Mark Sannes, Medicare Insurance Broker

Answer: Yes, losing employer-sponsored health coverage qualifies you for a Special Enrollment Period (SEP), allowing you to enroll in a new Marketplace plan outside the standard open enrollment period. You generally have 60 days before or after losing coverage to select a new plan

Answer: The least costly way to get basic hospital care in Medicare is to see if you qualify for a Dual Special Needs plan. These types of plans can help reduce your overall Pemiums, Deductibles, etc. Contact Social Security/Medicare to see if your income/assets will qualify.

Answer: You most likely will have SEP (Special Election Period) to get a Medicare Advantage plan or Stand Alone Prescription Drug Plan. You should contact a Medicare Broker right away to review your options.

Answer: It really depends on 'your' individual needs!

Medicare Advantage

Highlights:

Low Premiums with multiple Co-pays

MOOP (Maximum Out Of Pocket Limits)

HMO/PPO plan options

May Need Referrals for Specialists

May Include Routine Services (Dental, Vision, Hearing, Fitness, etc.)

Emergency & Urgent Care USA Coverage

MAPD – Medical & Drug Plan Included

MA – Medical Only-Great for Veterans

Some with $50-$100 monthly Givebacks!

Supplement / PDP

Highlights:

Higher Premiums but minimal Co-pays

Covers most A & B costs (incl 20% and Hosp)

Freedom To Choose Doctors

No Referrals Necessary

Some Routine Services ‘Not’ Covered (Dental, Vision, Hearing)

Covered most everywhere in the US

Need To Buy Drug Plan Separately

Answer: Just a few years ago, Medicare was virtually all paper-oriented. Now that COVID hit in 2020, the carriers have updated everything to be online. This has greatly helped with efficiency and compliance.

Answer: We love helping seniors understand the complex nature of Medicare Insurance. We love meeting with seniors who become like family to us. It's a great profession when you can help people with their health needs!

Answer: If you continued working past 65 and deferred getting signed up for Medicare you may be just fine if you work for a company with more than 20 employees and are on the employers health plan. If not, you may be subject to penalties when you do sign up, and these will be for the rest of your life. We suggest that you contact our agency before retiring and losing your current employer coverage.

Answer: The biggest mistake seniors make when enrolling in Medicare is missing their Initial Enrollment Period (IEP), a 7-month window (three months before, the month of, and three months after turning 65). Missing this deadline can lead to permanent late-enrollment penalties for Part B and D, and gaps in health coverage.

The next biggest mistake is not calling a Medicare Broker/Agent and getting no-cost expertise to understand how Medicare works and find the right plan for their needs.

Answer: Supplement Open Enrollment is within 6 months after your Part B Effective Date. There are No Health Questions, and you are guaranteed issue.

Medical Underwriting - If you do not sign up during the above times, you may have to answer health questions to qualify. They can deny you based on their risk factors.

Answer: This is a heavily debated topic. I personally believe that most smaller, local agents do a good job. Some larger call center-type agencies push the line on compliance. Then CMS (Center for Medicare and Medicaid Services) comes out with generic rules for all agent vs just addressing those entities that need addressing. I am all for making it easier and safer for the customer.

Answer: Normally, yes! If you are on a Medicare Supplement Plan, you can see 95% of all doctors in the US as they take Medicare Assignment. IF you are on a Medicare Advantage HMO plan, you will need to go to their contracted providers to get the best costs. Medicare Advantage plans do offer Worldwide Emergency and Urgent Care coverage as well. We can help review which doctors are contracted with which carrier plans, making it easy for you to make plan decisions.

Answer: My wife, Sandi, and I started this Medicare Agency in 2015, 11 years ago. We both have extensive backgrounds in insurance, working for Safeco, Pemco, Grange, etc. We left the corporate occupations to start our own Medicare Insurance agency, and we just love it!

We don't have office politics, we love our clients and treat them like family, and we really help people find the right health plan that meets their individual needs! And as we get older and things change, we are there to review their plans and find new ones as we transition.

This is the best job ever!

Answer: You’re part of an insurance risk pool. At any given point in time, any member of the risk pool may expose others in the pool to their loss. Those losses are often exponentially greater than the premium collected from the member. The insurer absorbs those losses, but to do so, it must collect and retain premiums from all of the other members who did not (or have not as of yet) sustained a loss. Statistically, while only a small percentage of the risk pool will sustain an insured loss at any one moment, the likelihood of you eventually becoming one of those people is high.

That's why having insurance is very much needed to avoid/reduce any financial crisis during your life.

