Justin Call, Medicare Insurance Broker

Answer: I really enjoy talking through everything with my clients. Not just about Medicare, but a retirement picture as a whole in regards to what their health needs are, dental needs, life insurance, cancer, heart attack, stroke etc. to really make sure they have the tailored coverage they need. Knowing what someones needs are, greatly affects the Medicare decisions they make. So it isn't just as simple as signing them up for Medicare.

Take for instance dental implants. Most Medicare Advantage plans include dental coverage, but don't cover implants. With that knowledge, I may suggest a Medicare Advantage plan that includes a Part B giveback, and then take that giveback and buy a dental plan that helps cover those implants. Then when they get those implants done, we can cancel the dental policy and move them to a different Medicare Advantage plan if they would like. It's so important to have seniors on the best coverage for themselves each year. And each year can change.

Answer: In the Medicare world, everything is a give and a take. If a carrier is going to give me a plan that includes out-of-network coverage, they usually will "take" something. Such as having higher medical copays, or not as much of a dental benefit etc.

Also, the misunderstanding I see a lot regarding PPO's is that people think you have to have a PPO to be able to see a doctor in case of an emergency while traveling. That is not true. If it is a potential loss of life, limb, or illness and you have an HMO, you can go to the ER and be covered in-network.

Answer: The most common types are below:

MAPD - Medicare Advantage Plan with Drug Coverage

MA - Medicare Advantage Plan without drug coverage

HMO - In-network only plans

PPO - In-network and out-of-network plans

PFFS - Private Fee For Service (not very common)

Answer: Marketing as a Medicare Supplement/Medigap, but then selling you a Medicare Advantage plan without reviewing your doctors/network. This is done a lot of times by shady agents that don't want to go through all the hoops and follow the rules of marketing Medicare Advantage appropriately.

Answer: 1 - We talk through the basics, and their options

2 - I relate it to a visual example for people that are visual learners

3 - I reiterate multiple times

4 - We go over the basics almost every time we talk for the first few times

5 - I send them a PDF presentation if they would like

6 - We take it one step at a time. The key is short conversations, but many of them

Answer: We look at Medicaid options, Low Income Subsidies (Extra Help), and other programs. We also talk about what you are paying for currently. Maybe you have a life insurance policy that is more than you need, or maybe we can get you a better rate on a similar policy.

Answer: As long as your prescriptions are on the carriers formulary, then yes! Everyone will have the same $2,000 cap and can setup a payment plan with the carrier if they would like.

Answer: I can definitely help. Reading a book, and online articles can be confusing, and often times contradict each other. You need tailored advice in your local area rather than generalized information for across the country. We start with a needs analysis, look at your prescriptions and doctors, and talk through the options you have.

Answer: You may have experienced a deductible that is new to your plan. Or you may have had what we call LIS (which helps pay for prescriptions) and don't have that anymore. We would need to look into it further to see what happened, but usually we can find a solution that will help.

Answer: You should absolutely reconsider your coverage. That doesn't necessarily mean you will change it, but we need to explore options before it's potentially too late. Sometimes there are only certain windows to make changes and we don't want to get outside any of those windows.

Answer: It depends on your plan. Many Medicare Advantage plans do cover you on a reimbursement level for emergencies if you are out of the country.

Answer: Make sure you understand Part B penalties, Part D penalties, HSA penalties, and decisions that will be permanent. If you don't know what any of those are, then call me please!

Answer: I believe you are referring to your Part B premium. Usually that cost is based on your income 2 years ago. There are brackets to determine this cost based on your income. If you gained some of your husbands income, but now there is only you filing single instead of two of you filing jointly, your income could be in a different bracket now.

You can submit a form SSA-44 to have your income reconsidered based on a life changing event.