Mitch Anderson, Medicare Insurance Agent

Answer: Too many people try to find the best "deal". There is no best deal, this is a long term decision and requires a thoughtful conversation to make a good decision.

Answer: I start by explaining how Medicare works and how the pieces fit together. Then I illustrate the similarities and differences between options. This helps to create a package of personalized solutions, not just a list of plan options.

Answer: Each Part D plan has their own specific formulary (list of covered medications). There are also deductibles, copays, and coinsurance that factors in. It is very likely that your cholesterol medication counts towards your coverage gap but is much more complicated than yes or no. We need to know what cholesterol medication, the dosage, and plan that you are enrolled in to give a solid answer.

Answer: Sometimes clients may think that my advice is based on a motivation to sell them something. This could not be further from the truth. My goal is to educate and translate Medicare into something that makes sense and help people find the plan that best fits their individual needs. There is no single plan that works for everyone.

Answer: I enjoy helping to educate and problem solve. Medicare can seem overly complicated and I enjoy trying to simplify the process and and help people find solutions that solve their specific and individual needs.

Answer: The short answer is "yes". Generally, when someone loses employer coverage they qualify for a Special Enrollment Period that allows them to get into a Medicare plan with no questions asked. The qualifier is that the employer coverage is "creditable". This means that the employer coverage is at least as good as Medicare's coverage. This information is provided by the group insurance provider and your human resources director should be able to answer this question for you.

Answer: Medicare approves the surgery and lenses that are directly related to the medically necessary repair of the cataract. Unfortunately, Medicare (and subsequently your plan), does not consider advanced lenses used to correct conditions like astigmatism and nearsightedness as medically necessary, this is considered elective.

Answer: Generally the answer is "yes". If you want to switch from one Medigap plan to another you would be required to answer health questions (medical underwriting) on the application. Some states, California for example, have a "birthday rule" that allows you to change plans annually around your birthday without underwriting requirements.

Answer: Yes but it is complicated. Part A and Part B are called Original Medicare and come from the government. Part A is hospital (inpatient) coverage and Part B is medical (outpatient coverage). Part A and B offer comprehensive coverage for medical care but they do have gaps. Ex. - Part A has a per benefit period deductible, Part B has an annual deductible as well as an uncapped (unlimited) risk for medical expense and neither Part A nor Part B provide prescription coverage for meds normally picked up at the pharmacy. To fill these gaps, a person eligible for Medicare would normally choose either a Medicare supplement plus a Part D prescription plan or a Part C Medicare Advantage plan which includes Part D prescription coverage. Choosing the right path to fill in the gaps is where it becomes very important for you to consult with an independent health insurance agent. We work with you to help you choose the path and plan that fit your individual needs.

Answer: The most common misconception people have about Medicare is that Medicare covers all of their health care needs and that it is free. Unfortunately, Medicare Part B is not free, there is a per month premium that is based in part by your income. There are also gaps in coverage with Original Medicare. Ex. - Part A has a per benefit period deductible, Part B has an annual deductible and uncapped (unlimited) exposure for medical costs. There is also no coverage from Original Medicare for prescriptions that are normally picked up at a pharmacy.

Answer: There are normally 5 tiers of medication on a Medicare Part D plan. Tiers 1 and 2 are generally generic medications, Tier 3 and 4 are generally brand name medications and Tier 5 is generally for specialty medications. One medications may be listed as Tier 1 on one Part D plan and may be listed as Tier 2 or Tier 3 on another Part D plan; there is not consistency on tiers from one plan to the next so it is always important to discus your plan options with an agent before enrolling in a plan. Usually, the higher the tier for a medication, the higher the risk of copay / coinsurance will be when filling the medication at the pharmacy.

Answer: The "cost" associated with a Medicare Advantage plan can come from the premium, copays, and coinsurance. It is important to understand the risk of cost and how they are similar and different from one Medicare Advantage plan to the next as they can very significantly.

Answer: Traditional Medicare generally does not include coverage for dental and vision unless the care is considered medically necessary due to the diagnosis of an illness or injury. Many Medicare Advantage plans include "extra benefit" coverage for dental and vision care ranging from a reimbursements for services to network benefits for basic and comprehensive care. If your plan does not include dental or vision coverage there are also stand alone dental and vision plan options that can help fill in the gaps.