Answer: Medicare generally covers the necessary medical procedure, cataract surgery, and a standard lens. They do not cover premium lens costs, which are considered upgrades.

Answer: This is generally a fraudulent scam where the caller is trying to get your personal information. Medicare agents can not call people without their permission. There are some Dual Special Needs Medicare Advantage plans that offer funds for healthy groceries, but you have to qualify for those by income and assets. People should not talk with cold callers who use this bait and switch tactic.

Answer: Do I need to sign up for Medicare when I turn 65?

Large Employer: More Than 20 Employees

Generally, if you have job-based health insurance through your (or your spouse’s) current job where the employer has more than 20 employees, then you don’t have to sign up for Medicare. You can wait to sign up until you (or your spouse) stop working or you lose your health insurance (whichever comes first).

Small Employer: Less Than 20 Employees

If the employer has fewer than 20 employees: You might need to sign up for Medicare when you turn 65, even when still working, so you don’t have gaps of creditable coverage and incur Part B and Part D Penalties. Check with the employer.

If you have COBRA Coverage

Sign up for Medicare when you turn 65 to avoid gaps in coverage and a monthly Part B late enrollment penalty. If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up.

Answer: If a person calls and pretends to be a relative and wants personal information on one of our clients, we require a signed POA and to have the client on the phone to agree to let us share information.

Answer: When we advise a client of plan options, we have reviewed their needs first, then looked at their doctors and prescription list, as well as the plan benefits. Then the client can choose from the best top options. We work with the client, and there is no obligation and no cost for our services.

It's rare, but now and then, a client chooses a plan just because.... could be that they like the carrier name, could be that one benefit outweighs all of the others. It could be price.

We will help them get signed up with whatever plan they want, and we are always there to help them in the future if they need it.

Answer: Sannes Insurance is a Licensed, Independent Agency that has brokers. Currently, we represent 1​6 health​ carrier organizations that offer 97 Medicare Insurance products in your area.

Medicare brokers represent you by comparing plans from multiple insurance companies to find the best fit, while agents (specifically captive agents) typically represent only one company. Both are licensed, free to use, and paid via commissions by insurers, but brokers offer a broader, unbiased choice of Medicare Advantage, Medigap, and Part D plans.

Medicare Broker

Representation: Independent; works for you.

Options: Offers plans from multiple, varied insurance companies.

Best for: Someone wanting to compare many options to find the best price and coverage.

Role: Acts as an intermediary to research and suggest the best plan, then helps with enrollment.

Medicare Agent

Representation: Captive; represents one specific insurance company.

Options: Limited to the plans offered by their employer.

Best for: Someone already loyal to one specific company.

Role: Sells you their company's products and handles the enrollment process.

Key Takeaways

Cost: Neither brokers nor agents charge you a fee; they are paid by the insurance companies.

Independence: Brokers are generally more independent, while agents are tied to one carrier.

Advice: Both can assist with finding the best plan, but brokers can offer more choices.

Answer: Mark Sannes, CPCU – Your Trusted Spokane Valley Medicare Expert

Making Sense of Medicare: Step-by-Step Guidance

Hello! I’m Mark Sannes, a seasoned Medicare insurance agent and Certified Property & Casualty Underwriter (CPCU) based right here in Spokane Valley, WA. With decades of local experience, I don’t just sell plans; I help my neighbors in Spokane Valley, Liberty Lake, and beyond navigate the overwhelming "Medicare Maze" with clarity and confidence.

Why Work With Me?

Local Roots & Trust: My wife Sandi and I have been part of the Spokane insurance community for over 30 years. When you meet with me, you’re working with a neighbor who understands the local healthcare providers and options.

The "Step-by-Step" Approach: I know that Medicare is complex. I take the time to understand your unique health needs and budget, and I walk you through Original Medicare, Advantage Plans, and Supplements so you feel empowered to make the best choice.

Independent & Unbiased: As an independent agent, I work for you, not a specific insurance company. I compare plans from national and local carriers to find the best fit for your situation.

No-Cost Consultations: My services are completely free. I am here to educate, not pressure.

Whether you are turning 65, retiring, or reviewing your coverage during AEP, I am here to simplify the process.

Let’s Get Started!

Call my office today to schedule a personalized appointment—in-person at our Spokane Valley office or over the phone—and be sure to mention you found me on Medicare Agents Hub!

Office: Sannes Insurance, 100 N Mullan Rd, Suite 101, Spokane Valley, WA 99206

Contact us.