Lesley Paul, Medicare Insurance Agent

Answer: There is an increase in Medicare costs every year due to paying for the care of members with high health needs, not just your own needs. A Medicare Advantage plan may have lower or no premiums and lower out of pocket costs.

Answer: Special needs plans with specific health conditions or circumstances, including chronic illnesses, disabilities, or those who are for both Medicare and Medicaid.

There may be additional benefits beyond standard Medicare coverage.

Answer: It is satisfying to help people, and especially older people, navigage and find the right Medicare plan that meets their needs, both financial and otherwise. I also like the flexibility of this business and being able to have the choice to meet my clients, or work from home.

Answer: Because a small section of people use specialty and brand name drugs, this leads to an imbalance in the total amount of spending. This lack of competition also drives up overall healthcare costs.

Answer: Many dentists find the reimbursements from Advantage plans to be too low. A lot of dentists prefer to accept stand alone dental plans. There are, however, dental practices who work with Medicare Advantage plans. You can call the Member Services number on the back of your card, or contact the agent who helped you obtain your plan, and find an appropriate dentist who accepts your plan.

Answer: More people are buying Medicare Advantage Plans, which have $0 premiums and include prescription drug coverage and some benefits for dental, vision and hearing. This is saving consumers more out of pocket expense.

Answer: You can call the member services number on the back of your insurance card. If you have your plan documents, you can check the information there. You can also contact the agent who sold you the plan and they will be happy to find out any information that you need.

Answer: You can call the insurance company you are interested in, and have them assign a Licensed Medicare Agent who can legally represent that carrier, and will give you legitimate information. You can also go on the Medicare.gov website, or call 1-800-Medicare.

Answer: Medicare only covers short term nursing care and does not cover long term care or assisted living. You need to have a separate long-term care insurance plan, Medicaid or use Veteran's benefits if applicable. You can also have a savings plan.

Answer: Medicare agents are not permitted to Cold Call potential clients. If you have not requested an agent to contact you, it is probably a scam or phishing call. Also, no valid agent will ask for your Social Security number or other personal information, or offer any kind of gift for signing up. Never speak to an agent you have not asked for help, so that you know they have legally contact you.

Answer: While some hospitals say that the payment rates offered by some Advantage plans are sometimes too low, or have other requirements that slow the reimbursement process, they solve these disputes within the contract negotiation period.

Answer: An Advantage Plan can save you money because you do not pay a monthly premium, and your prescription drug coverage is included. You do have some copays and deductibles. However, I would also advise that if you see lots of doctors and pay frequent copays and deductibles, a Medigap plan might suit you better, because you will pay a monthly premium, but essentially no copays or other out of pocket expenses.

Answer: Differences in your premium can affect your copays and deductibles. As your agent, I would explain that to you, so you can make an informed decision. You should always be informed as to what your plan includes, and the costs and differences that premiums can affect.

Answer: Of course. As a consumer, you are entitiled to gather all the information available as well as comparing the differences and other factors that plans and carriers have in common.

Answer: Clients new to Medicare often do not understand the labels attached to the parts of the system. They need to understand Original Medicare includes Parts A and B and how they receive that. The other parts of Medicare can appear confusing but as basically, Part A which is hospital, Part B which is the providers, Part C, or Medicare Advantage, is a bit confusing because it includes Part D which is Prescription coverage, as well as Parts A and B.

Answer: Yes. The process of choosing a Medicare plan can be daunting. It often appears to be more complex than it has to. You want to make sure you choose a plan that fits your health needs and your budget, and a good medicare agent can take the stress out of the process for you.

Answer: I like helping people simplify the process of choosing a Medicare plan that is appropriate for them. As people age, it is important to help them hold on to more of their funds so that they can maintain quality of life while being proactive and preserving their health.