Mel Stevens, Medicare Insurance Broker
Mel Stevens
I-Pros
Medicare Broker Licensed in AZ
6+ Years of Experience
Contact Details
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Location
Scottsdale, AZ
About Me
Medicare can be very confusing with all the rules, options, plans and benefits available and not everybody's needs and wants are the same. I specialize in assisting residents with addressing Medicare questions and ultimately finding the best plan that meets your needs. Call or email today if you have any questions regarding Medicare options and benefits or if you would like to review your current plan. I'm not just a voice over the phone or e-mail we can meet in the office or in the comofrot of your own home.
Directions to My Office
Q&A with Mel Stevens
Are there any tax benefits tied to paying Medicare premiums as a retiree?
Answer: Medicare premiums can be tax deductible if 2 requirements are achieved. Number #1 medical expenses must exceed 7.5% of Adjusted Gross Income (AGI) and if you itemize your tax deductions.
Can I keep seeing my current doctors if I switch to a Medicare Advantage plan, or do I have to find new ones?
Answer: When it comes to Medicare Advantage plans, there are many different providers and usually many different plans available per provider. If you are thinking about switching plans, it's important to review the plan and make sure your doctors, specialists and medical facilities that are a must keep are available within that plans network. When researching, be very cognizant of the particular plan. For example, Doctor X may be in network with United Medicare Advantage HMO plan 1 but may be out of Network with United HMO plan 2. In addition, there are many additional options like dental and vision that can vary widely along with wide ranging co-pays and max out of pocket limits from one Medicare Advantage plan to another. When it comes to making sure you make the right decision for yourself and it's important to sit down with a professional to review your options and benefits. It's doubly important if you are seeing a primary doc or specialist that you absolutely must keep in network!
How will advancements in wearable health tech (like smartwatches) integrate with Medicare?
Answer: Currently there isn't much integration with Medicare and items like Smart watches. Smart watches already have the capability of tracking exercise routines, blood pressure monitoring and pulse rate activity. What I see in the future is Medicare companies integrating with Smart Watches and Smart Phones to assist with monitoring health activity and providing incentives for meeting goals and completing tasks.
What is the biggest mistake seniors make when enrolling in Medicare?
Answer: When it comes to applying and enrolling into Medicare, there are many mistakes that can be made. Questions about when to enroll and what type of plan to enroll into is a big decision and often there isn't a lot of information available to make an informed decision. One of the biggest mistakes I have found with Medicare is when and insured signs up for Part B, there is a 60 day window to sing up for Part D, (the prescription drug plan). If a prescription drug plan isn't selected within a 60 day window, Medicare will penalize you for the rest of your life.
What's the best way to compare my current Medicare supplement plan to a Medicare advantage plan?
Answer: The best way to compare your Medicare Supplement plan with a Medicare Advantage plan is to physically sit down face to face to discuss and compare options and benefits because there is a lot to discuss regarding the topic. Many people like the Medicare Supplement plans because it's an open network meaning virtually every provider across state lines accept a Medicare supplement as long as they accept Medicare as payment. Medicare supplement is a very good option for snowbirds that have a second home where they live half of the year. Medicare Advantage plans are network and generally county based and in general your network resides in the state of your primary residence. That being said, if you are visiting Aunt Mary and Uncle Bob and have an emergency out of network, you will still have effective coverage. Some networks are larger than other based on the plan and provider. Medicare Advantage plans are either (HMO) Health Maintenance Organization or (PPO) Preferred Provider Network. Some Medicare Advantage providers have a passport program that would allow in network coverage if you were to travel outside your state for a prolonged period of time. The Medicare would just need to be notified ahead of time. Open Network plans with Medicare Supplement plans are nice but insureds will pay a premium for the flexibility. In addition, in general Medicare Supplements cover medical care but no extras. Prescription drug plans, dental, vision, hearing and other benefits aren't available with a Supplement plan. Medicare Advantage plans may not have as much flexibility; however most plans are at a zero monthly premium and in general they also have additional benefits such as Dental, Vision, Hearing, OTC card and other various benefits attached.
