Rose Cahill, Medicare Insurance Agent

Answer: If this happens, be sure to contact the person or company who enrolled you into the plan. They can guide you to the best resources available to help you based on the plan you selected. If the plan does not ultimately meet your needs because of a new diagnosis, you should discuss other options with your broker. Remember Medicare does allow you to make plan changes each year during Annual Enrollment which runs between October 15 and December 7.

Answer: Most Medicare brokers are paid when they enroll someone in a Medicare Plan, such as an Advantage Plan or a Supplement Plan. Medicare regulates the payments to brokers. This means compensation does not drive what plan is recommended.

Be sure to work with a broker who has your best interests in mind. You can tell because they will take the time to ask you questions, check your doctors and prescriptions and then provide you with options.

Answer: Medicare DOES NOT cover long-term care coverage. Long-term care is considered custodial care and is very different from the wellness and chronic care coverage you have with Medicare insurance.

There is separate long-term care insurance coverage specifically covering custodial care. This type of insurance is underwritten, meaning you must qualify health-wise for the coverage. If you are considering purchasing long-term care insurance, start doing so while you are still healthy to guarantee coverage for when you may need it.

Answer: Both can be sound ways to provide you with Medicare coverage. The best decision is unique to you and will depend on a number of factors including your health, your finances and your risk tolerance. The best way to proceed is to meet with a professional who will ask you these questions, check your doctors and prescriptions and then present you with options available in your geographical area that make sense for your particular situation. It's not a one size fits all. Take the time to know your options.

Answer: Since you currently receive SSI, you should receive your Medicare Card with active A&B dates automatically when you turn 65.

When you turn 65, MassHealth in MA (Medicaid) requires you to reapply for Medicaid using a Senior Form. In Massachusetts, you must do this in order to re-qualify for Medicaid assistance. Be sure to check with Medicaid in your State for specific state requirements. Don't automatically assume it will rollover.

Answer: I love taking the complex subject of Medicare and explaining it to my clients in a way that is easy for them to understand. I take the mystery out of it for them by breaking it down into manageable steps that fit their unique situation.

A well informed client is my best client because they actively participate in making the decisions that are right for them and feel good about the decision they have made.

Answer: You are not making a decision that you will have to live with forever. Sometimes people are plagued by analysis paralysis because they are trying to account for every possible thing that could come their way down the road.

Medicare allows you to review your plan and make changes, if needed, each year during the Annual Enrollment Period. That period runs from October 15 through December 7th. This is the time when you want to review your current plan, its changes for the coming year and your current needs. If still a good fit, you stay with your current plan. If plans and/or your needs are different, this is the time to review your options and select a plan that better meets your current situation.

Answer: The first step is to get educated on the topic of Medicare. Some people are ready to retire and start Medicare at their 65th birthday. Many other people are now working past 65 and continuing their employer provided health coverage. And some even go on Medicare while continuing to work past 65 because it is less expensive than paying for their employer benefits.

Each situation is unique. I suggest connecting with a Medicare broker who specializes in helping people who are new to Medicare. They can provide you with the guidance that is best for your personal situation as well as help you break down the process into management steps.

Answer: There are many Medicare Advantage Plans that are $0 premium plans. This means that you will not be charged any monthly premium for the plan by the insurance carrier. However, these plans can charge co-pays and co-insurance amounts when you use the services covered by the plan. As such, the plan is not "free".

There are some plans called Dual Special Needs plans that may be free for some people who qualify for the plan. These plans often have no monthly premium amount and the services covered by the plan are at $0 co-pay. However, you must qualify for these plans by applying for and receiving Medicaid assistance from your State. To qualify you must meet the income and asset standards set by your State.

Answer: Understanding Medicare drug pricing can be quite challenging. Every company has a Medicare-approved formulary of drugs they offer as part of the Part D prescription drug plan. Those formulary drugs are then grouped into 5 tiers. The lower tiers 1 and 2 contain the most commonly used drugs that have been around for some time and for which there are generic versions. These 2 tiers are the lowest priced drugs for you at the lowest co-pays. Some co-pays may be $0. Tier 3 drugs are comprised of newer drugs - often the drugs you will see advertised on TV. They are more expensive, often have no generic versions and are provided to you at a higher co-pay or co-insurance amount. More commonly, plans are now charging members a co-insurance amount of 20+% at tier 3, which represents a co-pay that is calculated as a per cent of the cost of the drug. Tiers 4 and 5 are specialty drug tiers. Here is where you would find many cancer and chronic care drugs. A good example would be chemo therapy drugs. When you are given a new prescription by your doctor, ask your pharmacist the drug's tier. You may be able to save yourself money by requesting a generic version of the prescribed drug.

