Maggie Flynn, Medicare Insurance Broker
About Me
I am a Putnam county native who now lives in Duchess County. My college years were at SJU in Philadelphia where I met my husband, Bill. We have been married for 34 years and have raised two wonderful sons.
In my free time I love to garden, travel, exercise, read and cook. I was active with the Master Gardening program for several years. Native plants are a passion of mine.
Alzheimer's is a personal cause for me. My mother and MIL both struggle with this heartbreaking disease.
I take pride in helping seniors understand their options and make sure they have the best fit.
Q&A with Maggie Flynn
I picked the plan with the lowest premium, but now every doctor visit feels like a surprise bill. Should I have gone with a higher premium instead?
Answer: I would suggest having a broker review your plan and your options. Medicare plans are highly individual. The lowest premium isn't the lowest if it's causing you unexpected bills.
There are so many plans that without seeing what your needs are or what you are in, it is very hard to give a direct answer.
I'm confused about when I can change my Medicare plan. Can you clarify the different enrollment periods for me?
Answer: There are Special Enrollment periods if you move, have a change in Medicaid status, are institutionalized, or can enroll in a five star plan.
Annual Enrollment is Oct 15-Dec 7th. During this time you may change plans multiple times for a start date of January 1. You may also make a one time change during Open Enrollment from January 1 - March 31.
My doctor wants me to try acupuncture for my back pain. Will Medicare cover any of this?
Answer: Original Medicare covers some acupuncture for lower back pain only. It is not unlimited. It has to be diagnosed and approved by your doctor. It can also not be related to a surgery.
Many Medicare Advantage plans have coverage for acupuncture that is at your will. You would pay a co pay to receive services. The acupuncture for MAPD plans has no specifications to it.
I’m a therapist who has opted out of Medicare. I have a client with BCBS-MA Medex. Can therapy be billed under this plan, and how can I do so without violating Medicare rules?
Answer: I would contact the plan directly and ask these questions. Normally, I tell my customers if a doctor or therapist is not contracted with Medicare, the full cost of the service is their responsibility. I wonder if you would reconsider being contracted with Medicare?
How can I tell if my Medicare Advantage plan is financially sustainable long-term?
Answer: If you are worried about the carrier being in the market for the long term, the larger carriers generally have more stability and are less likely to leave a market quickly.
To see if a plan is financially feasible for you, track your annual expenses. Are you paying more for drugs that are not on formulary? Are you paying for many out of network doctors, hospitals and procedures? If the answer is yes, the key to having the best financial outcome with a plan is to make sure your doctors, meds and hospitals are all in network. A broker can review your plan and make sure it is working for you.
What are some ways to save on prescription drug costs?
Answer: Discuss your concerns with your doctor. Are there alternate drugs that you could take that are a lower tier? Is there a generic form that would work for you?
Just because you have a drug plan through your carrier does not mean you can't purchase your drugs through other venues. Have your pharmacist check for coupons and also look on sites like Good Rx.
Many states have prescription drug plan programs to help with costs that complement your Part D coverage. These are usually based on income and can be quite helpful. Ask an agent if your state has a program and what it entails.
How can I save money on my Medicare Supplement?
Answer: First, have an agent or yourself look at plan options. F and G are typically the most expensive. Also, which carrier are you using? Prices differ dramatically across carriers. Also, Medicare Advantage plans offer much lower premiums and great coverage. Look at both and see what you really need for your circumstances. The vast majority of my customers in Medicare Advantage are extremely happy with their plans.
I signed up for a Medicare Advantage HMO, and I'm wondering if I can see a cardiologist out of network without paying everything myself.
Answer: If there are cardiologists in network near you then the answer is no. In rare circumstances, a plan may allow out of network specialists if that doctor is the only provider in your area.
In general, when you sign up for an HMO, you should be prepared to stay in network or pay ourt of pocket for out of network.
Does Medicare fully cover nursing home care, and are there alternatives?
Answer: Medicare does not cover long term care. The ways you can pay for long term care are; out of savings, Medicaid (if you qualify), long term care insurance, and life insurance policies that have a rider that pays out in the event of needing long term care. Be aware that the majority of nursing homes do not accept Medicaid either.
Is it better to get Medicare Part D or Medicare Advantage?
Answer: I feel a Medicare Advantage plan is a better choice than just a pdp plan. Why? The monthly premium on a pdp plan will be more than the cost of a Mapd plan in most circumstances. Also, the Medicare Advantage plan caps your medical liability. It also gives you added benefits; dental, vision, hearing and fitness options.
