Misty Bolt, Medicare Insurance Agent

Answer: Medicare plans, particularly Advantage (Part C), offer many overlooked benefits beyond basic coverage, including monthly over-the-counter (OTC) allowances, free gym memberships (SilverSneakers), transportation to medical appointments, and, in some cases, meal delivery or pet care. Other covered services include acupuncture for chronic lower back pain, telehealth, nutrition counseling, and dental/vision care

Answer: No Medicare does not require a referral to go see a specialist. The specialist my require a referral but Medicare does not.

Answer: There are HMO plans that you can not go out of network. There are PPO Medicare Advantage plans that you do have the flexibility to go out of network, just may cost you more to go out of the network. PFFS plans that are not in TN.

Answer: Hi, I'm Medicare Misty with Medicare Minutes. Thank you for tuning in. I get a lot of questions, and one of the questions I got today is, I'm on Original Medicare with no supplement, and I'm wondering how much I'd pay if I need an ambulance ride to the hospital tomorrow.

So if you're just on Original Medicare, you would have the deductible, and then you would have 20% that you would have to pay, and there's no max out of pocket. So you want to make sure that you either have an Advantage plan that has a max out of pocket or buy a supplement that has just a one-time deductible of $257. But usually, it has a higher monthly fee than the Advantage plan.

But you need something because if something catastrophic happens, you're gonna be left with a big max out of pocket. So if you have questions or questions on that, I'm Medicare Misty and would love to help.

Answer: Hi, you've reached Medicare MISTy with Medicare Minutes, and I get questions all the time on Social Security. One of the questions I got today is, when my husband dies, do I get his Social Security in mind? Unfortunately, you don't. You get the higher of the two. So if he is a higher earner, then you would get his higher income, but you cannot have both. If you're the higher income, then obviously you want to take yours, but you would not be eligible for both. You could ask for a widow's pension to see if his is higher or if yours is. So whoever is the highest of the two, then you would get that. Great question. Thank you for tuning in to Medicare MISTy with Medicare Minutes. Hope you have a great day.

Answer: Hi, I'm Medicare Misty with Medicare Minutes. One of the questions I usually get is, what advice would you give to seniors who are feeling overwhelmed by the Medicare options available? I totally understand, because in some states, there are 40, 50 different, 72, I think 72 options just in one state. So I can see how it can be overwhelming. I've talked to a couple of people and asked, why didn't you reach out? Some are so overwhelmed they don't want to reach out, or they don't want to be sold. So I would ask for a referral from your friends, your parents, your neighbor, or anyone who has used somebody locally where they felt like they were educated, not really being sold to. I would love to be the one that you choose if that's the case, if you're looking for someone to educate you on the plan. Now, we all want to make a sale, because that's how we get paid. But we want to make sure we're making a sale once you understand the product that you choose. One thing good about me is I am a broker. So I do all the plans, and I don't have to say one's my favorite. I just put your medication in, your doctors, and it helps me figure out which is the best plan based on your doctors and your medication. Then I see what kind of benefits you want in with your plan. So reach out if you're interested.

Answer: Hi, I'm Medicare Misty with Medicare Minutes, and we have a Q&A. The question we have today is, how do I appeal a decision by Medicare or my plan if they deny coverage for a procedure or medication I need? That's a great question, and everybody should know how to do this. You can do it with Medicare at Medicare.gov, or you can call the plan directly and appeal it and file for a grievance through that. I would advise you to do it, and I think you have three times to file through the carrier and then through Medicare also. Sometimes it does take that long, which it shouldn't. I totally understand, but I'd also get your agent involved to help you if you're not getting anywhere. If you appeal it and it gets denied, I'd get your agent involved because that's what we're here for. Okay, I hope you don't ever have to go through that, but at least you know how to deal with it. Thank you for tuning in to Medicare Minutes with Medicare Misty. If I can help, please reach out.