Answer: Sometimes people get distracted by a plan's extra benefits and shop for the best extra benefits. What's most important with a Medicare Plan is that your preferred doctors and hospitals take your plan. Yes, it's nice that your Medicare Advantage Plan may offer you some dental, vision or hearing benefits, but these aren't worth it if your doctor isn't in-network for your plan. Be sure your plan is taken by your doctors and covers your prescriptions. These are most important!

Answer: Good question. It will depend on your State of residence and the rules in your State. There are just a few States that are guaranteed issue states, meaning there is no medical underwriting required. However, most States allow you to enroll in Medicare Supplement plans with no underwriting initially; however, when changing from one plan to another, you will likely have to answer underwriting questions which can impact your premium rate and your acceptance. In contrast, there is no medical underwriting for Medicare Advantage Plans.

Answer: Not taking time to fully understand the Medicare Advantage plan they enrolled in. These plans have many preventive services covered at no charge. Additionally, they offer many ancillary services like dental, vision, hearing, gym memberships and OTC credits which go unused.

Answer: Short answer is yes you can. However, your coverage will be limited. Medicare A&B is referred to as Original Medicare and will cover about 80% of your expenses. However, there is no maximum out-of-pocket so your 20% has no cap. If you have an expensive health issue, it could be very costly to you. It also doesn't provide you with anything else, like prescription drug coverage, dental, vision or hearing insurance. You would be better off considering adding a $0 premium Advantage Plan to help defray the 20% not covered by Medicare. A lot more value at no extra cost to you!

Answer: Many people work past 65 these days. It's not a problem - as long as you have had health coverage through your employer. Now that you want to retire, you need to get a Medicare number and effective dates for Medicare Parts A&B. If you already have a Medicare card and an effective Part A date, you need only apply for Part B. You can do this by going on-line at medicare.gov or by working through your local Social Security office.

Once you have an effective A&B date, you are then ready to consider whether you want to enroll in a Medicare Advantage Plan or a Medicare Supplement Plan to help defray the expenses that Medicare does not cover.

Answer: Medicare Prescription Drug pricing is very complex. My word of advice as someone who works with Medicare clients every day, don't ever shop Part D prescription drug plans by the plan's premium. A higher premium plan in some cases may be your best option.

In order for you to find the best plan for your prescription drug coverage, I suggest working with an advisor or use a self-help tool that takes into account the many variables that go into calculating your estimated total annual drug cost. These variables include not only your specific medications, dosages and quantities, but also the monthly premium for the plan, any deductibles in the plan, the plan's co-pays by Tier and the government's $2000 maximum out of pocket calculation. For people who have lots of prescriptions and expensive prescriptions, the plans with higher premiums will likely be a better fit since some high premium plans have no deductibles, and this makes a difference.

If you find prescription drug pricing complicated, it is! Be sure to do the analysis before choosing your plan. Choose the plan that provides you with the lowest estimated annual drug cost!

Answer: Most Medicare plans allow you to set up a personal portal to track all of your activity throughout the year. I highly recommend doing this. Your portal contains lots of very valuable information. Among that information, most portals will track your doctor and hospital visits and summarize what your out-of-pocket expenses have been. Always compare your out-of-pocket expenses to the cost of your insurance. If your out-of-pocket expenses are significantly less than what you are paying in premium, there may be less expensive options for you to consider. On the other hand, if your out-of-pocket expenses exceed $3500-$4000 annually, you may want to consider an option that provides more benefits.

Answer: Medicare can be very confusing to people. My job is to educate you on how Medicare works and provide you with choices suited to your needs in a way that allows you to make an educated decision. A Medicare agent like myself takes away the frustration and confusion of having to figure it out on your own. I educate you and then walk you through the process step by step. And best of all, I stay with you even after you enroll. When you have questions about your plan, you can call me first. I'm always there to answer your questions.