing to assess my cancer risk based on family history. Will Medicare cover this preventive approach in my situation?
Answer: Generally, Medicare does not cover genetic testing as a routine screening test to assess your risk of developing cancer based solely on family history if you do not have symptoms or a personal history of the specific cancer being tested for.
However, there are specific situations where Medicare may cover genetic testing for hereditary cancer syndromes, including:
You have a personal history of a specific cancer:
Medicare may cover genetic testing if you've already been diagnosed with certain cancers, such as breast or ovarian cancer, and meet specific criteria related to age of diagnosis, family history, or tumor characteristics.
Does IRMAA go away automatically if my income drops, or do I need to report it to Social Security?
Answer: No, IRMAA (Income-Related Monthly Adjustment Amount) for Medicare Part B and Part D does not automatically go away if your income drops.
You need to notify the Social Security Administration (SSA) about the change in your income to have your IRMAA adjusted.
The SSA uses income information from two years prior to determine your IRMAA, so a recent income reduction needs to be reported to them.
Are mental health services like therapy fully covered under Original Medicare?
Answer: Original Medicare (Part A and Part B) does cover mental health services, including therapy, but not always fully.
While Medicare Part B covers outpatient mental health services, including psychotherapy, it generally requires deductibles and coinsurance, meaning beneficiaries pay a portion of the cost.
Additionally, while Part A covers inpatient mental health care, it is subject to benefit periods and may have deductibles and coinsurance costs.
Do your clients use Medicare Advantage over-the-counter drug cards? How does that work?
Answer: Yes, many Medicare Advantage plans include over-the-counter (OTC) drug cards as a benefit.
These cards, often resembling prepaid debit cards, allow members to purchase a variety of eligible health-related items at participating retailers.
The specific items covered and the amount available on the card vary by plan.
Here's how it generally works:
Enrollment:
You must be enrolled in a Medicare Advantage plan that offers an OTC benefit.
Card Issuance:
The plan will send you a card, often a prepaid debit card, specifically for OTC purchases.
Benefit Amount:
Each plan has a specific amount allocated for OTC purchases, which may be a monthly or quarterly allowance.
Eligible Items:
The card can be used to purchase a range of OTC medications, personal care products, first aid supplies, and other health-related items at participating retailers.
Purchasing:
You present the card at the point of sale, and the eligible items are deducted from your allowance.