Mark Summers, Medicare Insurance Broker

Answer: Medicare Supplement plans also known as Medigap plans, do have specific windows in which you cannot be denied coverage. If you try to enroll outside of specific windows then you can be denied based on health questions. The most common guaranteed enrollment windows are; within 6 months of acquiring Medicare plan B. You are age 65 or older and left an employer health plan. Your Medicare Advantage carrier. ceases to offer plans in your area. Always check with your insurance carrier to find out if you have a guaranteed right to enroll.

Answer: Medicare Part A covers "inpatient" hospital care. Ask you medical provider if you are being admitted as an inpatient. You will be responsible for the Medicare Part A deductible ($1,736 for 2026) per admittance, however the deductible is all you owe for up to 60 consecutives days of inpatient confinement.

Answer: Typically i use a two interview process for those who are new to Medicare. The majority of the initial meeting is to help my future client understand core principles. How original Medicare works. How Part D works. How Medigap plans work with Medicare versus replacing Medicare with a Medicare Advantage plan. The second meeting is our decision meeting.

For those wishing to switch plans. We do a quick review as i fill in the gaps based upon their understanding. Once i am comfortable they understand the pros and cons of their decision; then we take action to "switch".

Answer: Medicare Advantage plan designs are approved on an annual basis. Each year the insurance company adjusts the plans benefits in an effort to remain solvent. Once approved, the plans copays, premiums, co-insurance, in-network out of pocket maximum, and other benefits and features are effective January first. if the changes are not satisfactory to their clients; a different Medicare Advantage plan may be chosen between 10/15 - 12/07 for effective date 01/01.

Answer: Medicare itself does not cover hearing aids. But some Medicare Advantage plans do cover a select set of hearing aids. I suggest you call your insurance company at the number found on your ID card. You will want to do this before purchasing your hearing aids.

Answer: If you have not aged into Medicare and are diagnosed with End Stage Renal Disease (ESRD). Medicare will typically begin the first day of the fourth month in which you have dialyses. If you are already enrolled in Medicare Part A and Part B, Medicare dialysis coverage begins immediately.

Answer: Your daughter can work with a Medicare agent or broker on your behalf, if two agreements are executed.

1) Your daughter must have legal authority to sign document's on your behalf.

2) Your daughter signs a Scope of Appointment form at least 48 hours prior to meeting with the broker.

Answer: For those who have email, I send a Medicare narrative to read prior to our meeting. I include third party hyperlinks for those who wish to self-educate. The purpose is to help them think of questions they need answered. I also use a written agenda at our first meeting, to make sure all issues are given ample time.

Answer: If agent does not help you understand the difference's between Medicare Supplement and Medicare Advantage. Agent should help you uncover the pros and cons of both products. A red flag exists if you are presented with one but not the other.

Answer: Providers of healthcare services (doctors, facilities, etc.) negotiate with Medicare Advantage insurers to determine how much the Medicare Advantage plan pays the healthcare provider for their clients medical services. The Medicare Advantage must balance how much they pay the healthcare provider for their insureds medical services; versus how much the plan receives per insured client. When either party, (medical community vs. Medicare Advantage plan) cannot balance the outgoing costs versus incoming revenue. The relationship is terminated. Either the plan closes, or the medical provider will not service the insureds of the Medicare Advantage plan.

Answer: A great resource available to all is www.medicare.gov

Answer: Create an account at www.medicare.gov. You can review all options yourself or with help from a broker or Medicare volunteer.

Answer: First step (During the Annual Election Period) is to go to www.medicare.gov to see what plans cover your specialty drug. Secondly, I suggest you visit the National Council on Aging website.

Answer: Medicare agents can identify nuances to mitigate risk the typical Medicare beneficiary may not be aware of. You pay the same for the plan whether utilizing and agent's expertise to guide you through the process, or purchasing a product directly from an Insurance company.

Answer: For those who can determine when they apply for Medicare Part B. Make sure your tax return from 2 years ago put you below the threshold before enrolling in Medicare Part B. Or if you had a life changing event that warrants consideration; you can request a new initial determination.