Answer: Hi, I'm Medicare Misty with Medicare Minutes. I've been doing Medicare for over 20 years and I'm licensed in over 45 states. One of the questions I got is, do I need extra protection like critical illness insurance if I'm on Medicare? I don't think it could hurt because the critical illness will pay, depending on what benefit you choose—5, 10, 25, 50,000, or 100,000. It will pay you that lump sum of money to cover that critical illness. If you have a plan with a max out of pocket of 3, 4,000, or 5,000, whatever it may be, that critical illness policy could help pay for your max out of pocket. So your pocket expense. It could also help pay for hotel and transportation. I really think it's a good idea to have a critical illness policy if you can afford it. And I always say that if something were to happen, if you were to get cancer, you can't afford not to have it. Thank you for tuning in to Medicare Misty with Medicare Minutes. Hope that helps.

Answer: Hi, I'm Medicare Misty with Medicare Minutes, and you've reached out to our question and answer session. What benefits are there to working with a Medicare agent near me versus a remote agent or virtual? Based on this instance, I just remember the whole thing when we were kids, don't talk to strangers. Stranger danger. So I wouldn't want to give my private information to someone that I didn't know. If I had trouble or needed something, I know that I could go down there locally. When you deal with somebody remote or virtually, you don't have that capability of going to their office. If they don't answer the phone, sometimes it's even hard to get ahold of them. If they are virtual and remote, I always say shop locally. If you got a referral from someone that said, "I dealt with this person," then I feel like that would be a lot better to deal with someone that you got a referral from, like your best friend, your neighbor, or someone at the gym that you know very well. If this person was good, then you could do remote or virtual. But I would always do local if you can, because the local people know what your providers are, what the hospital does, and what the plans do locally. So thank you. Hope that helps. Thank you for reaching out to Medicare Misty in Medicare Minutes.

Answer: Hi, I'm Medicare Misty with Medicare Minutes. And today we've got a question on whether Medicare could ever adopt a tiered premium system based on lifestyle factors like smoking and not exercising. They have never talked about it, but I will never say never that that could happen. Right now it's based on income, so that's the only factor that kind of plays a part in that. And then, you know, paying into the system and how long you worked. But I would never say never because it depends on whose office and who's over Medicare. And thank you for joining Medicare Minutes. I hope that helps.

Answer: Hi, I'm Medicare Misty with Medicare Minutes, and thank you for reaching out today. One of the questions I get all the time, and one of my favorites, is: How do you educate clients who are completely new to Medicare? This is one of my favorites because I think I'm a teacher at heart. I use a Medicare 101 book, and it explains what Medicare A is, what Medicare B is, and what they cover. Once I explain what Medicare is, what they cover, and how much it costs, I go over the options of the two different paths you can take, whether it's a Medicare supplement and drug plan or a Medicare Advantage plan. Then I break those down based on what they are, and you make a decision on whether you want to go the supplement route, which is a little bit more expensive but has more coverage, or if you want to go the Advantage plan route that has more benefits. I break it down in more detail than I just did, but I make sure that you understand the ABCs of Medicare. Then you understand what the two options are, and we try to find what best fits you, what you have now, and what you don’t like. I try to make it as easy as possible because when I started 20 years ago, I remember telling someone, "I'm never going to understand this," and I'm so glad I didn't give up. So you have me as your expert, Medicare Misty. If you need more help, I'd be glad to break that down for you some more. Hope you have a great day.

Answer: Hi, I'm Medicare Misty with Medicare Minutes, and I've gotten several questions today. One of the questions is, "I have multiple medications, how can I ensure my Medicare Part D covers them all without breaking the bank?" That's a great question. I always tell my clients to come in with a list of your medications, the doses that you take, how many times you take them a day, and then which pharmacy you use. Based on that information, I'm gonna make sure that your prescription drug coverage is covered without breaking the bank.

One good piece of news is that for 2025, Medicare got rid of the donut hole. So what does that mean for you? It means that once you spend $2,000 out of your pocket, your prescriptions that are on the formulary of your plan are covered a hundred percent. That is great news, so you know that for the whole year, from January to January, you're only gonna be out $2,000 in the worst-case scenario. That's a great benefit that changed. Last year it was $8,000, so that's a big difference. That should help you a lot, but if $2,000 is still too much, they actually have a monthly payment plan where you can break that $2,000 down over a 12-month period to help you with that.

Also, we could try to look at generics, and we could also ask for help from the pharmaceutical company that makes your prescription. So if you still need help and $2,000 is too much for you, or you're not on a plan that provides that, then reach out.

