Larry Pereiro, Medicare Insurance Agent

Answer: We educate seniors in regards to all their options for Medicare benefits. Accomplish those out any cost or obligations and provide this assistance without any predetermined carrier focus.

Answer: With the PPO you have more flexibility to use utilize providers that are not “in network”, however, there is addition co-pays or co-insurance. With the HMO you must receive services from in network providers and you more attention to management of your health needs.

Answer: There is no affect, Medicare is guaranteed issue coverage do long as you have original Medicare Parts A and B and live in the area you are seeking coverage in.

Answer: Yes it is, however some PPO plans provide dental coverage both in and out of network with the same costs associated with the service.

Answer: Many of the plans available have "travel benefits" for in network providers when you are staying in your alternative location. We can always find a plan that meets this need for you.

Answer: Yes it does, travelling worldwide and dependent on which carrier you are enrolled either and the type of product (HMO or PPO)

Answer: It will not make a negative impact but may require a change of carrier to accommodate your choice of providers.

Answer: Contact your state health department or the manufacturers to receive the potential of discounted pricing

Answer: There are 18 different preventative procedures, the most common is bone density testing, colonoscopy and mammogram.

Answer: Yes they do, they get vitamins, supplements, pain relievers such as Tylenol and much more, toothpaste, toothbrush, healthy food items, i continence supplies, etc.

Answer: Most MA and MAPD Plans do cover these opportunities. There basic services provided at no cost and then there are also comprehensive services for minimal cost or cost savings. Most plans also provide optional supplemental plans if more extensive coverage is needed, however, at additional cost.

Answer: It doesn’t, but is defined by the type of service, who the provider is and the extent of the needed services sought. Each carrier defines these according to their policy and procedures.

Answer: This the question that truly relates to “universal care”. Its impact would depend on whether there is cost sharing and at what level. From there, many of the benefits of Medicare could be provided for the younger generation with minimal premium cost plans without tapping into social security funds.

Answer: Every agent is trained to review the consumer’s physician as it relates to in network coverage. This prevents this type of issue and the agent is accountable to both the carrier and CMS when this issue is encountered.

Answer: No, in fact it can, in actuality work to the positive because the more enrollees the wider the cost of cover us spread so the MER (medical expense ratio) could be reduced.

Answer: Yes, most carriers have programs that provide financial reward for engaging in healthy activities and habits. This includes but is not limited to routine annual check ups and so forth.

Answer: I believe Medicare could improve their engagement with the Senior Market by first of all making sure that Social Security Offices refrain from giving advise about Medicare other than "You should talk to a licensed and certified Medicare agent in your area about the options you have.

Then they could also regulate the call centers to insure their compliance with non-pressured, non-biased presentations that simply allow the educational process to allow the senior market to make an informed decision about their Medicare Options.

Answer: No one can ensure you of coverage until they have your list. Different carriers have different tiers for some drugs and cover different drugs as well as some of the same drugs. Use an agent to search the carriers in your area to determine which carrier covers all of your drugs.

Answer: Medicare Advantage plans different by carrier. "zero-premium" simply means that the carrier does not charge a premium for the coverage. There may be some benefits that also have zero cost share while other benefits can have co-pays and co-insurance until the maximum out of pocket limit has been reached.

Answer: Contact the Social Security Administration to determine if you are subject to the IRMMA and any penalties you be subject to. Those fees are added to the cost of the Medicare Advantage product, so even if the carrier has a zero premium, plan available to you, you must pay those fees and penalties to Medicare.

Answer: It has no affect whatsoever to Medicare coverage cost, all eligible seniors are enrolled at the same level according to the approved Medicare plan.

Answer: By eliminating the coverage gap, aka Donut Hole, out of pocket cost capped at $2,000.00 annually. Individual drug cost is still subject to the "co-pays" if any prescribed by the carriers Medicare approved plans.

Answer: Be careful of all the hyped, half-truth marketing being sent your way. Find a local agent who is willing to simply educate you about what you real options are without giving his/her personal preferences. If they don't ask questions relating to your preference for coverage benefits and immediately begin to tell you their opinion, thank them for their time and find then find you a real agent dedicated to doing the right thing, doing it the right way and doing it with the right motivation.

Answer: This is a great question, and yes it is, just like next year will be an opportunity to work on those issues again. Medicare, as does all health care services should consistently review and even adjust what is done and or recommended to fit the need of the consumer.

Answer: Yes it can. Medicare advantage plans have hospice available, some also provide coverage for Home Health Care and Home Care.

Answer: You have two options, find a specialist in network in you are in an HMO or see that specialist if you are in a PPO with the knowledge that you will pay higher out of pocket cost for the service.

Answer: A strong argument for Hospital Indemnity plans is that offset your out of pocket cost for hospital, lump sum cancer and skilled nursing facility stays. The cost of these three benefits in a typical Hospital Indemnity can be acquired for about the 3rd of the cost of a Medigap policy. In essence, a Medicare Advantage plan with a Hospital Indemnity plan produces what I call a Hybrid Medigap policy.

Answer: Medicare policies are not Medicare plans. They are "supplemental plans", providing benefits to off set the cost of Original Medicare Plan A and B, and if you are outside of the Open Enrollment period when you turn 65, they are medically underwritten. You must have Medicare Part A and Part B in order to enroll in a Medigap, but that is not guaranteed issue status outside of the open enrollment period.

Answer: Typically no. However, if you are in your initial enrollment period (just turned 65) and decided to change after enrolling in a Medicare Advantage plan, you can make that change.

Answer: The answer would depend on several factors, one is whether or not their group coverage considered credible coverage by CMS. Your HR department is required to inform you about this.

Answer: You have 63 days to enroll in a Medicare plan in the area you have moved to. This is not automatic and requires you to seek an agent or directly speak to a carrier to make that change. Your existing Agent of Record (assuming he/she is licensed and appointed in the area your moving to) can make that change for before you move in a timely manner that make the effective date of the new plan the 1st of the month of the month you will arrive in the new area.