How do you educate clients who are completely new to Medicare?
Answer: The best way that I educate clients who are new to Medicare is having a meeting face-to-face. I can speak with them over the phone, during a Medicare 101 event or through something like zoom. Choosing the right Medicare plan and making sure all the I's are dotted and all the T's are crossed, face-to-face is best.
What do I need to do if I didn't take Medicare at 65 and am now retiring?
Answer: First of all, congratulation on retirement, you deserve it! The first 2 important item are Medicare Part A and Part B. In general, as long as you worked for 10 years or 40 quarters, Part A which is hospital coverage should have already been issued, even if you were still working. You must apply for part B. You can contact Medicare by calling or stopping by the local Medicare or Social Security office. If you are a little tech savvy, I believe the option with the least hassle or most efficient would be to visit on-line and complete a Part B application at: https://www.ssa.gov/medicare/sign-up/part-b-only. For most Medicare recipients, in 2025, Part B will cost $184.70 a month with a higher sliding scale depending on income. Once you receive you part B effective date you will have 60 days to sign up for a prescription drug plan. Do not delay on signing up for prescription drug plan. Be aware if you pass the 60-day window, Medicare can penalize you for the rest of your life! Along with Part A and B you should also explore the option of Medicare Supplement or Medicare Advantage plan to give you additional coverage where Part A and B do not.
I'm turning 65 in three months but still working with employer coverage. Do I need to sign up for Medicare right now or can I wait?
Answer: As long as you are working and your employer medical insurance plan is considered creditable coverage then you don't necessarily have to apply for Medicare Coverage. In general, what will happen is Medicare Part A will automatically become effective once your turn 65 whether you are still working or not. When getting close to age 65 while also working you should do your due diligence and compare your Medicare options, benefits and costs with your employer plan to ensure you are getting the best plan at the most competitive rate that provides the care you need. Sometimes the employer medical insurance is the best option and other times Medicare is the better option.
Can you explain what "creditable coverage" means and when it applies?
Answer: Creditable coverage is Medical Insurance coverage you have through your employer. When you approach age 65 and beyond and still working hard, you have the option to either activate your Medicare coverage or keep the coverage through your employer Medical Insurance plan. Keep in mind that most plans set in place, especially with larger employers or government entities are creditable plans. However, it's always good to double check with your employer. The Human Resource Department is a good place to verify.
I'm confused by all the star ratings for Medicare plans. Do they actually mean anything for the care I'll receive?
Answer: Star ratings are based on items like customer service, paying claims on time and overall customer care. Star ratings range for 1 to 5 with 5 being the highest. The higher the rating, the greater the reimbursement from the government to fund the benefits offered to clients. Therefore, it behooves all Medicare Insurance companies to achieve a 5-star Medicare rating. One extra bonus with 5-star plans. If there is a 5-star plan within your area, an SEP or special election period exists where you can enroll into the plan throughout the year.
I'm a green card holder who's been in the US for 4 years and turning 65 soon. Am I eligible for Medicare?
Answer: Original Medicare has 2 primary components. Medicare Part A which covers items like Hospital Visits and skilled nursing, Home Health care and Hospice Care. Per Medicare guidelines in order to be eligible for part A you must have worked 40 quarters or 10 years in the system with the U.S. In general, there is no premium paid for Part as long as you meet those guidelines. However, you could be eligible for Part A at age 65 but you will have to pay a premium for the Medicare coverage. Medicare Part B covers all of your doctors / specialist visits, outpatient surgeries, durable medical equipment, lab work, Cat Scans, X-rays, etc. Depending on the situation you may be eligible for Part B but you would have to pay a premium for the coverage.
Why are people leaving Medicare Advantage plans?
