Jay Larshus, Medicare Insurance Agent

Answer: The biggest mistake seniors make is not knowing all of their options that go with Medicare. Understanding the differences in Part A, Part B, and the additional Part C and Part D.

Answer: I explain the differences between Medicare Supplements (Medigap) plans and the Medicare Advantage Plans (Part). We will also discuss the options with Medicare Part D. In addition, we will discuss he time frames involved with signing up for Medicare and the additional benefits.

Answer: I sell both Medicare Supplements to pair with Original Medicare and Medicare Advantage plans. The decision to choose one over the other is dependent on a number of items. I will discuss both the advantages and disadvantages of each type of plan.

Answer: If you already drawing Social Security prior to turning 65, Social Security/Medicare will automatically enroll and mail your Medicare card with both Part A and Part B approximately 3 months prior to the month you turn 65.

Answer: Clients who are new to Medicare need to be educated on the differences between Medicare Supplements and Medicare Advantage plans. They also need to understand the enrollment periods and the guaranteed issues guidelines.

Answer: Medicare Plan C plan benefits vary between plans and Companies. Some Plan C policies do cover blood work at 100% whether the lab work is part of preventive exam or not. All plans will cover the Bloodwork at 100% included in annual preventative exams.

Answer: An ambulance bill will depend on the type of Medicare plan you have. Most Medicare Supplements today will have a Part B deductible that needs to be met first. Medicare Plan C or Medicare Advantage plans will typically have a copay for an Ambulance.

Answer: A few points: 1. If you don't have Medicare Part A & Part B yet, then you will need to sign up for both. Medicare Part B pays for most medical expenses outside of the Hospital such as: Physician visits, diagnostic tests (MRI's, CAT Scans, & etc.), lab work, surgical procedures on an out patient basis, and physical therapy to name a few. Part A pays for Hospital expenses after a deductible per admission. 2. If you only have Medicare Part A & Part B, there is NO cap in your potential out of pocket expenses. Thus, most Medicare clients will sign up for a Supplement or Advantage plan. 3. Medicare Supplement/Medigap plans and Medicare Advantage plans will provide a maximum cap in your expenses. 4. Basic Medicare does not cover Part D prescriptions so a stand alone Part D prescription plan or a Medicare Advantage plan that includes Part D is usually recommended. 5. Lastly it is usually best to sit down with someone who specializes in Medicare products to learn about all your options and which option might be a good fit for you!

Answer: Medicare Supplements are Guaranteed Issued when you first sign up for Medicare or when you lose qualified Employer Coverage. However, if you wish to switch Medicare Supplement Company's, you may need to answer health questions and you can be denied.

In addition, if you enroll in a Medicare Advantage plan for the first time, you may leave the Advantage plan within one year and you can go back to your original Supplement or sign up for a Supplement with no health questions. After one year of being on an Advantage plan, you may still leave the Advantage plan and go to a Supplement IF you can pass the underwriting questions. If you cannot pass underwriting, you will be denied.

Answer: First, make sure you have signed up for Medicare Part A and Part B through Social Security. Once you have a Medicare number and Part A & B effective dates, you will be able to sign up for a Medicare Supplement plan or a Medicare Advantage plan.

Answer: Yes, Medicare is increasingly covering certain AI-powered diagnostic tools for early disease detection (especially in Cardiology), though the extent of coverage varies.

Answer: Seek out a qualified "Independent" Insurance Agent that is able to explain and sell various types of plans from a number of different Insurance companies. If someone only shows you details of one plan from one company, find another person to talk to.

Answer: IRMAA is based on your earnings from two years ago. For 2025, your income from 2023 is considered. In 2026, you income from 2024 is considered and so on. Many individuals will see their income drop dramatically once they retire. Under this scenario you may appeal the IRMAA immediately based on the drop in income.

Answer: It will cost too much. Doctors may not take Medicare. Medicare will not cover very many expenses.

Answer: If you are enrolled in a qualified Employer plan with credible prescription coverage, you do NOT have to sign up for Medicare when turning 65. However, every situation is different so it's possible you may want to sign up for Medicare depending upon cost and benefits of your Employer plan.

Answer: Going with Generic drugs over Brand Name drugs is the simplest way to save money. Many plans will give a discounted price for 90 day supplies and for mail order. For expensive drugs, discuss with your physician less expensive alternatives.

Answer: Original Medicare does not have any Network restrictions. Cost of Original Medicare is often less expensive then what individuals were paying prior to Medicare elgibility.