Jonathan Potter, Medicare Insurance Broker

Answer: All agents local and remote can look up a doctor or medications for you. The real value in seeing a local agent is that they know the local networks of doctors and dentists that take the plan and a good agent can make recommendations because they have actual relationships with local physicians.

It’s also nice to have someone that can drop off books and information to your home if they are close enough.

Answer: Just this past month I was able to sign up two ladies that had major problems applying for Medicare part B. I probably spent over 15 hours with them calling social security to get them on the part B of Medicare. I was persistent when they wanted to quit and we finally got it done.

Answer: The way it will change the coverage is dramatic. If you take expensive brand name drugs you will see a large difference in how much you pay. You will pay thousands less every year now.

Because of this change the insurance companies had to take some of the money they use for medical benefits to increase the coverage for the RX plan. You will notice higher medical copays.

If you only get a stand alone RX plan then your plan cost will be much higher than in the past.

Answer: So the word premium refers to how much the plan will cost you every month. Generally they are zero or no premium plans but there are some that will cost anywhere from $33-100. This is the cost to subscribe in the plan.

Zero cost can refer to the plan premium but some people get that confused with the plan copays when you use the plan for doctor visits. If someone uses the term zero cost I would clarify if they are talking about the cost to be on the plan or the copays when you use the plan.

Answer: Well that depends on a lot of factors. If you are not 65 then you don't have an option to get on medicare unless you are diagnosed with a disability.

If you are 65 and the your coverage will stop at 65 then you need to get on medicare part A and

B.

If you are 65 and the government is giving you lifetime coverage then you need to see if it is worth paying the medicare part B premium and adding medicare or just staying on your current coverage.

Answer: Yes, the cost for the part D plans did go up and the deductibles are very high but it will reduce what you pay for medications only if you take name brand drugs. If you don't take non generic drugs then you can get away with getting on the cheapest plan available.

Lets say that you take a drug that costs $500 retail. The first month on the plan you would pay your deductible and then a copay of around $45. The next three months you would just pay the $45 copay. Then for the rest of the year that medication should be free because you have hit your $2000 max drug coverage.

Answer: Many seniors don't know how to enroll in part B for medicare when they retire or turn 65. The government doesn't make the steps very clear. For this reason it is important to align yourself with an agent that has experience in the field. Most people don't know that your need to be starting the process of applying for medicare 3-4 months before you want it to go into effect. Because of this many seniors are rushed into a decision that they may not be comfortable with.

Answer: Part A covers hospital and Part B covers medical. Think of part A as the physical side of coverage and part B is the human side. Part B will cover the doctors fees and Part A will cover the facilities and other such fees.

Answer: I listen to a weekly podcast that does a deep dive on the news and notes of the industry. I just got back from an insurance conference in Las Vegas to keep me up to date and make connections. Because of the way the industry is constantly changing you have to keep up to date of you will be left behind.

Answer: It depends on the medication that you take. If it is covered under the formulary of the company you chose then you will have a great experience. If you need to get a pre authorization then that will be a more tedious situation but it is possible to get it covered depending on how much time your doctors office wants to spend on your case to fight for the coverage of the medication.

Answer: If you are currently getting Social Security and you are being billed for part B for the Medicare, I would call Social Security and make sure that they are deducting that part B premium out of your Social Security check. That normally should be happening.

Answer: If someone is pushing just one type of product, then I would be a little bit skeptical. I try to always show people both options that they have and the pros and cons of both. Then they can decide for themselves what is best for their situation.

Answer: Choosing between a supplement and Medicare Advantage is a individual choice. One option is not perfect for everyone. I would get with your agent and have them evaluate both options with the following information: List of Doctors, dentists and any medications that you take. They can take that information and calculate the best option for you.

Answer: Medicare agents are supposed to go over all the details of the plan and make sure you understand it before you sign up. Sometimes when an agent goes over the plan details it can be draining on the brain because of all the numbers you go over. I would talk to your agent and see if there is another plan option that would work for you or if you can add dental for a fee with your plan.

Answer: You can try to chose a plan by yourself but a good agent will know the differences between all the companies. Not all companies will cover the same doctors, hospitals, dentists and medications. A good medicare agent will be able to find the best plan for you with a little research and they can be a resource for you every year to evaluate the plan changes.

Answer: The biggest mistake you can make is not being educated on your options. In most areas you have dozens of supplement companies and possibly up to 10 Medicare advantage companies. Evaluating those companies with the medicare and you handbook or going online is cumbersome because of all the options you have. A good agent will be able to narrow the options down to just a couple and make the decision much easier.

Answer: If you can access the "Summary of Benefits" for the plan then you have in writing what the plan HAS to cover. Every plan has a plan number. It should look something like this: H4606-011. If you do an internet search for that plan number and the current year, you should find the Summary of benefits for the plan.

Answer: If you just need emergency care you can go to any hospital or instacare with any plan that you have and be covered.

If you need to see doctors on a regular basis then a PPO plan will work if they are in network. Your agent can help you check on this easily.

If you have a supplement then you just have to ask if they bill medicare and the supplement that you have.