James Wareheim, Medicare Insurance Agent

Answer: Original Medicare does not have dental benefits for cleaning. Most Medicare Advantage plans do have dental benefits. They are basic so changing just for dental benefits may not be the best plan. You should sit down with your agent to discuss your options, such as a stand along dental plan to get the most in dental benefits.

Answer: Agents and brokers get paid directly by the insurance company. There is no billing by the agent. There is nothing an insured needs to do to pay the agent.

Answer: Yes it does. Many people will buy a Medicare Supplement or Medigap policy to fill those gaps. Medicare doesn't have a drug plan, you will need to find a drug plan that works for you. Another option is a Medicare Advantage plan, which can include your drug coverage. Some have deductibles and some plans do not. Medicare Advantage plans come in either PPO or HMO coverage. It's important to review all your options with an agent that you are comfortable with.

Answer: When moving it will depend on your current Medicare coverage. A and B won't make a difference. If you have a supplement it should be good with out having to make changes other than an address change, same with A and B. You will need to change your part D to your new address which could mean changing carriers.

If you have a Medicare Advantage plan you will need to contact your agent or local agent to update it to your new address. Moving can cause you to change plans and or carriers.

Bottom line is work with an agent to get set up correctly.

Answer: In most cases Part A there is not charge for, Part B does have a month premium. Depending on your income it can vary. If you are taking Social Security they can take the premium out of your check. If you are not they will bill you, in most cases for 3 months at a time.

Some Medicare Advantage plans have a Part B give back. You will want to talk to a licensed agent about that. Most people find it is better to work with an agent then by calling an 800 number.

Answer: If you have traditional Medicare there are deductibles, co-insurance and co-pays. That is why most people buy a Medicare Supplement to fill the gaps in their coverage. In addition prescriptions are not covered which is why you also need to look at a prescription drug plan.

Answer: Medicare Supplement plans are standardized and in most states your choices will be the same. I like the major carriers like Humana, United and Aetna. I usually will look for the best price for a client between these 3 companies. Prices will vary based on your area. Most of the time Humana is the lower cost. They all pay their claims almost exactly the same. When you talk to your agent they should be able to explain this in more detail. And don't forget your drug card.

Answer: Once you enroll in Medicare, you can no longer contribute to an HSA, but you can continue to use existing HSA funds for qualified medical expenses, including Medicare premiums. So the answer is yes.

Answer: Your agent should be able to help you with this. The agent can go online to the different insurance carriers and check to see if your prescriptions are covered and at what cost. You will also need to consider the cost of the Part D plan.

Answer: For most people, no. It has deductibles and out of pocket expenses that can go very high. A supplement takes care of most or all of the out of pocket expenses except prescriptions. Upon becoming eligible for Medicare if you don't have group coverage you should enroll in Part A, B, and D. You can also enroll in a Medicare Supplement or Advantage plan. Speak with a reputable agent to get more information for your specific circumstance.

Answer: Cost will vary by area, age and plan. You would need to speak with an agent who is licensed in your area to get prices.

Medigap or Supplemental plans designs are the same where ever you are. Coverages won't vary for standard supplemental plans. The value for them is filling the gaps in Medicare which can be expensive. It is important to enroll during your open enrollment window so you have guaranteed acceptance. The same for your Part D, prescription benefits.

Answer: There are not a lot of differences. Many agents use the term broker and agent as the same. Generally an agent usually works for an agency or a carrier and represents the plans they offer. Where as a broker represents more than one carrier and has their own agency. Sometimes agents will work for the broker.

Answer: Yes it is. It can get confusing after a while. Like buying a car, the more you shop the more confusing it can get. The most important thing is to find an agent you are comfortable with. If an agent is pushy and wants you to enroll right then and your not ready but they keep pushing I'd recommend not working with them. And remember an agent can not call you or knock on your door for Medicare Advantage or PDP without you reaching out first to the agent.

Answer: I wouldn't worry about Medicare, not really at this time. There's always going to be changes with it, but you should check with your agent. Yeah, usually once a year, right around the open enrollment, which starts October 15th. In case there are any changes, Medicare supplements don't change. The prices will change for you. But your Medicare Advantage plans and prescription drug plans, they do make changes on them every year. Some of them are very small, some not at all. And then some of them, you end up wanting to change plans. But if you have a good insurance agent and you stay in touch with them, you should talk to them a little bit before open enrollment or as open enrollment begins to see if there are any changes. But no, I wouldn't worry at this point. Just keep an eye on it and keep checking with your agent.

Answer: Each Advantage plan has different levels of dental coverage. Each one pays claims in different amounts and has different maximum benefits per year. Example $1,000. The plans are not designed to be totally comprehensive like a group health dental plan. You can purchase an individual dental plan to go along with the Advantage plan.

Answer: That is a hard question to answer not knowing what plan you have and where you are located. I would recommend you contact your agent to discuss with them. You can also contact the insurance carrier that your plan is with.

Answer: Yes you can, with a but. You would not have a prescription drug plan, do most prescriptions wouldn't be covered. There is also deductibles and other out of pocket expenses that you would have. Also by delaying Part D if you don't have credible drug coverage through a group plan and you enroll later there are penalties that make it more expensive.

Answer: You can enroll in Medicare 2 months prior to your birth month or 2 months after. Example - If your birthday is in February you can enroll in Part A and B December or January and you would be effective 2/1. If you enroll in February you would be effective 3/1. Once you enroll you have open enrollment for a Medicare Supplement or a Medicare Advantage plan.

