Patricia 'Tif" Bush, Medicare Insurance Broker

Answer: Someone should have explained to you that when you choose a zero-premium plan, it is a pay-as-you-go plan, meaning you will have a co-pay every time you use the plan except for your annual exam. If you think you are getting nickel-and-dimed, it may be time to look at a supplement plan, where you pay a higher premium upfront, but what you have to pay for at the time of expense is either zero or very low.

Answer: With an Advantage plan, the doctor would have to agree to bill the Advantage plan carrier if they were out of network, and with a Medicare primary plan, there is no network, so as long as they bill Medicare, they are fine and will be reimbursed.

Answer: Yes, in 2025, the maximum amount that any member on a drug plan would be responsible for paying for the calendar year would be $2,000, and the donut hole is no longer on the drug plans.

Answer: Some of the disadvantages of an HMO are that you have to stay in network except for emergency or walk-in coverage. You have an out-of-pocket maximum that can be pretty high.

Answer: If you are disabled, you can apply for Social Security disability. This will be the money you received if your disability is approved. 24 months after your disability has been approved, you can receive Medicare coverage.

Answer: You should always look at all of your options during the annual enrollment period, which is beginning October 1 to December 7. It is very important to consider what has changed with your health, and this way you can make a determination as to what coverage you will need for the future.

Answer: Plan G is the richest plan you can get if you turn 65 after January 1, 2020. Basically, you pay a higher premium, and you only pay a deductible for any outpatient expenses, as long as Medicare covers the expenses. Plan K is a little more tricky; while it does carry a lower premium, you’ll be charged for certain expenses that Medicare paid for along the way until you reach an out-of-pocket maximum.

Answer: Part B will pick up 80% of your outpatient charges after you pay a small deductible. The only problem with that is there’s no out-of-pocket maximum that you are held to. Meaning the 20% you pay can go on and on and on. It’s always a good idea to check in with an agent and find out what other options you have to add to Original Medicare, and those options would be either with a Medicare Advantage plan or a supplement plan.

Answer: During the open enrollment, October 15 to December 7, I would advise that you touch base with an agent and talk to them about the different options. You might have a plan with another carrier or a supplement plan.

Answer: I would say yes. Treat it like you are shopping for an important purchase, as healthcare should be in the top three of most important things in life. If you use my services, we shop for you compliantly and with compassion. And we stick with you until you are done with Medicare. In other words, we help you find a plan, hope you understand it, and service you so that if there are any issues, we are here for you.

Answer: In my opinion, more people are choosing them because there’s less red tape about what is covered versus going with an Advantage plan. As an agent of 20 years for Medicare plans, I offer both Advantage plans and supplements. And I am clear about the fact that both are offered and give the opportunity for a client to choose one or the other. Many people like a zero-premium plan, such as with an Advantage plan.

Answer: You can go on Medicare.gov, enter all of your medications and pharmacy, and the program will let you know what medications are covered under each carrier plan.

Answer: If you move, and you have a supplement plan, you can always take it with you. No one can deny you coverage as long as you keep paying premium. You will have to change your drug plan to the state you are moving to. If you have an Advantage plan, you will have to move your plan to another carrier in the new state. Depending on what state you are in and if you want a supplement plan, you will have to answer health questions and be medically underwritten. Or you can choose another Medicare Advantage plan in the new state.

Answer: Well, finding one now in Connecticut will be difficult. Major carriers have told us they are taking a pause for 2026 and really don’t want any new business for Medicare Advantage. Therefore, if you’re looking at a PPO, I would recommend that you change your thought to a supplement plan. Mainly for the reason that if you go out of network on a PPO, your out-of-pocket max could be up to $10,000. If you go out of network on a supplement plan, your out-of-pocket is basically your premium.

Answer: It’s wise to consult with an agent like me, who has over 20 years of experience with Medicare plans. There are lots of questions that need to be answered and information collected before someone can help you with choosing the plan that best suits your needs. Contact me.

Answer: The answer is that is not true. Medicare will not pay for implants. And now most carriers in Connecticut on Advantage plans will not pay for implants.

Answer: You should always talk to an insurance agent like me, because I know exactly how to ask the right questions and will be honest in my response as to whether or not I think a Medicare Advantage plan fits your particular situation, based on the doctors you see and the care you need.

