Melissa Roth, Medicare Insurance Broker
Melissa Roth
The Medicare Store
Medicare Broker Licensed in NM and FL
10+ Years of Experience
Contact Details
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Location
Rio Rancho, NM
About Me
I’m an experienced agent who loves untangling the Medicare confusion. My goal is simple: get you through the Medicare process in one piece and without tears!
I’m a Minnesota girl who’s lived all over — Pennsylvania, Florida, New Hampshire, and now New Mexico. The Land of Enchantment has become home, and I’m grateful every day that I get to experience its beauty.
I’ve been married to Steven for 27 years, and when I’m not helping people with Medicare, I’m busy trying to stay one step ahead of my cockatiels, Henry and Olive — two tiny, feathered masterminds who wake up every day ready to overthrow the government (or at least the household).
Q&A with Melissa Roth
Can I change my Medicare Part D drug plan during the Open Enrollment Period (OEP)?
Answer: You can change your Medicare Part D (D for drugs is how I remember it) during special circumstances like moving from one state to another etc. But there is really only once per year to change your Medicare Part D (prescription drug plan) and that is October 7th-December 15th.
OEP runs January 1-March 31 each year and is specifically for people who are currently on an Advantage plan and want to switch to another Advantage plan, OR drop an Advantage plan and pick up a Medicare Supplement and Medicare Part D plan,
Which Medicare Supplement plan (Medigap) offers the best value for most seniors, and why?
Answer: Plan N is the plan I will pick for myself and family. Covers everything Medicare leaves behind except; Medicare part B yearly deductible, a $20 copay for primary care or specialist visits, $50 copay for ER visits (waive if admitted to the hospital).
Yes, plan N does not cover excess charges, but in over 10 years of selling Medicare insurance I have never seen nor heard of a client ever getting billed an excess charge. Not saying they never happen, I'm sure some boutique Doc in Manhattan may charge a bit more, but they are very, very rare.
What do you like most about being a Medicare agent?
Answer: I love helping people untangle the confusing mess that Medicare has become. I always tell my clients "I promise not to make you cry". I get genuine joy when I explain the system and see a lightbulb go off when they finally understand it.
What is the biggest disadvantage of Medicare Advantage?
Answer: If you are in bad health and on a Medicare Advantage plan more than 1 year and you eventually want to go back to original Medicare and purchase a Supplement plan, you have to be able to pass each companies medical underwriting questions.
If you can't pass medical underwriting, you will be on an Advantage plan for the rest of your life and if someone needs lots of healthcare, that can get expensive on the yearly basis.
Am I responsible for an IRMAA surcharge?
Answer: Yes, each individual that incurs a charge is responsible for paying the amount. If you are receiving Social Security, it will automatically come out of your monthly check, If you do not currently receive Social Security, then you will be responsible for paying the IRMA charge directly to Medicare. You can pay by check, bank draft, or their self-pay system.
Does SilverSneakers come with Original Medicare, or do I need a Medicare Advantage plan?
Answer: Original Medicare will not provide a Silver Sneakers program, they just pay the 80% of medical bills. You can purchase a Medicare Supplement plan as more and more Supplement plan companies are offering some form of "healthy living" program that may include gym memberships, online classes, etc.
What are the reasons why I should work with a Medicare agent?
Answer: Honestly? You COULD do this on your own, but a GOOD Medicare agent will ask questions to get a better understanding of your needs and be able to point you in the right direction and get you enrolled in the plan that is best for YOU.
Sometimes people don't know the products well enough or even know what their current and FUTURE needs might be. A good agent can suss that out.
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: Every year companies that offer prescription drug plans may change their formularies (just a big name for the drugs they choose to cover). They may change which insulins they will pay $35 for. Some companies may move the insulin to a different tier, making the $35 price go up. Some companies even change their 'preferred' pharmacy list. If your pharmacy moved off the preferred list, your insulin could go up then, too.
I always advise my clients to check their medications every year on medicare.gov. Medicare.gov will list the best prescription drug plan for the upcoming year. October 15-December 7th is when you can make your plan switches.
If you are on an advantage plan, it will also tell you which advantage plan works best for your medication.