Answer: Hi, it's Medicare Misty with Medicare Minutes. We are getting a lot of good questions today. One of the questions I got is, "My plan covered my cataract surgery, but not the lenses I actually needed. How do they get away with that?" That's a great question. They do cover basic lenses, but if you need a different lens, then you would pay a little extra for that. If you look at the total bill based on what they paid versus what you had to pay, it should be that they paid substantially more. But sometimes the lenses that the optometrist is selling are a little bit more progressive than what Medicare covers. Medicare thinks that the basic lens should be enough. The doctors always upsell the extra lens. Sometimes I've heard, "Hey, it was better, so glad I did it." And someone else said, "It wasn't worth it." But you do what feels good for you. Now, you may also be able to, if you have an HSA, use that card to pay for those co-pays through the HSA. Or if you have a Flex card that helps pay for co-pays on your plan, that may help you pay for the extra cost. Sorry for the extra cost, but they do pay a lot for the surgery, just not for the extra lens. Great question. Thanks for reaching out. I'm Medicare Misty with Medicare Minutes.

Answer: Good afternoon. It's Medicare Misty with Medicare Minutes, and it could be good morning, depending on where you are, or good evening, depending on what time you're logging in and seeing this. We get a lot of questions, and one of the questions we got today is, how can I select the right healthcare company and representative to work with? I love this question because I'm in over 48 states. So I can do basically any plans in those 48 states. But a lot of times it's better to go with local because local knows what your hospitalization situation is, knows what the provider situation is, knows which plans are better in that area. It does depend on what state you live in, based on how that plan is. The plan could be good in Tennessee, but in Georgia, it might not be such a good plan. So I would look at the years that they've been in the business. I would shop locally if you can. Then I would just look at the reviews of that agent, and maybe email them to see if you get a feel for whether you love what they respond with or check their website out. But do your research. I've been in the business for over 20 years, so I would love to help you.

Answer: Hi, I'm Medicare Misty with Medicare Minutes. We have got some great questions today. One of the questions is, what's one tip for balancing affordability and personalization when finding the best Medicare plans? That's a great question. I always ask my clients to come in with a list of your doctors, a list of your medications, what the milligram is, how many times you take it, and then what you want in a health care plan. We go over what you have now, what you would like to change, what you would like to keep, and then we just look at all the options based on what zip code you're in and what county you live in. It can make it easier if you have those things ahead of time written down and ready for your appointment. Great question. Thank you for joining Medicare Misty with Medicare Minutes.

Answer: Hi, I'm Medicare Misty, and we've got some great questions today. I'm Medicare Misty with Medicare Minutes, and one of the questions we got today is, what is Medicare Advantage and the three midnight rule? Medicare Advantage does not have the three midnight rule. What does that mean? If you're on original Medicare, not a Medicare Advantage plan, but original Medicare with the supplement, then you would have to be hospitalized three full days in order to go into a skilled nursing facility. But on a Medicare Advantage plan, they waive the three-day rule. So you don't have to be in the hospital three days before you can go to skilled nursing. They could directly put you into a skilled nursing facility. So that's a great question, and thank you for joining Medicare Minutes. Hope you have a great day.

Answer: That is very false! Medicare was made to cure you when you are sick. Medicare does not pay for burial or leave a legacy for your family!

Answer: They dont explain the difference between HMO and PPO plans. HMO means you have to stay in network and PPO means you have the flexibility to go out of network.

Answer: No Medicare covers rehabilitation in a nursing home. You need an long term care insurance policy to cover nursing.

Answer: Most plans cover tele-health for little to no copay. Make sure you tell your agent that is important to you.

Answer: I can help you or Medicare.gov can tell you. I would use an agent because medicare. Gov is not 100% accurate.

Answer: Its great for seniors! It went from 8k out of pocket to 2000. Which means once you spend 2000 out of your pocket from Jan 1 to Dec 31st you pay nothing else for your medicines that are on the formulary.

Answer: Annual enrollment is 10/15-12/7

Open enrollment is 1/1-3/31

You would need a special election to change any other time.

Answer: How much is your specialist copays. What city and state do you live in and I can try to find you a lower copay.

Answer: No what city and state are you in? I can look for one that have dentist in the network. Also depends on MA plan.

