Melanie Baxter Black, Medicare Insurance Agent

About Me

Some things about me

MELANIE BAXTER BLACK

• I have been in the insurance industry for 14+ years.

• I am a proud Native East Texan. My family has been in Texas since 1836 when Texas was its own country!

• I am a 14+ year colon cancer SURVIVOR and a 7+ year Trigeminal Schwannoma brain tumor SURVIVOR. I have learned through very personal experience how not having adequate or appropriate insurance can negatively impact your health, health treatment and your recovery.

• My calling in life is to help people.

• I am an avid Senior Advocate. I help educate people and help them understand the importance of all types of health and life insurance. I also educate people about programs available to them and assist them in applying for these programs, i.e. Extra Help program, Medicare Savings program, etc.

• I am committed to helping my clients choose the best insurance coverage for their specific situation both health-wise and budget-wise. I believe that no one should have to spend every last penny they have to pay for insurance coverage. Insurance coverage should provide security and help to increase the quality of one’s life, not detract from it.

Get in touch with Melanie using this form

Q&A with Melanie Baxter Black

What are the reasons why I should work with a Medicare agent?

Answer: Having a Medicare Agent adds another level of protection for you, the Medicare client. Your Medicare Agent should provide you education, guidance and be your Senior advocate for you during your Medicare journey.

What's the most frustrating misconception you have to clear up with clients about Medicare every year?

Answer: The most frustrating misconception that I have to clear up with clients about Medicare every year is that ALL Medicare Advantage plans are bad. This could not be further from the truth. If you have a Medicare Agent worth his weight in salt, the Agent will educate you about all of your options i.e. Medicare Supplements with a Part D plan -AND- Medicare Advantage plans, and explain to you the advantages and disadvantages of each and how it applies to your specific situation.

I'm turning 65 next month and the amount of Medicare mail I'm getting is overwhelming. How do I sort through all this?

Answer: The best way to "sort through all this" is to find an Independent Insurance Agent that you can trust to guide you. An Independent Insurance Agent is contracted with different carriers and can shop plans for you instead of being beholden to one company like "captive" agents. You will also be able to contact your trusted Agent after the sale for help with questions and issues, shoud they arise.

Does Medicare cover hearing aids, or do I have to pay out of pocket?

Answer: It depends on the plan that you have, but generally speaking, you will have to pay a copay per hearing aid, per ear for a specific time frame which is usually per year or every two years.

I'm on Medigap Plan G, and I'm curious how my upcoming knee replacement surgery will be billed. Does the plan cover it all after my deductible?

Answer: The only out-of-pocket expense you should have on a Medicare Supplement Plan G, apart from your monthly premium, is your Part B Medicare annual deductible. After your annual Part B deductuble is met, anything hospital or doctor related is covered at 100%

How will the new 2025 Medicare Part D out-of-pocket cap impact seniors and prescription drug costs?

Answer: Many people on Medicare have high prescription drug costs, especially those with diabetes, heart issues and COPD. Weekly injections for diabetes control, blood thinners and inhalers are inherently very much needed for treatment and very costly. Some of these drugs retail costs can run into thousands of dollar monthly.

A littel history to consider, until January 1, 2025, patients were subject to the prescription "gap" or a.k.a " the donut hole". Once you were in the "donut hole" you had a large amount of out-of-pocket expense until you reached the catastrophic phase of the prescription drug coverage where your costs were reduced significantly. Some, made it through the "donut hole" by the end of the year while others did not. If you happen to be one of those people who hit the donut hole in past years, this $2,000 annual out-of-pocket expense cap will MOST DEFINITELY HELP YOU. Thankfully, the prescription "gap" or a.k.a " the donut hole" is no more as of January 1, 2025.

The annual $2,000 cap on out-of-pocket prescription drug expense is a cap or ceiling on your total out-of-pocket prescription drug expense. This cap ensures that should you reach the $2,000 out-of-pocket prescription drug expense maximim during the year, you will owe nothing more. Any prescription after you have reached the cap is at no cost to you.

Another great option that was implemented in 2025 is a payment plan provision for your prescription drugs. If you cannot afford your medication at the time of pickup, you can opt-in for the payment plan provision. This is an all or nothing provision. If you opt-in, you opt-in for the entire year and it will include ALL of your prescriptions. You cannot pick or choose which prescriptions are added. A monthly statement will be sent to you for payment. Payment is expected monthly and the balance must be paid-in-full by December 31st of each calendar year. They will not allow a roll over balance into the next year.

How to know if a Medicare agent is legitimate?

Answer: You can look up any licensed Agent in the State of Texas visiting Texas Dept of Insurance website:

https://txapps.texas.gov/NASApp/tdi/TdiARManager

This will show you if the agent is active, currently licensed and what insurance companies they are contracted with.

What's the cheapest way to get Medicare coverage if I only need basic hospital care?

Answer: Medicare Part A is for hospitalization. It generally does not have a monthly premium. You can simply have Part A for basic hospital care but you must realize that there is a hospital deductible that must be paid per each 60 day benefit period as well as co-insurance. You are required to have a Part D prescription drug plan when you become eligible for one and you CAN purchase a Part D plan with only Part A Medicare. In order to purchase a Medicare Supplement or a Medicare Advantage plan, you must have BOTH Part A -AND- Part B Medicare. Part B is for doctor/medical coverage outside of inpatient hospitalization. Part B Medicare has a monthly premium as well as annual deductible and co-insurance that must be paid.

I've had the same Part D plan for years, but this year my insulin shot up in price. Did the Inflation Reduction Act not fix this yet?

Answer: The Inflation Reduction Act ensured that Medicare beneficiary would an annual $2,000 maximum out-of-pocket expense. For purposes of the payment plan, the year begins on January 1st of each year and ends on December 31st of each year. The Inflation Reduction Act provides an optional payment plan that would allow you to get your medications without payment at the pharmacy at the time of pickup. You would receive a monthly billing for all of your copays for payment up to the $2,000 annual maximum out-of-pocket expense. You have until December 31st of each year to pay it off. Once you opt into the payment plan, you cannot opt out for that year -AND- ALL of your prescriptions are included in the payment plan. You may not pick and choose which presctiptions you want on the payment. Prices of your insulin are decided on by the Part D presctiption drug plan carriers. The Inflaction Reduction Act does not affect individual drug pricing.