Laverne Ward, Medicare Insurance Agent
Laverne Ward
Medicare Agent Licensed in GA
Contact Details
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Location
Jonesboro, GA
Laverne Can Help With:
About Me
Hello! I'm Laverne, your trusted Medicare agent in the area. My specialty is Medicare, and I'm passionate about helping you select the ideal plan that caters to your individual needs and budget. I'll efficiently sort through plans from reputable national and local companies, saving you time and effort. Best of all, my services are provided at no cost to you. Contact me to discuss your Medicare choices and don't forget to mention that you found me on Medicare Agents Hub!
Q&A with Laverne Ward
What is the biggest disadvantage of Medicare Advantage?
Answer: The biggest disadvantage is that you must use the plan’s network of doctors, hospitals, and pharmacies — and you could face limited access or higher costs if you go outside that network.
What are the 6 things Medicare doesn't cover?
Answer: Here are 6 common things Original Medicare does not cover:
🦷 1. Routine Dental Care
Medicare doesn’t cover cleanings, fillings, dentures, or other routine dental services. Only limited dental work related to a covered medical procedure (like jaw surgery) may be paid for.
👓 2. Vision Care
No coverage for routine eye exams, eyeglasses, or contact lenses. Medicare will only cover eye exams if you have a medical condition like diabetes or glaucoma.
👂 3. Hearing Aids
Medicare doesn’t cover hearing exams for fitting a hearing aid, or the devices themselves. Many Medicare Advantage plans do offer hearing benefits.
💊 4. Prescription Drugs (under Original Medicare).
Part A and Part B doesn’t include most prescription medications. You’d need to enroll in a Part D plan or a Medicare Advantage plan with drug coverage.
🌍 5. Medical Care Outside the U.S.
Original Medicare doesn’t pay for care received while traveling abroad (with very few exceptions). Some Medigap and Advantage plans include limited foreign travel coverage.
🏡 6. Long-Term or Custodial Care
Medicare doesn’t cover stays in nursing homes or assisted living facilities if the care is primarily custodial (help with bathing, dressing, eating, etc.). Only short-term skilled nursing or rehab after a hospital stay is covered.
I've heard about Medicare fraud. What steps can I take to protect myself from scams related to Medicare?
Answer: Protect Your Medicare Number
Treat your Medicare card and number like a credit card.
Never give your Medicare number, Social Security number, or banking information to anyone who contacts you unexpectedly by phone, email, or door-to-door. (If you didn’t request anyone to call you or come to your home and you don’t know them, it doesn’t matter what they say, hang up, delete email, and or close your door.)
Medicare will never call or visit to sell you anything or ask for payment.
Do I have to pay taxes on Medicare?
Answer: While you’re working (before Medicare enrollment) Yes, you pay taxes.
Medicare payroll tax is automatically withheld.
How much you pay depends on your wage earnings or if you are self employed.
When you are receiving Medicare (during retirement) you do not pay taxes on Medicare benefits. But you may pay taxes on your social security income if you income is at a certain level.
How do I appeal a decision by Medicare or my plan if they deny coverage for a procedure or medication I need?
Answer: How to Appeal a Medicare Denial
Step 1. Read your denial notice carefully
You’ll receive one of these:
Original Medicare: a “Medicare Summary Notice (MSN)” explaining what was denied and why.
Medicare Advantage or Part D: a “Notice of Denial of Medical Coverage” or “Explanation of Benefits (EOB)” from your plan.
👉 Look for:
The reason for denial (e.g., “not medically necessary,” “not on formulary,” “out of network”).
The deadline to appeal (usually 60 days from the date of the notice).
Step 2. File your appeal in writing
You can use the form included with your notice or write a letter that includes:
Your name, Medicare number, and contact info
The service or medication being denied
The date of service (if applicable)
A clear statement like:
“I am appealing Medicare’s decision to deny coverage for [service/medication] because my doctor believes it is medically necessary.”
Attach:
A copy of your denial notice
Supporting documentation (doctor’s notes, prescriptions, or letters of medical necessity)
Step 3. Send your appeal to the right place
Original Medicare: Mail your appeal to the address on your Medicare Summary Notice.
Medicare Advantage (Part C) or Drug Plan (Part D): Send your appeal directly to your plan using the address on your denial notice.
Keep copies of everything you send.
Step 4. Wait for the plan’s review
The timeline varies:
Part C or D plans: Must respond within 30 days (or 72 hours for expedited requests if your health is at risk by waiting).
Original Medicare: You’ll get a decision within 60 days of receiving your appeal.
If the decision still isn’t in your favor, you can move on to Level 2 and beyond — there are five total levels of appeal, all the way up to a federal court review if needed.
How to Strengthen Your Appeal
Ask your doctor to write a Letter of Medical Necessity explaining why the service is vital for your health.
My plan covered my cataract surgery but not the lenses I actually needed-how do they get away with that?
Answer: When your surgeon offered the “better” lenses, you were essentially presented with a non-covered upgrade.
Medicare and Medigap paid their share for the standard lens and surgery, but you became responsible for the difference in cost — often several hundred or even thousands of dollars per eye.
Providers are required to have you sign an Advance Beneficiary Notice (ABN) acknowledging that you understand the lens isn’t covered and you’ll pay the difference out of pocket. That’s how they “get away” with it legally.
What you can do now
1. Check your bill: Make sure you were only charged for the lens upgrade portion — not something that should have been covered under Medicare.
2. Ask for an itemized statement: Sometimes the office bundles charges that can be challenged.
3. File an appeal: If the charge doesn’t clearly separate covered vs. non-covered items, you can request a review from Medicare.
4. Plan ahead for the other eye: If you ever need surgery again, tell your provider you want only the standard covered lens unless you specifically choose to pay for an upgrade.
I went with Medigap because I travel a lot, but now I'm paying a fortune in premiums. Did I make a mistake?
Answer: Why Medigap appealed to you
You travel often, so you probably liked that Medigap:
Lets you see any doctor or hospital nationwide that accepts Medicare (no networks).
Often includes foreign travel emergency coverage (some plans up to $50,000 lifetime).
Means no referrals or prior authorizations — great flexibility if you’re on the move.
Those are major advantages if you’re frequently out of state or even abroad.
What you can do now
Compare your usage – How often do you travel or see out-of-state doctors? If it’s less than before, you might not need that much flexibility.
Get quotes for Medicare Advantage (PPO) – Many PPOs now include nationwide travel benefits and $0 premiums, though you’ll have copays and may need pre-approval for some services.
Check guaranteed issue rules – If you switch from Medigap to Advantage, you can try an Advantage plan during the Annual Enrollment Period (Oct 15–Dec 7) and, in some cases, switch back to Medigap later if it doesn’t fit — but your medical underwriting options may vary by state.
Ask your agent to do a side-by-side comparison of your current Medigap premium vs top Advantage PPO options with travel coverage.
What's the most important question I should be asking about Medicare that I probably haven't thought of yet?
Answer: Most people focus on what their plan costs today — premiums, copays, givebacks, dental, vision — but they rarely ask how that plan will perform if their health changes.
These question opens up deeper conversations like:
Will this plan still meet my needs if I’m hospitalized or diagnosed with a chronic condition?
If my prescriptions change, how will my costs look under this plan’s Part D formulary?
Would a PPO or an HMO give me more flexibility if I need to see a specialist out of state?
If I move or travel often, will my plan’s network follow me?
If my income or Medicaid status changes, how will that impact my plan choice or eligibility?