Answer: Did you try the pharmaceutical company or the foundation. 340 B pharmacy might be able to help. Maybe Canadian pharmacy. Send me the names and I can see what kind of help is out there.

Answer: You can wait until you retire unless your employer has less than 20 employees. If your employer has less than 20 employees you would need to sign up for medicare. If you are not paying into an health savings account I would sign up for Part A only. It will be secondary to your group.

Answer: Today the question is, my doctor recommended a bone density test. Is this considered preventative care under Medicare? Great question! Yes, it is preventative and does not cost anything to have done. I do recommend it, so I hope that when your doctor recommends it, you do get it done. They might find something, and the quicker they find it, the easier it'll be to get the help you need. Thanks again for listening to Medicare Minutes with Medicare Misty.

Answer: Hi, it's Medicare Misty with Medicare Minutes. For those that don't know, I've been doing Medicare for over 20 years. I'm in 45 states and I have over 50 agents. I get these questions all day long, so I started putting together short videos to help you get your answers.

So, the first question is, what's the key difference in how Medicare Advantage and Medigap handle out-of-network providers? That's a great question.

On Medicare Advantage, there are a couple of different options. A PPO, or Preferred Provider Option, means you can go out of network; it just may cost you more. You would want to check that beforehand before you go see your doctor. But that's the key. That's what we do for you, so you don't have to worry about that.

HMO Medicare Advantage means you cannot go out of the network, so you want to make sure that your doctors are in the network. Again, that's what we do for you; that's what we handle for you.

There is also a Point of Service plan, which is usually an HMO. Point of Service means that there are probably some things you can go out of network for, but not all of them. So, we would just want to check before you sign up for that plan.

There are Medicare Savings Plan options for you, and some states still have Private Fee-for-Service, which kind of works like a Medicare supplement. As long as the facility takes it, then the doctor will bill the Medicare Advantage. A supplement has no network, so anywhere that accepts Medicare, you can go with the supplement. Even on some Medicare supplement plans, let's say they don't take Medicare's assignment, you can still go, and then they'll pay the 15% that the doctor is allowed to bill you because they don't accept Medicare's assignment.

Answer: This is probably one of my favorite questions. Hi, for those that don't know, I'm Medicare Misty, and I'm here to deliver your Medicare Minutes. I get questions all the time, so I do these small little videos so you can just hear a quick answer.

The question I got today is, what role do you think technology will play in the future of Medicare? Well, I know a lot of people already Google things, so it's kind of like with medicine. They already Google, but you still need a doctor. It's the same thing with Medicare. You can Google any of that, but you're still going to need a Medicare agent.

When you're not doing this every day, like if I were to Google how to do leg surgery, I probably wouldn't want to attempt that. It's the same thing with Medicare. You don't want to be in the wrong plan when something major happens in your life. So, I still think technology is going to play an important role, but you're still going to need someone live, someone local, to handle and guide you through this Medicare maze.

Answer: This is a great question. Hi, I'm Medicare Misty. For those that don't know, I'm licensed in 45 states, I have over 50 agents, and I keep getting these questions every day. I got a good one today: Is Original Medicare or a Medicare Advantage plan better, and why do you recommend one over the other? That's kind of a loaded question, because it depends on what medications you take, who your doctors are, and how much you travel. So it's hard to do a blanket statement for everybody.

I go over both options and then let you choose which one you like better. Then I show you the options with Original Medicare. If you choose Medicare Advantage, then I show you the options with Medicare Advantage, and you choose which is the best for you. Which one has the benefits that you want? Which one is more affordable? I'm just here to help you through the maze, because depending on where you live, there are anywhere from 15 to 45 different plans, and that's very confusing. Let alone one plan, but 45 different options—how do I choose the right plan? Everybody tells me and calls and says that. So you don't have to worry about that; that's what I'm for. I have 20 years of experience just doing Medicare, and I'm licensed in 45 states with over 50 agents.

