Matthew Moreno, Medicare Insurance Broker

Answer: Networks, networks can change at any time of the year but you can't change coverage at any time of the year so this is the first and main issue.

Prior Authorizations also known as PA or Prior Auth is there to protect people and insurance companies from unexpected waste from the provider. However there are times in history where the insurance company's will tend to require the doctors approval for something and the doctor will have to speak to the insurance company's doctor and then try to sort out something. It's a complicated mess that makes the person feel as if the insurance company is denying coverage. From time to time I wish that Prior Auth was not a thing.

Formulary's, sometimes after a year or so certain Medicare Advantage plans may not cover all prescriptions someone has for the year or change formulary's the next year. This tends to get tedious but even if someone was on a part D only plan this would still occur.

Answer: I believe it will help for us to understand and diagnose a condition earlier to keep health insurance costs low both for medicare supplement and medicare advantage plans.

Answer: You will have Guranteed Issue upon losing Cobra coverage. You are able to use the Special Election Period to enroll into a medi-gap/Medicare Supplement Plan without Underwriting!

Answer: Theres pros and cons to each one. You tend to prefer a more open network and no prior authorization requirement for medicare. As long as a doctor accepts medicare they accept you're plan. More doctors tend to accept medicare than a Medicare Advantage Plan.

Answer: The insurance company is only going to offer what they offer. Every insurance company and plan is not created equal. Some plans don't cover certain prescriptions while others do. Along with doctor concerns as well. Going with an agent that represents more than 1 insurance company is going to allow you to see the plan that fits you're needs.

Answer: I am not a tax advisor. Please consult a tax specialist for this question we as agents are not allowed to answer tax related questions.

Answer: Traditionally it's going to be covered by you're PDP if it's done at a pharmacy and you're Medicare Advantage or Medicare if its done at a medical office. Usually Prescription Drug Plans Are going to be covering prescriptions that are considered recommended for adults and shingles is one.

Answer: So medigaps are regulated by the state level and not by medicare or medicaid services. So that means that the insurance company's assuming there is no guaranteed issue reason such as a life event are allowed to do underwriting and deny you for medigap coverage by them. A good idea is sometimes to ask the agent is there any guaranteed issue medigaps in my area? In some cases there are and in others there is not.

Answer: It sounds like to me you're friend is under a Medicare Advantage plan and you are under a medicare supplement plan. medicare advantage plans are plans that have a 0 dollar premium usually however you pay for the cost with medical copay's or coinsurance and you are exposed to the carriers network for it's doctors usually. With a medicare supplement premium plan you are paying for the premium in advance of medical costs. You are subject to Medicares network which is traditionally bigger than a insurance company's network.

Answer: It's going to allow insurance companies to help with bettering you're health and to track you're daily progress with exercise. Some insurance companies rewards you with benefits for exercise. This can help you and the insurance company together. It's a win, win on both sides.

Answer: You may have to choose a new hospital if it's for doctor visits or specialists. However for a HMO Medicare Advantage Plan you can visit an out-of-network provider in the event it's an emergency.

Answer: Yes and no. As long as you check for the keyword "education" it is not a sales pitch and is just there to help you with educating you. However if its a seminar that does not say its a education seminar and you call them and they tell you it's not then it's kind of a sales pitch of there policys. We as agents want to educate as many people as possible to build a relationship and to help the community. Yes we do make commission for each policy sold, however you are not required to participate in calling us.

Answer: You could try to do discount drugs like good rx or clever rx for prescriptions in the meantime. Another option is by going to the manufacturer and let them know and they might be able to give you a discount as well.

Answer: A hospital indemnity plan is meant to fill in the copays associated with hospital stays. You would be paying a relatively high copay per day in the hospital. I'd always recommend a hospital indemnity plan for my clients. However it is still in there own hands if they wish too.

Answer: no. Maybe an hra you can use it for premiums depending on the employer. However an HSA no you cannot. You can use it for copays/coinsurances or deductible amounts.

Answer: It may feel like a mistake at first, however you are traveling a lot currently. Medigap Plan helps to cover you as you're traveling. Maybe the next idea should be to try going through underwriting for a better premium?

Answer: Usually medicare plans are individual coverage. It is going to depend on the employer. Please first call them and ask them if you can still keep the coverage if they specify no. Make sure to ask when the coverage ends. Before coverage ends reach out to a medicare health insurance agent/broker. Tell them the situation and they will be able to advise on what coverage to pick up so that way you do not have a gap in coverage.

Answer: I look at network first. If the Medicare advantage plan does not have there doctors then I go to medicare supplement. Next is I look at what my client values in terms of a plan. Do you plan to travel? Is the premium a concern you have for a medicare supplement plan? If no concern then I usually recommend a medicare supplement/medigap plan if they have a concern on network and prior authorizations.

Answer: If at any time you are unsure of trusting a medicare agent ask them for their license# from them. You can then call the state department of insurance and provide them with that license number and ask them if they are real or not for a licensed agent. This is the way I'd recommend without coming off rude.

Answer: When it comes to traditional medicare theirs a lot of gaps with it. Notably medicare part a has a deductible of of 1676 for the year and it's known as hospital insurance. When you start to go past a certain amount of days in the hospital or receiving care you start to have to pay a list of copays and coinsurances. medicare part b is known as medical. deductible is 257 yearly. Usual costs for services are 20% after the deductible

We start to notice a gap of 20% and additional copays so what we do is we pair a medi-gap plan. Also known as a medicare supplement plan. These plans fill in the gaps that medicare has.

Answer: When it comes to medicare advantage plans, instead of the government handling the paperwork, billing and etc. The insurance company handles these things. In return the insurance company gets an amount of money for covering you with health insurance from the government. When it comes to the amount that they get we as licensed sales agents are not told what the amount is. We would have to be in another department to know.

Answer: You have to show you're medicare advantage card. I am deeply sorry that you're provider does not take you're advantage insurance.

Answer: Yes, you will get an Annual Notice of Change letter every year assuming there is a change. Keep in mind if you are on a medicare supplement plan you will get a letter on you're renew date which is the month you enrolled into the plan for the first time.

Answer: I really like helping people with choosing there medicare plan options. being able to tell someone and yes we can switch you to another medicare supplement plan G to another carrier for 100 dollars difference is such a great feeling to tell a client. Another one was where I enrolled someone into a plan which gave them food vouchers at no additional cost to them. They received a voucher for food around 40-60 dollars per month. They told me they were behind on bills and was not sure on how to pay the electric bill next month. I also let them know if they want to use the card to pay for bills they can as well since it said in the policy they can use it for bills.

Answer: If you picked up a medicare supplement plan inside the united states. Usually medicare only covers inside the country of the united states on certain circumstance such as emergency situations you can submit in a claim to medicare to get back the money like a ppo plan but only in certain situations where the bills are in English. I always recommend my clients to pick up traveling insurance when going outside the united states.

If you are outside of the united states and are coming to the united states that is different but very similar. You will need to purchase traveling insurance. You're insurance from outside the united states does not come with you.