Ricky Rash, Medicare Insurance Agent

Answer: Medicare recipients can do a Google search on specialty medications to find various options, such as online Rx coupons, manufacturer coupons and/or financial assistance. Their physician can also provide samples of a given medication or see if they can qualify for a free trial period. They can also apply for state pharmaceutical assistance based on income and/or medical condition criteria.

Answer: Hopefully these advancements will be able to keep real-time statistics on things such as heart rate, blood pressure, sleep activity, stress, steps/miles walked, etc. With this data, health care professionals can help Medicare beneficiaries make smart decisions that can affect better health outcomes and prevent unnecessary hospital admissions.

Answer: It depends, especially since Medicare does not cover services outside of the United States; however, if you decide to suspend/terminate/cancel your Medicare, they may impose penalties upon your return to the U.S. Most people keep their Original Medicare active and purchase a Medigap plan that includes a foreign travel benefit, or they enroll in a Medicare Advantage plan that covers them outside of the United States for both ER and urgent care visits.

Answer: Every quarter CMS mails out these summaries to Medicare recipients so they can see the details of any costs and amounts paid for medically-related services on their behalf. They can expect to see things such as deductibles, coinsurance, Medicare-approved services paid for, etc. This is not a bill, just an explanation of what is or isn't being paid for by all parties involved, from the insurance company to the beneficiary. The member can opt for either paper or electronic copies, so they do not have to incur endless hard copies year after year.

Answer: If you are on a Medicare Advantage plan then you would have to contact the insurance company so they can help you find a DME provider that is in network. That company will then make arrangements to have the wheelchair delivered to your home. If you purchase a Medicare Supplement policy you can work with any DME company as long as they accept Original Medicare, so you have more options and flexibility.

Answer: Most Medicare recipients have two enrollment periods to make changes, one from October 15 to December 7 (AEP) and again from January 1 to March 31 (OEP) for those people on an Advantage plan; however, there are a number of Special Enrollment Periods or "SEP" opportunities for people with certain chronic conditions, for people who are losing or gaining Medicaid or LIS, people moving in or out of a county or territory, for people who were affected by a natural disaster, etc.

Answer: Absolutely -- cuts to Medicare affect all of us, from health care workers to hospitals to caregivers, children of seniors, and Medicare recipients themselves.

Answer: Seniors are losing their plans because the (for-profit) insurance company is losing money! When their claims-loss ratio is too high, the insurance company terminates the Medicare Advantage plan to stop the financial bleeding. The senior is then faced with the choice of finding another MA plan in their county or purchasing a Medicare Supplemental Plan, which often times is out of their monthly budget.

Answer: A Medicare broker generally represents a much larger range of plan options and carriers, whereas a Medicare agent might just represent one company. An agent might be salaried and work in a fixed location, whereas a broker works on commission and is not confined to a singular office or region, so he/she may work outside of a specific territory. Most brokers have access to other products and services, such as Medigap plans, Long Term Care insurance, Cancer/Stroke/Hospital Indemnity policies, etc. Agents are usually single-minded and are only focused on selling a single type of insurance, such as Medicare Advantage Plans.

Answer: There are several -- first, you are working with someone who goes through rigorous training and certifications every year to stay current with all of the changes to both Medicare as well as the various products, from Advantage plans to Supplemental options, dental/vision, etc. Second, most agents represent a variety of plans and do not have a bias towards any particular provider or product. They are usually paid a direct commission from the insurance company and not from the consumer, and those commission are regulated by CMS. Every agent has a fiduciary responsibility to the consumer and must put their needs before themselves. Finally, working with a Medicare agent relieves the consumer of having the burden of sifting through endless marketing and educational materials that can sometimes be misleading or simply too confusing. A good Medicare agent can explain things in a manner that is clear, concise and informative, leading to a clear decision for the consumer.

Answer: Yes, and this is a growing trend that all Medicare consumers should be aware of before making a decision on what type of insurance they choose - Advantage or Supplement. If someone chooses an Advantage plan, they need to understand that both hospital and physician contracts can be entered into or terminated at any time during the year, which can spell disaster for Medicare clients who are seeking care. On the other hand, if someone purchases a Medicare Supplemental Insurance policy, he/she can seek medical care wherever they choose, so long as the provider/facility accepts Original Medicare.