Answer: Good afternoon. It’s Medicare Misty. I am here with your Medicare minutes, and we had a lot of questions today, one of them being, "I'm turning 65 soon. When can I enroll in Medicare?" I get that question all the time. Great question. So it depends, of course, like everything else. What does that mean? It depends on if you're not working anymore, because the rule is your initial enrollment period is 90 days before your birthday month, your birthday month, and 90 days after. After that 90-day mark, your penalty will start unless you're still working and you have coverage through them. So if you're still working and your coverage is affordable through your employer, then you can stay with your employer as long as your employer has more than 20 employees. If you have any other questions, please call MedicareMisty.com. My phone number's on there. We'll be glad to assist you with any other questions and help you enroll. I'm in 45 states. Excuse me. So let us help you.

Answer: Hi, Medicare Minutes are back with Medicare Misty. Good question we got today from a client: Am I eligible for a special enrollment period if I lose employer coverage? Great news! You are eligible for a special enrollment period if you lose your employer coverage. This means you can enroll in Medicare Part A and B and also get an Advantage plan.

Answer: Hi, Medicare Misty is back with Medicare Minutes, and the question today is: I picked the plan with the lowest premium, but now every doctor visit feels like a surprise bill. Should I have gone with a higher premium instead?

So, yes, we may want to look at that. A higher premium usually means lower copays, so you'll pay more up front and less when you go. We can take a look at that, so give us a call.

Answer: There are plans out there that will help pay for your Medicare part B. Call me and lets look at those options for you?

Answer: Hi, it's Medicare Misty, and you are listening to Medicare Minutes. Your question is, "I'm interested in nutrition counseling to help manage my diabetes. Will Medicare cover this as preventive care?" The good news is they will cover it at 100% as long as the provider takes Medicare's assignment. So, great news! I'm so excited. Great question! Have a great day!

Answer: There are plans that are called PPO they allow out of network services. It may cost you more going out of network.

Answer: Medicare Part B can cover medically necessary outpatient occupational therapy for arthritis or mobility issues if a doctor certifies the need for it. There is no limit to how much Medicare will pay for medically necessary occupational therapy in a calendar year.

Answer: I would meet with a broker like me that has been licensed for over 20 years and does all the plans and is licensed in several states.

Answer: The decision of when to start claiming Social Security is a personal one, but generally, waiting until your full retirement age (currently 67) or even delaying until age 70 can lead to a larger monthly benefit. However, early claiming at 62 results in a smaller, but potentially long-term, benefit.

Here's a breakdown to help you decide:

1. Full Retirement Age (67):

Benefit:

This is your "baseline" benefit, the full amount you're entitled to based on your work history.

Recommendation:

This is a good starting point to consider, as it balances potential lifetime income with a reasonable level of monthly payments.

2. Delaying to 70:

Benefit:

You'll receive "delayed retirement credits," increasing your monthly benefit by about 8% per year, for each year you wait beyond your full retirement age.

Recommendation:

This option is best for those who believe they will live a long time and want the highest possible monthly benefit in the long run.

3. Claiming Early at 62:

Benefit:

You'll receive a reduced monthly benefit, but you'll start receiving payments sooner.

Recommendation:

This might be a good option if you need the money sooner for immediate financial needs, if your health is a concern, or if you think you'll have a shorter life expectancy.

Factors to consider:

Your life expectancy: If you anticipate a longer life, delaying can be advantageous.

Your current financial situation: Do you need the money now or are you comfortable waiting?

Your health: If you have health concerns, claiming early might make sense.

Other retirement assets: If you have other retirement savings, you may be able to delay Social Security for a larger monthly benefit.

Your work history: The amount of your Social Security benefit is based on your earnings history.

In short:

Delaying to 70: The highest potential monthly benefit, but you'll receive it for fewer years.

Full Retirement Age (67): A good balance between a reasonable monthly benefit and lifetime income.

Claiming at 62: A smaller m

Answer: Hi, it's Medicare Misty. We are doing Medicare Minutes here to answer any questions you have. There's no dumb question; we know this is tough. I've been doing Medicare for over 20 years, I'm in 45 states, and I have over 50 agents.

One of the questions I got today is about the biggest frustration Medicare agents face when helping clients enroll. I think it's a frustration I hear from you guys all the time regarding the tools. There should be a tool now where you can do more. We have texting capability on most tools, but voice capability is really what a lot of seniors want. They want to figure out how to use a text and how to open it up, and that can be very frustrating for you all.

