JP Richardson, Medicare Insurance Broker

Answer: Hello, there are three ways an individual under 65 can qualify for Medicare. The first is being on Social Security disability with Social Security disability income for 24 months, or having ALS or Lou Gehrig's disease, or end-stage renal disease.

Answer: Medicare Advantage plans can be a great fit. Depending on if you choose a PPO or HMO plan will impact your Dr's. Once you join a Medicare Advantage Plan you are then subject to networks the providers have for Dr's. If you find a plan that you really like, but your Dr's are not contracted with then plan you would have to choose between your Dr's or the Plan. You should have a NEEDS analysis done by a broker to help determine which is best for your unique situation. There is no "cookie cutter" process with this and every person is different and may have different needs from their plan.

Answer: This is a great question and a very important question. It is extremely important that Brokers/Agents education their prospects and clients on a regular basis. For those that are new to Medicare I conduct a 45-60 minute Medicare 101. In this meeting we go in depth on the parts of Medicare and also when and why you need to apply for the different parts. This is extremely important so that they can avoid late enrollment penalties, but also not pay for more than what they need. We very rarely discuss specific plans during this meeting and schedule a follow up to meet a second time and go over specific plan benefits and help guiding them so they can choose the plan that best fits their unique situation.

Answer: Chiropractic care is only covered for Subluxation of the lower back. If you are on a Medicare Advantage plan or an Original Medicare with a Medicare Supplement you will need to ensure that your Chiropractor codes the billing correctly or it will be rejected by the carrier or Medicare. This is not a carrier determination, but a Medicare determination for what codes will be accepted during the billing process. You will also want to make sure your Chiropractor accepts Medicare and if you are on a Medicare Advantage plan check with your Broker or Carrier to ensure the Chiropractor is “Contracted” with the plan. Some Dr’s are not contracted with every plan with a carrier so you will want to confirm they are contracted with your specific plan.

Answer: Every individual is different and unique in their needs. Medicare Advantage plans are a good fit for many people just like Original Medicare with a Medigap or Supplement with a stand alone prescription plan are a good fit for many people. One advantage to Medicare Advantage plan is they typically add additional benefits like dental, vision, hearing and gym memberships. Not every plan does, but many do. One advantage to Medigap is you are not tied to provider network like you are with a Medicare Advantage plan. It is important to work with a trusted broker who can help guide you so you can find the best fit for you and your unique situation.

Answer: Preparing for AEP in very important. You should have an updated list of all of your doctors and all of your current medications ready by October 1. This is when the plans for the next year are released and details are available. You should also schedule an appointment with your Broker/Agent for sometime after October 1 as soon as they are scheduling. I would reach out some time in September to get on their calendar.

Answer: The best way is to find a trusted Broker/Agent to work with. We have access to all the tools as well as the proper training and certifications to help guide you so you can find the best fit for your unique situation.

Answer: If you find out your preferred hospital is out of network you should contact your carrier to verify the network status. If it is confirmed out of network you can consider another hospital or look to make a change of plans if you have a valid enrollment period available.

Answer: Medicare Plan options are not a one size fits all scenario. Everyone has different needs and different requirements of their health plan. What is right for them might not be right for you.

Answer: A Medicare Broker is an independent who works with multiple carriers. A Medicare Agent is typically tied to one carrier only.

Answer: Medicare does not do a very good job of communicating beneficiaries responsibilities in regards to their requirements for enrollment. It is important to talk with someone who is knowledgeable about the process and what the pitfalls could be if you do not enroll when Medicare says you need to.

Answer: I enjoy helping clients with their Medicare needs because it can be very confusing for those that don't do it everyday. I love being able to help guide clients through the process and helping THEM choose their Medicare Benefits. Not just during the enrollment process, but also after the enrollment if they have any questions.