Lynn C Shurtleff, Medicare Insurance Broker

Answer: Medicare Advantage plans are mostly network based plans so the physicians and facilities available could be limited. This is going to depend on the carriers and the networks where you live. These can vary greatly so you want to be sure to check all of your providers and not be misled. I hear from beneficiaries that an agent told them with a PPO they could see anyone and just pay the higher copay, I just was told this a few days ago by someone referred to me. This is not true, the provider has to agree to accept and bill the PPO plan and they are not required to. Network based plans is the biggest disadvantage.

Answer: Yes, Medicare Advantage and Part D plans vary from state to state, county to county and possibly city to city. The plan your friend has may not be available in the location where you live.

Answer: If you have not enrolled in Parts A and B, you will want to do so right away. If you are already collecting Social Security you should have been automatically enrolled and received a Medicare card. If you are not collecting you must enroll either online, on the phone or at possibly at a Social Security office. That is the first step. If you are already enrolled, the next step is to look over the types and available supplemental plans in your area and see what will best fit YOUR needs, they are not one size fits all.

Answer: Original Medicare does not cover routine eye or hearing exams, nor does it cover eye wear except after cataract surgery or hearing aids. It also does not cover dental except in very limited instances or custodial care in a nursing facility, only rehabilitation. Medicare Advantage plans may cover some of these additional benefits but Original Medicare does not. Over the counter benefits, food cards, and gym memberships are also not covered by Original Medicare. When someone illegally cold calls and tells you Medicare covers these things and you are eligible because you have Parts A and B, hang up, this is not true.

Answer: Switching from paper applications to online applications has greatly streamlined processes for signing beneficiaries up on plans, but it has also increase agents misleading clients as well and opened the door for non-compliance. Now a signature is not required on most electronic applications, all the agent has to do is check a box which in my opinion is not a good practice or secure. It has also increased the illegal cold calling for Medicare Advantage and allows these call centers to break many laws including lying to the beneficiary simply to make a sale and move on. I myself have recently gone on Medicare and the 40 to 50 illegal daily cold calls are actually harassment and needs to be stopped. I advise clients to never ever talk to these people and to simply hand up.

Answer: I really have not found this has affected my work as a Medicare Agent. I do believe the Medicare Advantage plans have adjusted and set copays for procedures and tests based on hospitals charging more than stand alone facilities and physician group facilities.

Answer: Being licensed in Florida, I see many really great plans pop up every year largely due to the large population of Medicare beneficiaries in Florida. Plans vary not only state to state but also county to county so it is hard to say one state or another has the "best" policies for Medicare Advantage and Part D. Medicare supplements do not vary in their coverage, but they do vary in the premiums. Where you live determines the premiums and what plans are available to you.

Answer: I would advise contacting a local elder care lawyer or someone versed in your states Medicaid guidelines for Nursing Homes. There should be a local Agency on Aging in your area that can help too.

Answer: Because you already have A and B, you are subject to the 63 day window for losing employer coverage for the Guaranteed issue period for a Medicare Supplement. Normally, Cobra will be costly and will not excuse the penalty period for picking up a Part D plan either.

Answer: I always advise Veterans to pick up both A and B. Having Part B gives you options and choices outside the VA. I am a Vietnam Veterans widow and understand some of the challenges and limitations when using and dealing with the VA. I hear Vets complain about the Part B premium but there could be ways to minimize that cost depending on what is available in your area. If you delay your Part B, if you want to add it in the future you will have to pay a penalty so I never advise that because it could cost even more with the penalty.

Answer: No, you will not be penalized as long as you are on insurance through an employer or a spouse's employer. It is advisable though to weigh the differences in her plan and going on Medicare, it could be a better option to fully switch to Medicare. Also check with her employer to be sure they don't require you to go on Medicare when first eligible. If she works for the state or local school system or government, they usually do require you to switch over to Medicare when first eligible. Note too that you can get Part D with just A and to avoid a penalty for not picking up a Part D plan when first eligible for Part A, you will need to be sure her plan is considered credible coverage according to Medicare's guidelines. It probably is, but you will want to be sure. This is a separate penalty from delaying Part B due to employer coverage.

Answer: With a Masters Degree in Education and 17 years working for the state of Tennessee in education, I enjoy educating seniors on their options for Medicare and retirement. I love what I do and have been working as an Independent Agent for almost 2 decades taking care of my clients as well as taking care of their insurance choices. I'm a senior myself and on Medicare so I understand the challenges of aging. I truly consider my clients my friends.