Answer: It is too soon to know. Nothing has been released by the government. Keep in mind Medicare doesn't provide great benefits for long term nursing home care.

Answer: At 65 you should at least enroll in Part A, there should be no premium charge to you for that. If you are on a group health plan with doctors visit co-pays and prescription drug co-pays you don't have to enroll in B or D and you won't be penalized. There are exceptions at times. You should talk to a reputable agent to go over your details.

Answer: This kind of marketing is not allowed. Unless you contacted the agent first they are not allowed to contact you regarding Medicare Advantage plans. If you have their contact information you should report them to Medicare in your area.

Answer: As always, it depends. Do you have employer coverage now? How comfortable are you with the payroll deduction amount and the coverage. Turning 65 you can enroll in Medicare and either a supplement or an Advantage plan. You may save money and get very good coverage with Medicare. Or you may be better off staying on the group plan. The best thing is to talk with a reputable licensed agent and go over your specific situation.

Answer: There are some disadvantages with a PPO. One, you would need to stay in network for the lowest out of pocket cost for care. The second is the plans can change year to year. With a Medicare Supplement your coverage is locked in, although your rates could change. Also with a Medicare Supplement you would want to have a Prescription Drug Plan. That coverage and cost can change year to year.

The advantage of the PPO is it has a low to $0 premium and includes your prescription coverage. They usually have extra benefits such as Silver Sneakers.

It comes down to personal needs, and wants.

Answer: It depends. If you are on traditional Medicare with a Supplement as long as the insurance company for the supplement is licensed in the new state it won't have any affect. You will need to update your address. Now, with a PDP or Medicare Advantage plan you would have to look for plans in your area. It would be a special election period so the timeline would be based on when you move, not the annual open enrollment period.

Answer: Most of the time it goes very smoothly once we have looked at plans, doctors and prescriptions. It's important that the client has their Medicare card and information. If they don't it makes the process harder. Usually it's not someone turning 65 it is someone looking to switch Medicare Advantage plans. They haven't had to use their Medicare card so understandably they think their Advantage card has the information.

Answer: It's easy for your agent to look it up. They would just need the name, dosage and frequency and they can look it up under your plan or other plans you are considering.

Answer: It is hard to say unless we know more about your needs. Historically we have found that Humana offers very good options. But they may not be the right plan for you. More information would be needed.

Answer: Are you at least 65? If so and if you are leaving a group health plan you should enroll in Medicare A and B. From there you should meet with a licensed agent to look at Medicare Supplement plans or Medicare Advantage plans to see what is a good fit. If you just enroll in A and B you need to at least enroll in Part D, drug coverage so you don't get a penalty. Hope this helps.

Answer: I have several clients move from one state to another. With a Medicare Advantage plan we have to find the plans that are available in their new home area and help them pick a plan. In some cases we need to get a non-resident insurance license for that state in order to be able to help them.

Answer: It depends on your situation. If you are turning 65 many times the premium for the Medicare Supplement is less then the under 65 you are paying for. To be able to decide on what is best for you working with an agent can help. Since there are a number of plans and options a good agent can take the confusion out of it.

Answer: Not normally. If you are working with a local licensed agent and not calling 800 numbers you should feel comfortable.

Answer: Their are two types of Medicare Advantage plans in general. HMO and PPO. Some doctors don't like the HMO since they are somewhat restrictive. But their are doctor groups the specialize in the HMO plans. The PPO plans are less restrictive, more doctors like these plans although the best benefits are if you stay in network.

Answer: It would depend on a number of factors. You should check with your accountant. They will be able to guide you on it.

Answer: There is not a set answer. We would need to talk about the needs of the client. Look at their budget and other factors to help them decide what is best for them.

Answer: Try to avoid calling 800 numbers you see advertised on TV, mailers and print. Find a trusted agent. Usually one of your friends knows someone they work with. Make sure you get copies of the plan details. Have them check your doctors and prescriptions to make sure you don't have any surprises.

If it sounds too good it just may be. Check the details.

Answer: I haven't seen anyone losing Medicare Advantage plans in Florida with the carriers we work with. The plans change on an annual basis and some plans may be dropped but other plans are offered. The benefits can also change.

Traditional Medicare is consistent and doesn't change. Rates for supplements can increase. For someone looking for consistent coverage without having to stay in a network that is a good way to go if it works for your budget.

Answer: I haven't had that experience. But if a person can budget for it, staying in Medicare and buying a Supplement with a separate drug card gives you less potential out of pocket expenses. Although you don't get all the extra's of a Medicare Advantage plan. I do prefer the PPO plans over HMO plans in most cases.

Answer: Some plans are and some plans are not. Some have premiums and some don't. It's important to sit with your advisor and go over the options so you can decide what works best for you. Every year the plans can change somewhat, it is good to review them at open enrollment.

Answer: It depends. Were you in your initial open enrollment. In other words did you just turn 65? If so yes.

Answer: If they are asking for your social security number and or Medicare number. They will also press you to make a decision so you will give them all your information including bank info.

Answer: I find that I'm able to sit down with people and either help them get started with Medicare when they are turning 65 or at the annual open enrollment period to review their current plan and plan options.

Having an office for folks to visit while we talk seems to put them at ease knowing we are an established agency and not just an agent trying to get their business. Having been working in the insurance industry for over 20 years I am more interested in helping them and not what my commission will be.