Answer: In my opinion, there aren't a lot of people leaving Medicare advantage plans. In fact, I see the opposite as many people are switching from Medicare supplement plans to Medicare Advantage. Medicare Supplement are good but in general they do cost more money out of pocket because there is a monthly premium that needs to be paid. In addition, if a Medicare recipient would need to pay additional money out of their pocket if they needed benefits such as dental, vision and hearing. Medicare Advantage plans have additional benefits included where Medicare Supplement plans may offer discounts but do not have full ancillary benefits available. Those costs can start to add up quickly in this current day and age where inflation is taking a toll on all of us. In addition, Medicare supplement premiums will increase from year to year as well. Be aware, if you decide to switch form a Medicare supplement plan to a Medicare Advanta age and decided that you want to switch back, medical underwriting will be required. If you develop major health issues, then you may not qualify.
I went with Medigap because I travel a lot, but now I'm paying a fortune in premiums. Did I make a mistake?
Answer: Medigap policies can be expensive. Keep in mind that coverage would be in effect if you have an emergency when traveling and holding a Medicare Advantage policy as well. However, if you need ongoing medical care while traveling a Medigap policy is probably the right decision even though the cost may be higher. The question is how much do you travel, how long are you in a particular location at one time and how much medical care do you need? If you travel to a particular location for a period of time like a few months, there are some Medicare Advantage providers that offer a passport option where you can transfer coverage to that particular location as long as they are notified ahead of time. If you are thinking about this option, it's always a good idea to verify coverage protection with the Insurance carrier in the other location you plan to visit.
I called to ask about a knee replacement and suddenly they said I need prior authorization. I thought my plan was supposed to be good-what's going on?
Answer: Medicare plans are good plans and prior authorization is a standard for many procedures in this day and age. Many procedures require prior authorization because they are costly and the insurance carrier needs to complete due diligence to make sure procedures are medically necessary. This helps keep insurance rates and benefits within the plan to remain competitive for all.
My doctor prescribed physical therapy, but I'm not sure how many visits Medicare will cover. How do I find out?
Answer: Every plan is different. Details regarding items such as how many physical therapy sessions are covered and co-pay charges if any should be specified. If the summary of benefits is not available, call the customer service number on the back of your insurance provider card. When discussing with a customer service representative you can also request to have the insurance provider e-mail or send a copy of your summary of benefits upon request.
Don't you think Medicare's focus on treatment rather than prevention is backwards?
Answer: I don't think Medicare is based on treatment versus prevention. In fact, I believe the opposite is true as Medicare plans will provide incentives for items like completing an annual exam, lab work, cancer screenings etc. I believe docs are on the same page as they want healthy patients also. If you want to keep up on health maintenance and get incentivized for doing so, then make sure you are aware of benefits your plan offers.
When it comes to treatments, that depends on the philosophy of the doctor and the facilities which you visit. Some docs will recommend a treatment or for example a surgery that sometimes may not be medically necessary. If a particular treatment or especially an evasive procedure is recommended by a doc, it's always a good idea to get a second opinion. Especially if you are second guessing in your head whether or not it's necessary or perhaps there may be a better solution. A few years back, a doc recommended a leg amputation up to his knee for one of my clients. He decided to get a second opinion and guess what, today he's walking around with both feet.
What's the biggest mistake seniors make when choosing a Medicare Part D plan?
Answer: By and far the biggest mistake is not electing Part D in a timely manner! Once you receive your part B effective date, Medicare will give you a 60-day window to elect a prescription medication plan. If you exceed the 60-day window, Medicare can and will penalize you for the rest of your life. It's very important to know these rules which unfortunately aren't explained or conveyed very well. Even if you don't take any medications, you still need to sign up for a Part D prescription medication plan. There are various Part D plans available in each state. If you don't take any meds or just perhaps a couple generics, tier 1 and tier 2 medications, there are some zero premium Part D plan available in Arizona. Premiums and formularies vary from company to company and plan to plan. It's important to check the formularies to ensure your meds are covered and to calculate your expected medication costs.
