Michael Pyers, Medicare Insurance Broker
Michael Pyers
Health Insurance Options LLC
Medicare Broker Licensed in OH and MI
20+ Years of Experience
Contact Details
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Location
Mansfield, OH
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Phone
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Website
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Facebook
About Me
Greetings! I'm Michael, a Medicare insurance agent dedicated to serving your local area since2005. Medicare is my area of expertise, and I'm committed to helping you pinpoint the most suitable plan for your individual needs and budget. I'll handle the research and comparison of plans from top national and local companies, so you can relax. Plus, my assistance comes at absolutely no cost to you. Reach out to me today to discuss your Medicare insurance possibilities, and remember to mention you found me through Medicare Agents Hub!
Directions to My Office
Q&A with Michael Pyers
What benefits are there to working with a Medicare Agent near me vs remote/virtual?
Answer: None- We are always a phone call away. We have regular business hours and over 20 years of experience in the Health Insurance industry. We interview you to determine what type of insurance you plan is in your best interest.
Are Medicare Advantage plans really "free," or is that just clever marketing?
Answer: They are not free. You have to pay copays for just about everything and sometimes have a very large out of pocket! So, if you never get sick, they might be a money saver - God forbid if you develop a major illness!
What do you enjoy most about working with Medicare clients?
Answer: Working with people who are similar age to me and hold the same values. They are smart enough to figure out that they are working with someone who has the same values. You don't have to tell them you are honest- just let your light shine and they are smart enough to figure that out for themselves!
Will I be penalized if I do not enroll in Medicare when I turn 65?
Answer: Depends, If, you work for an employer that has more than 20 employees and coverage as good as Medicare. That would be considered Creditable coverage, and you could hold off until that coverage ends. However, if you have 40 quarters of paying into Medicare, it would be wise to go ahead and sign up for part A since there would be no premium.
Am I eligible for a Special Enrollment Period if I lose employer coverage?
Answer: Yes. As long as you had creditable coverage that ended. You have 60 days to elect Medicare. At which time you could enroll in an Advantage Plan, Medigap plan and Part D Plan.
If a senior is turning 65 but still working, should they enroll in Medicare or delay it?
Answer: They can delay enrollment in Medicare A and B as long as they are working for a group of 20 or more people and the employer coverage is a good as Medicare. However, we always recommend that they go ahead and enroll in Part A.
What is one of the the most common misconceptions people have about Medicare?
Answer: That they feel that Medicare is tied to Social Security and that they cannot enroll in just Medicare. They feel that if you have Medicare then you have to collect Social Security also.
How does life insurance contribute to financial planning?
Answer: By passing they face amount to your spouse, children, etc. tax free.
Financial Security, the ability to borrow money on the policy.
Does Medicare cover eye exams, or are seniors left paying too much?
Answer: Medicare covers medical procedures for your eyes. However, Medicare does not cover routine eye exams. Usually in this area $40-50
What's an underrated benefit of Original Medicare that many people overlook?
Answer: No network on Medicare you can see any healthcare provider as long as they accept Medicare. With an Advantage Plan you have a network of doctors. If you have an HMO, you can only see the Doctors on the Plan or you pay then entire bill.
Which Medicare Supplement plan (Medigap) offers the best value for most seniors, and why?
Answer: Plan G is the top of the heap for current enrollments. However, you can save $ by choosing a plan N.
What are some ways to ensure your parents feel supported during the Medicare decision-making process?
Answer: Careful planning to make sure that the Medicare Recipient has the best fit for their needs.
We have software that shows carriers current rates, history of rate increases, Planned rate increases and the Carriers Medical Loss Ratio, which could signal a coming rate increase.
Financial rating of carriers are only a part of the equation have seen Carriers that are rated A with a negative outlook. Watch out!
What additional coverage options are available for international travelers?
Answer: Some Plans offer Foreign travel. You have a $250 Deductible and then it pays 80 percent until the maximum of $50,000
Do I have to answer health questions when switching from one Supplemental/Medigap plan to another?
Answer: You have to answer health questions if you move from one Medigap plan to another. However, you can switch any month of the year as long as you meet the health requirements.
What happens if I am already retired and collecting Social Security when I turn 65?
Answer: Then you will automatically be signed up for Medicare. Your Social Security check with have the part B premium withheld from the check you are receiving. Unless you qualify for the extra help available for people with lower incomes and assets.
Why did I receive a Medicare Summary Notice, and what should I do with it?
Answer: Check it over to make the charges are for services you received. The notice will also show if you owe anything. Such as your part B deductible no being met yet.
What is the biggest disadvantage of Medicare Advantage?
Answer: Tied to a Specific network of Physicians and Facilities. Must get approval from the plan for some procedures. Such as an MRI.
What's one Medicare decision that too many people regret later?
Answer: Signing up for an advantage plan and then becoming ILL. The out of pocket costs are sometimes staggering. In fact we have had clients call the Disadvantage Plans!
If I move to a rural area, how might that limit my Medicare Advantage plan options?
Answer: Limited Physician and Hospital Network. Some Plans might not have the same benefits due to the reimbursement the plans get from CMS. So, benefits not as good as larger metro areas.
What's the difference between a Medicare broker and a Medicare agent?
Answer: Agents normally only contract and represent only one carrier.
Brokers handle more plans and give you more options.
Using the Medicare Name is not permitted, especially if you represent yourself as being a representative of Medicare.
I'm turning 65 soon, when can I enroll in Medicare?
Answer: 3 months before your 65th birthday. And up to 3 months after. You may delay enrollment if you have a job that gives you creditable coverage if you want to delay signing up for Medicare. Normally if you are receiving Social Security you will be signed up automatically.
My Medicare Advantage plan denied coverage for a specialist I need to see. What are my options now?
Answer: You can file an appeal with the plan. If all else fails, you can contact the Dept of Insurance in your area. Also, you can report the plan to CMS Quality Improvement Organization at 888-524-9900.
What's a red flag in a phone call that it might be a Medicare scam targeting my personal info?
Answer: For one thing, making unsolicited calls to a Medicare recipient is against the law. Per CMS regulations. And Ohio revised code 3901-8-09.
I'm worried about the 'donut hole' in my Part D plan. How do I manage my medication costs once I enter it?
Answer: The doughnut hole was eliminated in 2005 by the Inflation Reduction Act. The maxumum out of poket is now $2000. After you reach the $2000 limit your covered Medication will be a zero cost share. Also, you can request to make monthly payments on the $2000.
If I need hospice care in the future, can my Medicare plan cover it?
Answer: It is covered by part A Medicare. Patients must have life expectancy of 6 months or less. It is for palliative care only. Not for clinical care to cure.
My doctor prescribed physical therapy, but I'm not sure how many visits Medicare will cover. How do I find out?
Answer: It is determined by medical necessity that the patient requires. However, after around $2400 of therapy the physician must submit proof that continued therapy is necessary.
I chose Original Medicare to keep my doctors, but now I'm drowning in bills. Should I have gone with Advantage instead?
Answer: Actually, a Medigap plan might have been a better fit for you. Once you have met your Part B deductible, you would be done paying for Medicare Approved services. However, now if you have certain pre-existing conditions, you may not be able to sign up for a Medigap plan.
What's the financial risk of sticking with Original Medicare without a Medigap plan?
Answer: There is no maximum out of pocket for straight Medicare. You would have to pay for a Medigap Plan, but it seems like pay me now or pay me later.
So my friend told me I should just go with the cheapest Medicare plan. That sounds too simple - what am I missing?
Answer: Not that simple. So many things to consider, network, co-pays, maximum out of pocket. If it seems to good to be true, it probably is.