Answer: You engage the services of a trusted agent like myself. I have 20 years of experience helping people with just their Medicare coverage. And 20 years of experience with group medical benefits. You may also contact Medicare.gov, but it is very hard to navigate that Site.

Answer: We do not use the word free; we use the word zero premium because when you become a member of a Medicare Advantage plan, Medicare will pay the private insurance carrier a certain amount of money every month to cover you. So that’s where the payment comes in for your coverage. It comes partly from your pocket because you paid into the Medicare pool your entire life, and you’re also paying for Medicare Part B, which is part of the payment that the Medicare system pays the private carrier on a Medicare Advantage plan.

Answer: Hello, Medicare will only cover what is medically necessary and prescribed by a doctor. Anything beyond that will typically end in a denial. The best way to find out if something is covered, you can go on Medicare.gov and scroll down to see the "Is my test or expense covered" section. Wishing you the best of health in the days to come.

Answer: Currently, Medicare expects that each person who becomes eligible is going to do their own homework. By going online or contacting an agent. I have just recently seen that Medicare is trying to increase their education. I’m sorry this happened to you. If you live in Connecticut, you do not have to go through medical underwriting, and we can get you on a plan right away as soon as you can get on Part B.

Answer: As long as you have covered your annual Part B deductible, this year $257, the MRI should cost you nothing more.

Answer: Your cost will be capped a lot sooner with the change. The total cost of your Scripts once they equal $2,000 means that you will pay nothing for your medications for co-pays. For drug costs up until the $2,000, you will be paying co-pays or coinsurance.

Answer: Talk to an agent to find out if you need to come on board to Medicare. They should ask you if you are currently working and plan to keep your commercial benefits or if you are retiring and may be eligible for retiring medical. If the answer to both of these is no, then they will explain next steps about timing and getting on board to Medicare A and B.

Answer: The most overlooked benefit that Medicare provides is free labs. This is a nice surprise benefit that most people are used to paying a co-pay for.

Answer: There should definitely be stricter guidelines on agents who call folks who are on the do not call list. Agents are not supposed to reach out via cold calling, and there are no consequences currently.

Answer: Yes. It was a client who was being referred to rehab, and the insurance carrier didn’t want to pay under a Medicare Advantage plan. I spent days on the phone going back-and-forth with the client, the rehab center, the primary care physician, and the plan. Eventually, an appeal was made, and the client got to stay for an extended period of time until they were ready to go home.

Answer: Ask at the time the labs are being drawn if they are covered under the client's plan. If they are not, ask the lab to indicate what the co-pay will be before the draw.

Answer: I really enjoy helping people navigate something that is quite difficult after leaving a commercial plan. I am compliant and compassionate and will research plans to be sure they match the client.

Answer: Yes. Once you pay your annual outpatient deductible, the charges once approved by Medicare will be covered at 100%.

Answer: Yes. As long as your doctor indicates they are medically necessary, they will be covered as diagnostic services.

Answer: If there is an honest Medicare agent running the seminar and doing it compliantly, the answer is no; they are not sales pitches. In an actual Medicare educational seminar, we only educate. We don’t talk about plans. We just talk about how Medicare works and what the options are.

Answer: We as agents believe that people will always need help face-to-face, or via a phone call. And that AI will not be able to shop appropriately for Medicare plans.

Answer: You may do so during an enrollment period. The next one coming is between October 15 and December 7, which will allow you to make a change to an Advantage plan if you so choose, which will become effective January 1. Can I help you look for plans?

Answer: Medicare Advantage plans are part of Medicare. They are held to standards by Medicare. And they are actually part of Medicare.

Answer: We are not all created equal. Personally, I educate my potential clients about all of their options and then let them choose. The reason you want a good and experienced Medicare agent is because we know the plans inside and out. I have 20 years' experience with just Medicare. I also do not write and run. I will be your service agent for the rest of your time on Medicare, answering all your questions and helping you renew your plan every year.

Answer: Social Security and Medicare are independent of one another. In other words, you can delay your Social Security but can start your Medicare anytime on or after age 65. Do you plan to continue to work upon your 65th? And will you keep employer coverage?