I'm on Medicare but recently declared bankruptcy due to medical bills. How will this affect my coverage and options going forward?
Answer: In regard to claiming bankruptcy, Medicare coverage will remain intact. If you have a supplement that requires a monthly premium you are still responsible for making the premium payments or the policy could lapse. If the supplement payments are creating a financial strain, there are other zero Medicare Advantage options available. In addition, depending on income, there may be some extra help available to assist with paying for the Part B premium and lowering the cost of prescription medications. Also depending on Income, Dual Medicare / Medicaid plans available which offer some extensive benefits such as an additional food card.
I thought I signed up for both Part A and B when I got my Social Security, but now I'm getting bills for Part B. Did I miss something during the enrollment period?
Answer: Often when you sign up for Social Security people also sign up for Medicare Part A and Part B at the same time. If you sign up for Social Security at Age 66, then you more than likely were issued part A already once you turned age 65. In this situation it appears that more than likely you signed up. A card showing your effective date should have been sent in the mail and as we know, sometimes items get lost in the mail system. Contact Medicare as soon as possible to inquire about the status. There are various options. You could either stop down at the local office, call at: (800) 633-4227 or contact on-line at - https://www.ssa.gov/medicare/sign-up/part-b-only . It's very important to inquire about your effective date because you only have a 60-day window to sign up for Part D or a prescription drug plan once your Part B becomes effective. If you fail to sign up within that window of time, Medicare can and will penalize you for the rest of your life.
I don't understand how my friend pays nothing for their plan and I pay over $200-are these plans just totally random by ZIP code?
Answer: More than likely you have a Medicare Supplement plan and your friend has a Medicare Advantage plan. Medicare supplement plans require a monthly premium, whereas a very large majority of Medicare Advantage plans are offered at a zero - $0-dollar monthly premium. In addition, Medicare supplement plans also require purchasing a stand-alone prescription drug plan where most Medicare advantage plans combine the prescription drug portion all into one plan.
My friend gets SilverSneakers with her plan and I don't-how are we both paying for Medicare and getting such different stuff?
Answer: Most Medicare plans come with a gym membership through Silver Sneakers or through Silver and Fit and the majority of gym memberships are at $0 cost. Not all gyms are included so you will want to check with your plan provider on availability. Often times you can attend multiple gyms. For example, attend one gym for a spin or yoga class and stop by another gym to pump some iron. Double check your plan because a lot of insureds do have the benefit but are simply unaware it exits.
How can I verify if a Medicare Advantage plan's advertised benefits are legit?
Answer: Issues with Medicare advantage advertisements and solicitations. First of all, Medicare commercials viewed on television can be very misleading. Medicare advantage plans benefits will differ from state to state and even county to county. When an advertisement is aired on television, generally the company will ramble off the richest benefits available. The problem is that those benefits might not even be available in your state and you may not even qualify for the benefits stated on the advertisement even if you did live in that particular area. Usually the benefits are referring to and Medi - Medi or rather a Medicare / Medicaid plan. Some people do qualify for the Medi - Medi plan but its income based.
In addition, there are a lot of Medicare scams. Scammers call people all day long stating they have a plan with a lot of benefits like a food and gas card. Those benefits are available with some plans but the scammers don't care. They just want your information. What they are looking for is people with the older Medicare cards that actually have your social security number as your Medicare number. The scammer will ask you to verify your number, your date of birth and often your address as well. At that point they will have enough information to pull a scam. The cards switched from social security number to an actual code about 5-6 years ago. If you have an old card, contact Medicare to have them issue a new one. Once you receive your new card, destroy the old one.
There are many Medicare plans available and to make sure you are in the best plan based upon your needs, I feel it's always best practice to sit physical sit down with a Medicare specialist to review plan. The problem when people enroll over the phone, people are usually talking with a representative that only represents one company. Often during phone consultations, the rep fails to list your primary doc and fails to double check to make sure all of your specialists are in network.