Pamela Camey, Medicare Insurance Broker

Answer: Your first Steps towards Medicare Enrollment should be to contact Social Security Administration to enroll in Part A Hospital and Part B Medical Insurance Coverage during your initial Enrollment Period, which begins 3 months before your birthday, month of your birthday, and three Months after your birthday. It's important to work with a licensed broker like myself, who will take the time to teach you about Medicare, how it works and your coverage options.

You may sign up for Medicare online or by calling Social Security Administration or by setting an appointment with your local Social Security Office.

Answer: The answer is simply. A PPO Medicare Advantage Plan offers greater freedom to choose providers, including those outside the network while HMO Medicare Advantage Plan generally require staying within the network except during true emergency situations. You need to follow the HMO plan rules for approved network coverage.

However, with a PPO Medicare Advantage Plan, when visiting an out of network provider will include higher fees and a separate deductible.

Answer: Yes, you will most likely face a penalty if you do not enroll in Medicare Part B medical insurance when you are first eligible, which is during your Initial Enrollment Period (IEP). Initial Enrollment period starts 3 months before your birthday, month of your birthday and then 3 months after your birthday. There are some exceptions to this rule. If you continue to be employed and your employer is providing you creditable health Insurance, you may waive signing up for Part B.

If you do not enroll in Part B during your initial enrollment period, or have creditable coverage, you will be required to pay a penalty for each 12-month period that you delay enrollment. The penalty is 10% of the standard monthly premium for each 12-month period of delay. You will pay this penalty as long as you have part B coverage.

There is a similar penalty for Part D (prescription drug coverage) if you do not have creditable drug coverage and delay enrollment.

There are also a few situations where you may have to pay a penalty for part A (hospital insurance) also called premium-Part A.

Answer: I absolutely love working with Medicare Clients. I love teaching and making a meaningful difference in their lives with it comes to Medicare. When they become a client, they also become part of our FAMILY. I take great pride in assisting the through this process. Providing assistance when needed throughout the year.

Educating my clients on current changes is upmost importance to me. I make sure my clients understand their choices and how the plans work. I want to make sure my clients feel secure in their choices in the immediate but also in the long-term decisions on their healthcare needs.

Working with my clients is truly a passion.

Answer: The new $2000 out- of -pocket cap on Medicare Part D prescription drugs is a game changer for many of my clients. This change is the result of the 2022 Inflation Reduction Act, aiming to make HealthCare more affordable and more accessible for seniors.

Beginning in 2025 Indvidual's enrolled in Medicare Part D Prescription plans will have their out - of pocket spending cost for prescription drugs capped at $2000 annually.

The Inflation reduction act also includes measures to lower the drug costs, such as capping the cost of insulin at $35 a month. This law allows Medicare to negotiate drug process with manufacturers and offering free recommended vaccines.

This new cap on Medicare Part D Prescription projected save millions of Medicare beneficiaries thousands of dollars annually.

Answer: The Biggest mistake Seniors can make when enrolling into Medicare is not understanding how the plans, they selected work and affordability of that plan not in immediate but also in the future.

Questions to ask yourself:

1) Medicare Supplements: It's human nature to gravitate towards the lowest cost premium, but can that company handle the medical loss Ratios down the road? Does it have that history to do so? Can I pay for much higher premiums as I become older? You have to be your own financial steward with healthcare because it will be the most expensive financial expense during retirement.

2) When selecting a Medicare Prescription drug plan- many are influenced by premium cost and not looking at the details of the plan drug formulary or when will you be charges the Medicare Prescription drug deductible.

3) Medicare Advantage Plans- Continuity of Care: Are my doctors in that plans network? Am I willing to switch plans if they are not? Are my medications on this plan's formulary?

Answer: If you lose creditable employer or union healthcare coverage, you will qualify for a special enrollment period (SEP) to enroll in Medicare Parts, A, B, C, or D, which allows you to join or switch plans outside regular enrollment periods

Answer: If you have a Medigap plan F there would be no copayment for emergency room visit, but if you are travelling internationally that is a different story. Plans provide 80% to a lifetime maximum of $50,000 in coverage after the first $250 deductible each calendar year

Answer: Medicare does not provide long-term care coverage or custodial care unless medical care is needed.

Medicare does cover 90 standard days for long-term acute care at a hospital.

Currently, Medicare will pay for Home Healthcare for as long as you qualify. However, you plan of care must be recertified every 60 days by your doctor. If a person has a three -day inpatient stay at a hospital or has a Medicare-covered skilled nursing facility ( SNF) stay, Part A will cover up to 100 days.

If you are considering the purchase of Long term care Insurance, these guidelines vary from State to State. In retirement planning, you may want to consider purchasing a Long Term care Insurance policy to protect your assets. There are also short term care insurance policy available as well. When planning for Long term care needs, there is no need to settle for just one solution. You may want to consider looking at Traditional Long term care insurance, Asset- based LTC policies or even consider stacking them together. National Association of Insurance Commissioners wrote a Shopper's Guide to help you understand long-term care and the insurance options you may choose.

https://content.naic.org/sites/default/files/publication-ltc-lp-shoppers-guide-long-term.pdf

Answer: For most individuals the answer is YES. Medicare advantage plans can save money on healthcare costs compared to Original Medicare, especially when it comes to out-of-pocket expenses and premiums. However, there are very important considerations to Medicare Advantage plans. All Medicare Advantage plans have network restrictions, and Prior Authorization for certain services are required. The cost and benefits vary greatly between plans. It's important to understand and review how these plans differ. Compare them carefully.

There is potential savings with Medicare Advantage plans. They often have lower monthly premiums, and reduced cost-sharing. Many plans offer lower copayments, co-insurance and deductible for medical services. Most Medicare Advantage plans include Prescription drug coverage as well. All Medicare Advantage Plans have a maximum out of pocket spending limit. Which means to you, should you ever reach the out-of-pocket maximum, you will not have to pay for services the rest of the year. Medicare Advantage plans provide extra benefits like dental, vision, hearing and fitness program, which many find attractive if they need those services. The easiest way to remember - you pay as you go when you use a Medicare Advantage Plan. Recent studies have shown Most seniors on Medicare Advantage plans so an average savings of $2,541 a year.

Answer: You may be required to get Medicare Part B even when you are working. There are situations in which you must obtain part B when you turn 65.

1) Your employer has less that 20 employees. Medicare becomes the primary payer, and you may be required to enroll in Medicare Part A and Part B, Your employer's health plan becomes the secondary coverage. Employer Health group plans may not be able to provide you the same level of coverage as Medicare.

2) Employers with 20 or more employees, your employer's group health plan is considered primary payer. This means you can generally delay enrolling in Part B until after you lose that coverage.

3) If you have health insurance coverage through a spouse's employer, you may also delay enrolling in Part B until you lose that coverage.

Coverage based on current employment does not include COBRA, retiree health coverage, VA benefits or individual coverage through the health insurance Marketplace.