Joanne Sherwood, Medicare Insurance Broker

Answer: Anyone receiving SSDI benefits will automatically be enrolled onto Medicare after 24 months. Also anyone with Lou Gerrig's disease, in Hospice or end stage renal failure is eligible for Medicare.

Answer: Yes! Call Social Security or log in to your online account and change your address. This will notify Medicare of your address change as well. It's also important to contact your carrier or broker/agent and inform them, as many plans you are eligible for are dependent on the zip code or county you live in. Medicare supplements generally move with you, but Advantage plans and Part D plans will need to be reviewed and potentially changed to a new plan offered in your new area. You have 60 days from notice of move to change plans, but keep in mind your plan may not cover much in your new state other than urgent care and emergencies if it's an HMO tied to the local network in your former state.

Answer: It's not a mistake but more about what is important to you and how much premium you wish you to pay to have the benefits that a supplement offers. A medigap supplement is essentially the strongest coverage available, with most medicare covered benefits covered either in full or with a small yearly deductible. Some supplements have higher deductibles but many people prefer supplements as they limit the out-of-pocket cost at the time of service. There is a higher premium for this. It's paying up front like traditional insurance on a car or a house, you will pay it monthly regardless of your usage. If that doesn't suit you or you are interested in looking at options to save money, then looking at an Advantage plan at the next open enrollment period may be cost effective for you. These have a much lower, sometimes zero premium, and costs required when you need the services.

Answer: Not right now, however when you leave your insurance plan you will need to submit a Medicare form L564 Proof of Loss of Coverage within 63 days to enroll onto part B, (and D) with no penalty.

Answer: What are the pros and cons of waiting to enroll onto Medicare in terms of costs and guaranteed issue plans. What are the Medicare Supplement premium increase trends over the past 3-5 years for each carrier?

Answer: Yes, provided your employer coverage was "creditable" meaning it covers the equivalent minimum coverage of Part D, Medicare's drug benefit. A notice of creditable coverage is sent out after a plan termination and can also be confirmed by contacting your employer group or the plan itself. Most employers over 20 employees have creditable coverage but it's important to check. The time period is 63 days from loss of coverage to qualify for a special enrollment period with no part D penalty, and 8 months from loss of coverage to avoid part a B penalty.

Answer: ANOCS are generally sent out by carriers at the end of the plan year and are required to be received in your mailbox by October 1st yearly. If you didn't receive yours, call your carrier or login to your online account to view the changes for the upcoming year.

Answer: I don't recommend it. It's important to choose your broker or agent carefully by looking up client online reviews, attending a seminar or education and outreaching to them to ensure you have a good rapport and feel comfortable, however meeting with multiple brokers and agents is not doing you or them any favors. You will be essentially hearing the same information as they all usually have access to the same plans. Your time and theirs can be best served by choosing someone you feel comfortable with and continuing to work with them as you move toward your plan decisions. You should never work with someone you are not comfortable with and trust that they have your best interests at heart. I have been called in the past to validate questions that were given by another broker, and I am hesitant to do so, as there are many factors that are not clear and could change the answer, giving them the appearance of being incorrect. Find someone you like and work with them, develop a relationship over the years and you will develop a bond with someone that truly cares about you and has your back year over year.

Answer: In general Medicare Advantage Plans have many comprehensive benefits that provide well rounded medical and extra wellness benefits like gym memberships, vision, dental, hearing aids and many more benefits that Original Medicare does not cover. On the other hand, many Advantage Plans have networks of doctors that must be used to provide benefits and some other extra steps like pre-authorizations before receiving care. The most important consideration is the network of doctors and hospitals that a plan covers, and it's important to research this before enrolling. Many beneficiaries find large networks that cover all their providers, however this can change at any time if a doctor or facility leaves the network, and this can be a problem. There also can be more administrative burden in terms of billing documents that can get cumbersome. I find that many beneficiaries do not really understand Advantage Plans and what they cover before enrolling. When the benefits are discussed in detail and all questions answered, there are less opportunities for surprises. While Advantage plans are in general not good or bad, they can be a very good choice for the right person. Others prefer Supplements which decrease a lot of these issues but also only cover what Medicare covers, leaving someone to purchase extra plans to cover benefits like dental, vision and more.

Answer: Medicare allows for a no cost Welcome to Medicare physical when you are new to Medicare, however on an ongoing basis, Medicare does not generally cover routine well visits. Most people have at least one underlying issue, diagnosis or concern, and when the doctor codes the bill with your diagnosis or concern, it will not be treated as an annual physical, but a follow up visit and thus will be paid according to the fee schedule of the plan.

Answer: The best way to verify this information is to look up the Medicare plan on the actual carrier website for your zip code. This information is also housed on Medicare.gov under find health and drug plans. Both of these options will provide official benefit summaries for each plan.

Answer: This is a service I provide for my clients, however all carriers have online provider directories on their sites, or you can call the customer service number on the back of your card to speak to someone live. Some carriers will mail you a provider directory, but most have stopped doing this as it's very cost prohibitive and can quickly become incorrect as networks change often. It's important that you ensure the provider is in network with your particular plan, which is listed on your ID card. Carriers also have online portals which members can log into and check providers as well as review benefits, claims, order ID cards, etc.

Answer: First you should always contact the billing office and validate that the bill is correct. Questions to ask are: what insurance did you bill, what did they pay and what were you told is my balance. Calling the carrier or checking on your online portal will also confirm these answers. If there is still a discrepancy after calling the carrier, and it is not resolved you have the option of contacting Medicare directly for assistance. You will not get in trouble. Medicare will fully investigate the bill and provide you a response. Because of the administrative cost of going this route, it is advisable to attempt to resolve the issue first with the carrier and the provider. As a Medicare agent I assist my clients with their billing issues as I can usually resolve them by working directly with the carrier internally. This is an additional service I offer my clients to ensure they have the best experience possible with their chosen plan.

Answer: Original Medicare does not cover Silver Sneakers, a gym membership within the Silver Sneakers network of gyms across the US. However, many Medicare Advantage Plans do offer this benefit for no additional cost and select Supplements do as well. Other carriers offer similar fitness and wellness programs branded under different names.

Answer: A Medicare Agent has the ability to offer you multiple plans and carriers to meet your healthcare and financial needs. Your medications, doctors and hospitals will be cross referenced with available plans to ensure you are able to continue your care with your providers and receive your medication at the best possible price. As a Medicare agent, I speak the language of Medicare, and doing this every day for many years gives me the perspective to understand carrier issues, provider networks and plan changes at a deeper level. In addition, there are many important rules that are not well known and can save you from making costly mistakes. There are also rigorous annual testing requirements that ensure we remain up to date on all related information. Lastly, there is no charge to work with an independent agent, so why wouldn't you want an expert who has your back 24/7?