Samantha Jellison, Medicare Insurance Broker

About Me

Hello! I'm Samantha, your trusted Medicare agent in the area. My specialty is Medicare, and I'm passionate about helping you select the ideal plan that caters to your individual needs and budget. I'll efficiently sort through plans from reputable national and local companies, saving you time and effort. Best of all, my services are provided at no cost to you. Contact me to discuss your Medicare choices and don't forget to mention that you found me on Medicare Agents Hub!

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Q&A with Samantha Jellison

What is the biggest mistake seniors make when enrolling in Medicare?

Answer: Usually, the biggest mistake I see seniors make when enrolling into Medicare is not working with a professional, such as an agent or broker. With the vast amount of choices out there, seniors should be getting a full education about their options before making any decisions.

An agent/broker is someone who can lay your options out for you, explain the differences and answer your questions… for as long as you remain their client AND at no cost to you.

When enrolling with a call center, unfortunately, there are no guarantees you will be speaking to the same person each time. If you are only speaking with one carrier, you are only learning about that carrier’s product.

What is one of the the most common misconceptions people have about Medicare?

Answer: That Original Medicare, Part A and Part B, is enough coverage. Remember, Original Medicare Part A is your Hospital Coverage (room and board so-to-speak). Part B is your Medical Coverage (Doctors Visits, lab services, medical treatment, immunizations, ect.).

Original Medicare Part B is only covering 80% of your bill, leaving you responsible for the additional 20%.

You really should have additional coverage to help cover the associated costs, whether that is a Medicare Supplement or a Medicare Advantage plan.

I’m retiring next year—do I need to do anything with my Medicare?

Answer: If you are already enrolled in Part A and Part B, and you have either a Medicare Supplement with a Prescription Drug Plan (Part D) or a Medicare Advantage with Prescription Drug Plan, there is nothing more to do than to enjoy your retirement!

If you are transitioning from an Employer group insurance plan or you delayed Part B past the age of 65, there will be some additional steps you will need to take.

This is when it is best to talk to a licensed agent/broker, who can guide you on the next steps in order to make your transition to retirement that much more effortless.

If I need long-term care in the future, how does Medicare fit into that plan, and what should I be doing now to prepare?

Answer: This is a great question and I am pleased to hear that you are thinking about this proactively.

Unfortunately, Medicare does not cover long-term care, such as your stay in a nursing/retirement home or having someone come to your own home daily for custodial care (bathing, dressing, feeding, ect.).

You should consider discussing a Long-Term Care policy with your agent/broker.

One thing to note is that as you age, these policies become more expensive. In many cases, people faced with the situation to enter Long-Term care may have to apply for Medicaid in order to receive any financial assistance or cover their costs. In some cases, extended family members may be able to contribute, however it can end up being a hefty financial burden.

Do I have to answer health questions when switching from one Supplemental/Medigap plan to another?

Answer: It depends. There are a lot of factors to consider here, such as the State you reside in, how long you have had your current Medigap policy, and the timeline of when you plan to switch.

Unfortunately there are a lot of rules when it comes to Medicare Supplement policies. That’s why it’s important to work with a knowledgeable, trustworthy and licensed professional.

What are some ways to ensure your parents feel supported during the Medicare decision-making process?

Answer: Be sure to discuss with them abe understand what is important to them regarding their plan.

Do they want to travel? Do they want to remain with their current doctors? Are their prescriptions covered on the formulary? What type of coverage is important to them? What type of budget are they working with? If they can no longer afford the costs of their healthcare, will they qualify for assistance or will the family be able to support them?

Working with a licensed agent/broker is a great way to ensure those difficult questions are asked and addressed.

What is the biggest disadvantage of Medicare Advantage?

Answer: Networks, prior authorizations and referrals.

It’s true that you have more “freedom” with a Medicare Supplement (Medigap) policy, but it will cost you. For some, that additional expense can be cumbersome.

Medicare Advantage can be a very good fit for some people. It just depends on everyone’s unique situation.

Again, that’s why it’s important to work with a professional, someone who can explain your options in-depth and discuss the pros and cons of each.

Why is the new $2,000 out-of-pocket maximum for drug costs important?

Answer: The Inflation Reduction Act went into effect at the beginning of 2025. When you are going to the pharmacy to pick up your prescriptions, you are usually paying a co-pay. Over the course of the year, all your co-payments are applied to something called TrOOP- True Out Of Pocket costs. Before 2025, your TrOOP was capped at $8000 per year, and once you reached that, you were put into what they called the “Donut Hole” which is a period of time you would be paying higher amounts toward your prescriptions before you would be transitioned to Catastrophic Coverage stage. This is where you are no longer paying anything towards your prescriptions.

With the Inflation Reduction Act, your TrOOP is now capped at $2000 per year, there is no more Donut Hole and once you’ve contributed towards your TrOOP and it’s reached $2000, you will go directly to Catastrophic Coverage.

Why do some seniors end up paying lifelong penalties for Medicare Part B or Part D?

Answer: Lack of appropriate retirement planning education. One of the foundations I have built my business on is education. Medicare 101 seminars can be really useful to people to learn how to avoid these penalties.

It is important to know that unless you have what is known as Creditable Coverage, delaying Part B and or Part D can carry lifelong penalties. Each situation is unique so it’s important to consult with a professional to understand if you have Creditable Coverage or not and have a plan in place, months before you turn 65. Sorting out your Medicare coverage is best done up to 3 months before you turn 65.

Do Medicare Advantage plans really save seniors money in the long run? Why or why not?

Answer: They can. Medicare Advantage typically offers additional benefits such as Dental, Vision and Hearing- the emphasis on these plans is Preventative Care. The better you take care of your health, the less costly it tends to be.

If you break it down, usually a Medicare Advantage plan is about $0 monthly premium, and includes your prescription drug coverage. You will still have to pay your Part B premium (in 2025 the standard premium is $185) and any copayments associated with your plan for doctors visit, procedures, medications. This is why Medicare is considered the Pay as You Go Plan. And that suits some people just fine.

With a Medicare supplement, you are responsible for your Part B premium, your Medicare supplement premium, your prescription drug plan premium and any additional policies you may require such as a Stand-alone Dental, or bundled Dental, Vision and Hearing policy (because Medicare Supplement plans do not include coverage for these). This is why a Medicare Supplement/Medigap plan is known as a Prepaid Plan.

If a senior is turning 65 but still working, should they enroll in Medicare or delay it?

Answer: It depends. Are they on their Employer’s group coverage plan? Is it creditable? Is it more expensive than Medicare? There are a lot of factors to consider. Do you have a spouse under 65 that you are providing coverage for? Does is make sense financially?

This is why it’s important to work one on one with an agent/broker in order to determine what is right for you.