Jim Carroll, Medicare Insurance Broker
Jim Carroll
USA Benefits Group
Medicare Broker Licensed in FL, AL, GA, KY, MI, MO, NC, OH, PA, SC, TN and TX
4+ Years of Experience
Contact Details
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Location
Titusville, FL
Jim Can Help With:
- Medicare Advantage
- Medicare Supplement
- Prescription Drug
- Dental Plans
- Vision Plans
- Hearing Plans
- Individual / Family Plans
- Group Benefits
- Life Insurance
- Final Expense Insurance
- Critical Illness
- Long Term Care Insurance
- Short Term Care Insurance
- Disability Insurance
- Hospital Indemnity Insurance
- Annuities
About Me
I'm an independent, full-service health and life insurance broker, backed by USA Benefits Group, who's earned the trust of clients ranging from young adults to seniors. With over two decades of experience in leadership, higher education, and strategic problem-solving, I bring a steady, knowledgeable approach to helping you protect what matters most.
Before transitioning into insurance, I spent 21 years improving outcomes in higher education, honing my skills in analysis and personalized solutions. As a U.S. Air Force veteran and owner of Jim Carroll & Associates LLC—a Certified Veteran-Owned Small Business—I apply discipline and integrity to every client relationship. My analytical training as a Ph.D. in Organizational Leadership helps me navigate complex insurance options so you don’t have to.
I understand that Medicare is confusing. Whether you are healthy or have pre-existing medical conditions, you don't need anymore confusing in your life. I'm here to simplify it for you.
Reach out to me today and we'll explore your Medicare insurance options, with no obligation.
Q&A with Jim Carroll
What are the reasons why I should work with a Medicare agent?
Answer: Would it be a bad idea to use the knowledge and experience of a licensed health insurance agent/broker who also has the annual Medicare certifications and insurance carrier trainings? It costs you nothing, but can gain you everything.
Although you may be completely comfortable choosing and self-enrolling into either a Medicare Advantage Plan or Medicare Supplement and Prescription Drug Plan, working with an certified agent/broker might mean the difference of you paying thousands of dollars more during the year by not having the knowledge of how different plans may or may not meet your specific medical needs. Can you afford to choose the wrong plan yourself and have a huge medical bill cause you financial hardship?
What's the trade-off between a Medicare Advantage PPO and HMO when it comes to flexibility?
Answer: A PPO allows you to choose any providers in-network, and generally don't require referrals for specialist. And, although you will pay more for services, you can go to an out-of-network provider.
In contrast, with an HMO, you must select a Primary Care Physician and see that provider before you are allowed to see a specialist. That said, no services will be covered if you go out of the insurance carrier's network except for medical emergencies if you are traveling out of your network area.
Will Medicare cover asthma and other breathing conditions?
Answer: Yes, certain Medicare Advantage Prescription Drug Plans (MAPDs) and Medicare Advantage Dual Eligible Special Needs Plans (D-SNP) (Dual = Medicare/Medicaid), will cover different chronic and severe asthma and breathing conditions. Depending on your geographic location and insurance carrier availability, there are deductibles, and out-of-pocket maximums to meet each year.
Also, a Medicare Supplement combined with a Prescription Drug Plan (PDP) is another viable option because if purchased when you are Medicare first eligible, it is guaranteed issue and there is only a $250 annual deductible.
Every year I stress over picking a plan and still end up surprised by the bills. Is there any way to just get peace of mind with Medicare?
Answer: Absolutely. A Medicare Supplement Plan G covers 100% after you meet the $257 annual deductible. The reason this sounds so simple is because you are paying a monthly premium to a private insurance company. But, if you do the math, the 12 months of premiums are still less than the typical deductible and out-of-pocket maximums with a Medicare Advantage Plan. You can also add a Prescription Drug Plan usually a zero to little cost, depending on the Tier level of your medications.
I'm interested in nutrition counseling to help manage my diabetes. Will Medicare cover this as preventive care?
Answer: Yes, if you qualify for a Medicare/Medicaid Chronic Special Needs Plan (C-SNP) for diabetes. The insurance carrier will assign a case person to help you find the nutrition counseling.
My friend lives in a different city and has a much more detailed Medicare plan. Is their plan dependent on their location?
Answer: Yes. This is why the first thing you are asked is to verify your zip code.
Health insurance companies use hundreds if not thousands of datapoints to determine what plans they offer in geographical locations.
If you move to a different zip code, it is critical you contact either your broker or agent, or insurance company if you self-enrolled. Otherwise, you might go to a new provider who doesn’t take your plan.
Think of it like this - Insurance companies have many types of plans, and the different types have specific nuances. Much like a car manufacturer has different models of vehicles, and each model has different trim levels.
What is one of the the most common misconceptions people have about Medicare?
Answer: There are several misconceptions:
1. Medicare is free.
Fact: The cost of Medicare Part B is taken directly from your Social Security check.
2. Medicare Advantage Plans are free/have $0 monthly premiums.
Fact: Albeit there are Medicare Advantage Plans that do have $0 monthly premiums, people are often surprised to find they have doctor/specialist visit copays, annual deductibles, and maximum out-of-pocket costs. And, Medicare Advantage Plans only pay for the first 21 days in a skilled nursing facility.
Is Medicare Part A enough for hospital coverage?
Answer: My general answer is that Original Medicare Part A and Part B are Never enough coverage.
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Relatively speaking, how much you consider is "enough" coverage depends on how much money you are comfortable spending on medical expenses.
Medicare.gov > Inpatient hospital care web page shows,
"You pay this in each benefit period (in 2025):
* Days 1–60: $0 after you meet your Part A deductible ($1,676).
* Days 61–90: $419 each day.
* Days 91 and beyond: $838 each day for each lifetime reserve day (up to a maximum 60
reserve days over your lifetime).
* Each day after you use all of your lifetime reserve days: You pay all costs.
https://www.medicare.gov/coverage/inpatient-hospital-care
https://www.medicare.gov/coverage/long-term-care-hospital-services
https://www.medicare.gov/coverage/inpatient-hospital-care/inpatient-outpatient-status