Rene Casanova, Medicare Insurance Broker

Answer: An experience Medicare agent will be there to help you in times of confusion, help with a claims issue, assist in changing plans during AEP, and answer any questions a client may have when the Member Services department wasn't clear to them. We're local, and most importantly we have a fiduciary responsibility to help all of our clients any time they need us.

Answer: Most Medicare plans do not have a monthly premium. The most important benefits to look for is the copays we all use the most such as doctor's visits, prescription drug copays for your medications, copays for outpatient procedures, copays for diagnostic procedures such as MRI's, CAT Scans, and CT scans, but most importantly what is the annual maximum out of pocket limit.

Answer: What is most important to the client such as the freedom to go to any doctor or hospital without having to make sure they are in a network or getting a referral to see a specialist, and their budget. If they can afford a Medigap policy and Part D prescription drug plan and want the freedom to choose any doctor they want to see the choice is an easy one.

Answer: The IRA did limit copays for insulin to $35 a month. This is applied to all Prescription Drug plans.

Answer: The right healthcare company will have your physicians, and hospital(s) in their network, reasonable copays, extra benefits you want such as dental, vision, hearing, Over the Counter benefits, gym memberships and a rewards card for keeping up with your health appointments. The right representative like myself will answer the phone anytime of the day or night and if the client wants a face to face visit I will be there every time when requested.

Answer: If someone calls a beneficiary and wants to speak to him/her about Medicare they should ask them for their name, phone number and agency they work with and then tell them you will report them to the Centers of Medicare and Medicaid Services. Medicare beneficiaries cannot be called by anyone unless they have previously given that person their permission to be contacted.

Answer: Have the discussion at their home where they're comfortable. I make it a point on my first visit with all my clients to meet them at their home.

Answer: Once any of us on Medicare with a Part D prescription drug plan (PDP) pay out of our pocket $2,000 in any calendar year you are done and all medications thereafter this limit are covered at 100%. This limit includes the $590 calendar year deductible when you have to pay it.

Answer: The best resource at your disposal is the Medicare "What's Covered" App you can download from the Apple store. Just type in What's Covered in the search feature and download it. It'll answer all of your questions on how Medicare covers medical conditions.

Answer: This is true only for people what have both Medicare and Medicaid referred to as Dual Eligibles. The type of plans that do offer some coverage to cover the cost of groceries as a benefit are HMO plans only that require you choose a Primary Care Physician from the network and get a referral to see a specialist. You cannot go out of network or risk paying 100% of the bill. Very rich in benefits, but only for people who qualify.

Answer: Medicare and all group insurance plans cover illnesses and injuries. If you are diagnosed with an illness you will be covered subject to any deductible and coinsurance whether it's covered by Medicare or your group insurance plan at your employment.

Answer: Who ever helped you choose your PDP plan should have told you there are three components all PDP plans must contain. One is Step Therapy, the second is Quantity Limits and the third is Prior Authorization. It’s a cost savings measure and should not be thought of it as penalty of Medicare Beneficiaries.