Ron Gambles, Medicare Insurance Agent
Ron Gambles
RG Medicare Agency
Medicare Agent Licensed in TN
13+ Years of Experience
Contact Details
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Location
Cordova, TN
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LinkedIn
About Me
Hi, my name is Ron. I am an Independent Agent that provides access to top tier Medicare Plan providers, both Medicare Supplement plans and Medicare Advantage plans. My services also include Financial Services, such as, Life Insurance, Annuities and Disability Insurance.
I began in these services in 2012. Prior to that, I served 24 years in the United States Air Force and retired as a Master Sergeant. I completed my Bachelor of Business Administration from Mercer University's Stetson School of Business in Atlanta, GA.
Listening to my clients express their unique healthcare needs and goals to gain an accurate understanding, is central to ensuring they can select the Plan that best meet their expectation. The same is true concerning any Financial Service needs or goals they express. I make sure my clients have an accurate understanding by answering their questions, even the ones they may not know that they should ask.
So, reach out to me for a "No Obligation" and "Free" consultation. No "Sales Pressure", just friendly "No-nonsense" factual dialog to answer your questions and provision of key insights.
Q&A with Ron Gambles
What's the most important question I should be asking about Medicare that I probably haven't thought of yet?
Answer: Between Medicare Advantage and Original Medicare with a Med Sup Plan and a Rx plan, which will best meet my specific healthcare needs in the long term? It is important to get a full understanding of the benefits and downsides of both options before choosing.
What's the trade-off between a Medicare Advantage PPO and HMO when it comes to flexibility?
Answer: The trade-off is cost. While you will gain a greater degree of flexibility, your portion of cost-sharing will increase what you pay out of pocket. Also, your cost could be further affected if you do not contact the Plan to verify the out-of-network treatment you are seeking is medically necessary and will be covered.
What should I do with my Medicare plan if I'm diagnosed with a rare disease requiring specialists?
Answer: In general you should contact your plan, particularly if you have an Advantage Plan. They typically have specialized treatment classes that target specific conditions.
I'm confused about preventive services under Medicare. Which screenings are actually free?
Answer: Generally, services such as yearly immunizations for example, flu, shingles and routine screenings like mammograms'. However, these are typically limited to a set number for a given period. For a full comprehensive list contact your Plan.
How could a universal healthcare debate shift Medicare's structure in the next decade?
Answer: The short answer is that it will impact at least three variables; cost, scope of coverage and types of coverage available. Where this actually lands is an open question with no certain answer until it is decided.
How can I save money on my Medicare Supplement?
Answer: The first thing you can do is decide and enroll into a plan when you first become eligible. You will need to assume responsibility to gain an understanding of how to navigate the Medicare processes, or have a reliable loved one to assist you. Shop for the Rx plan that best meets your needs at the best price, they change every year.
I just moved from New York to Florida and have Original Medicare with a New York Medigap plan. Do I need to change my coverage?
Answer: Always consult with your Plan when you relocate. It may or may not be necessary because each Plan varies in it's geographical coverage.
Can I enroll in Medicare if I've never paid into Social Security due to working overseas?
Answer: You can enroll. However, you will be required to pay both Part A and Part B Premiums out of your own pocket in addition to premiums for a Medicare Supplement Plan, Rx Plan or whatever Premiums for an Advantage Plan. All of which will be very costly for the average person.
What role might private insurers play if Medicare expands to cover more preventive care?
Answer: More than likely private insurers will lobby to set limits on that expansion. It will also probably result in cost increases somewhere in the plan.
I missed my Medigap window by a few months and now no one will cover me without underwriting. Why isn't this rule more well known?
Answer: Every year CMS publishes a Publicly available (Online) guide called "Medicare and You". It explains in great detail the Process of how Medicare works. It also highlights the rights and responsibilities of Medicare Beneficiaries. I would encourage you to work with your agent to get more information, the key is taking control of your healthcare by seeking the answers.
What's the projected impact of an aging population on Medicare Part A hospital funds?
Answer: With an increasing number of new Medicare enrollees each year, the higher demand on the resources available in the Hospital Insurance trust fund, shortfalls are expected by 2036. However, given the current efforts to reduce government expenditures, particularly for Medicaid, Medicare and Social Security … we are in a period of heightened uncertainty.
I want to get a shingles vaccine. Will Medicare cover this preventive service?
Answer: Medicare Part D covers the Shingles vaccination. Part D is a prescription drug plan that you would purchase from a CMS approved Insurance provider. It is typically purchased to compliment a Medicare Supplement Plan. Or, one is bundled with a Medicare Advantage Plan.
People with a Part D plan usually do not pay out of pocket for most vaccines, including for the Shingles vaccine. Neither Part A or B covers the Shingles vaccine.
What's the key difference in how Medicare Advantage and Medigap handle out-of-network providers?
Answer: Medicare Advantage Plans are "Coordinated Care Plans" where as, Supplement Plans are not. What that breaks down to is that the Advantage Plan Provider and willing Physicians agree to provide care in agreed process in a variety of different formats. For example, an HMO, PPO or PFFS. These all have particular guidelines that must be followed in the healthcare process.
On the other hand, Med Sup Plans do not function this way. There are no "Coordinated Care" formats to adhere to, a beneficiary is free to see any physician that accepts Medicare and most do.
So, this is a very basic distinction between the two. Both have "pros and cons", it really means that you should get an accurate understanding of how each work. Then you will have to decide which will work best for you.
I keep hearing about Medicare Part D changes for 2025. Will these actually lower what I pay for my prescriptions?
Answer: As of today, the current cost structure is that the highest prescription drug deductible is $590. After that the cost to you will be 25% of the cost in the form of coinsurance until your prescription drug expenditure reaches a max of $2000. This includes any payments made on your behalf from the Extra Help program.
I'm confused by all the star ratings for Medicare plans. Do they actually mean anything for the care I'll receive?
Answer: Yes, they absolutely do. The Star Rating system is a tool created by the Centers for Medicare and Medicaid Services (CMS) for indicating the quality of services provided by Advantage Plans and Prescription Drug Plans. This system was designed to specifically aide beneficiaries in selecting the best plans possible.
Also, as incentives for Plans to constantly review their processes to maintain CMS standards and excel in patient care. They are rated in 5 categories that have a direct impact on patient experience. Plans with an Overall 5-Star rating is the highest possible rating. A Plan with a 5-Star rating in a single category does not make it the highest ranked Plan.
Don't you think Medicare's technology systems are outdated and inefficient?
Answer: These days technology is evolving with blistering speed. No, I do not think Medicare's technology is outdated and inefficient. Much like purchasing a new car, laptop computer or cell phone every year to keep up with the latest upgrade … could easily be considered as wasteful spending.
Likewise, seeking to make technology upgrades across the board in short intervals would be costly. So, prudent evaluations are made to access the need to make upgrades that would improve performance in areas that are not keeping pace with the demands.
How might artificial intelligence change how Medicare approves claims in the future?
Answer: Hmmm, I must say that I'm not a fan of AI driven "Customer Service."
While it may benefit on the "Man-Power" side in terms of staffing, I think that the "human-touch" will be absent for the beneficiaries … but we will have to wait and see how it works out.