A lot of people would rather come in person because they weren't raised on technology. I believe that's the biggest frustration we have for you, because that's the frustration you face all the time: the technology. But don't worry, Medicare Misty has all those technologies to help you get enrolled over the phone or in our office. I'm in 45 states, so I would love to help!

Answer: Hi, it's Medicare Misty again with Medicare Minutes, and we have great questions today. If a senior is turning 65 but still working, should they enroll in Medicare or delay it? Amazing question, great question. First, it's kind of a loaded question. If you have less than 20 employees, you have to enroll in Medicare Part A and Part B, because Medicare needs to be primary, and your insurance could deny you if you don't have Medicare. Then you would be responsible for those claims. So, if you have less than 20 employees, you cannot delay Medicare; you need to enroll in it.

But if you have over 20 employees and you're still working, you do not have to take Medicare. You can delay it as long as your work coverage is credible coverage. Now, if your work coverage is really expensive, Medicare, depending on your income, may be a better option. You might want to take Medicare and delay your employer coverage, but that's your choice. Again, I know this is hard. I've been doing Medicare for over 20 years, I'm in 45 states, and I have over 50 agents, so call us.

Answer: Hi, I'm Medicare Misty, and I'm licensed in 45 states. What's one Medicare decision that too many people regret later? In my experience, I've been doing Medicare for over 20 years now. The most common decision people make and regret is thinking that COBRA is credible coverage. If you're eligible for Medicare, COBRA is not credible coverage. A lot of people make this mistake, and you end up getting a 10% penalty each year that you didn't take Medicare when you were eligible. So don't let that happen.

Answer: IT DEPENDS ON EACH SITUATION. I NEED A LIST OF MEDICINE AND DOCTORS BEFORE WE CAN ANSWER THAT. BECAUSE EVERY SITUATION IS DIFFERENT.

Answer: SOME COULD BE. AS FOR US WE ARE HERE TO EDUCATE YOU RATHER YOU PICK A PLAN OR NOT. IF YOU ARE NOT WORKING YOU HAVE TO PICK A PLAN OR YOU COULD BE PENALIZED.

Answer: WE HOPE NOT. NO PROMISES ON THAT BUT FOR AS NOW YOU SHOULD NOT HAVE TO WORRY ABOUT THAT. THAT WOULD BE MILLIONS OF PEOPLE WITH NO HEALTH COVERAGE.

Answer: IF YOU MOVE YOU WILL NEED TO TAKE A PLAN OUT IN THE ZIPCODE AND COUNTY YOU MOVED TOO. THE PLANS CHANGE AND MEDICARE MAKES YOU TAKE A PLAN OUT IN THE AREA YOU LIVE IN. I AM LICENSED IN 45 STATES SO I CAN HELP YOU IF YOU MOVE.

Answer: IF YOU ARE TAKING YOUR SOCIAL SECURITY YOU CAN NOT. MEDICARE WILL TAKE IT OUT OF YOUR CHECK AUTOMATICALLY UNLESS YOU GO ONLINE AND CHANGE IT TO BE TAKEN OUT OF YOUR HSA.

Answer: IT DEPENDS ON THE MEDICATION YOU ARE TAKING. OUR JOB IS TO A MAKE SURE YOUR MEDICINE AND DOCTORS ARE COVERED

Answer: YOU HAVE A ADVOCATE ANYTIME YOU HAVE A CLAIMS ISSUE. IF YOU NEED ANY KIND OF HELP YOU HAVE A LOCAL NUMBER NOT A TOLLFREE NUMBER.

Answer: Yes but we have to make sure the brand you are using is in network with your medicare plan you enroll in.

Answer: They cover 190 days lifetime. Which means there is no more coverage after you have uses all 190 days.

Answer: Yes the only way to get out of paying for Medicare is to have low income and qualify for Medicaid to pay the premiums.

Answer: It depends on the county and zipcode that you live in. Also want to make sure the doctors and pharmacy on staff at CCRC are in the network of which plan you choose.

Answer: PPO has more flexibility to go outside of the network. You can only go outside of Network on HMO in an emergency ONLY!

Answer: I have been doing medicare for over 20 years and I like that i can make it simple to understand. I like that it is job security because it is so complex.