Sandra Teel, Medicare Insurance Broker

About Me

As a dedicated licensed insurance agent specializing in Medicare serving Berkeley & Jefferson County WV, Washington County MD, Frederick County VA and many other states, I provide compassionate, NO COST assistance to help you navigate the complexities of Medicare. With access to all major insurance companies, I offer a wide range of options tailored to your unique needs and budget.

My personalized, one-on-one approach ensures that you fully understand your choices and can make informed decisions about your plan. Whether you need a Medicare Supplement, Advantage, or prescription drug plan, I'm here to guide you every step of the way.

Contact me today for a NO COST consultation and find the right Medicare plan for your health and well-being.

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Articles by Sandra Teel

Q&A with Sandra Teel

What's one piece of advice you wish every senior knew before picking a Medicare plan?

Answer: It's okay that you don't understand. Medicare is complicated. There are so many options, and every state and county are different So what works for your friend in another state or county may not work for you. Don't just talk to your financial advisor or call one insurance company that can only tell you about their plan. Talk to a professional Medicare Broker who can tell you about all your options.

How do you educate clients who are completely new to Medicare?

Answer: I take the time to start at the beginning and walk them through the whole process. Once they get their Medicare card, then we sit down and look at all the options available to them. One size does not fit all, every situation is different, so I personalize what options best suit their needs.

Can you help me understand Maximum Out-of-Pocket (MOOP) limits in Medicare plans, from your experience as an agent?

Answer: There are two maximums out of pocket limits to consider.

The first one is on prescription drugs.

In 2024, Medicare changed the way prescription drug plans work. Out with the old and in with the new $2,000 maximum amount you will pay for your covered prescription drugs. Our prescription drug plan insurance company keeps track of how much you've paid for your prescriptions and when you have reached your maximum, your covered prescriptions will drop to zero amount for the rest of the year.

The second maximum out of pocket to know about is with the Medicare Advantage plans.

If you have a Medicare Advantage Plan, commonly known as a Part C, the insurance company keeps track of how much you pay for co-pays and co-insurance through the year. Once you reach the plans maximum out of pocket amount, then the insurance company pays the remaining co-pays and co-insurance for the rest of the year. Each plan has a different Maximum out of pocket amount, so knowing what that amount is important.

Make note that if you only have original Medicare, there is no maximum out of pocket amount for your 20% co-insurance.

I chose Original Medicare to keep my doctors, but now I'm drowning in bills. Should I have gone with Advantage instead?

Answer: Possibly. The only time I recommend anyone to stay on original Medicare is if they are also on the State Medicaid program that will pay for your 20% co-insurance.

 

There is no maximum out of pocket amount with original Medicare. That means you will continue to pay your 20% with no limit.

If you chose a Medicare Advantage plan there would be a maximum out of pocket amount to help keep your costs under control. Choosing the right Advantage plan is very important. Getting help from a professional Medicare Insurance broker will help you see if your doctors accept Advantage Plans along with which ones they accept. It would also help cover your prescriptions premium because most Advantage plans include prescription drugs.

If keeping your doctors are the most important thing, and they don't accept Advantage plans, you might possibly qualify for a Medicare Supplement plan (Medigap) to help cover your costs.

What should I do if I miss the Medicare Open Enrollment period, and I want to change my plan?

Answer: If you have a Medicare Advantage plan and you have missed your opportunity to make a change in the Open Enrollment Period, then perhaps you might have the ability to make a change using one of the several Special Enrollment Periods (SEP) that are allowed by Medicare.

Some of the SEP's include things like the following:

1) Have you moved to another county or state? Have you recently moved back to the United States after living abroad? Have you moved into or out of a skilled nursing facility?

2) Have you lost Medicaid? Or lost the Extra Help for prescription drugs? Did you lose the PACE program?

3) Have you recently been granted Medicaid or Extra Help with prescriptions? Do you have a Chronic condition like diabetes or heart disease?

4) You could join a 5-star rated plan

5) Were you affected by a FEMA disaster?

There are many other SEP's that you might possibly qualify for. So, talk to a local Medicare Insurance Broker to know all your options.

How can I lower my Medicare Part B premium if my income drops after retirement?

Answer: If you have incurred a higher Part B premium because you were considered a high-income earner, you can ask Medicare for a reconsideration if your income has dropped significantly.

Every year Medicare looks at your Adjusted Gross Income from 2 years previously to determine what you will pay for Part B. If you were a high-income earner, then you received a letter letting you know that your Part B premium would be adjusted. In that letter there is an explanation of how to apply for a reconsideration.

If your income has decreased significantly and takes you to a lower premium bracket, Medicare will automatically decrease your Part B premium to match the new lower premium level when they look at your filed income taxes.

What do you enjoy most about working with Medicare clients?

Answer: Medicare can be very confusing. There are so many rules and penalties that scare people. It makes me happy to help people understand what applies to them, and what does not apply. Because I am a broker, I'm able to help them all the way through the process so they feel confident in the choice they make with their insurance option. My clients become my friends, and I'm available when they have questions.

Am I eligible for a Special Enrollment Period if I lose employer coverage?

Answer: Yes. If you are losing your employers insurance, whether you are retiring or losing your coverage for other reasons, it opens up a Special Enrollment Period (SEP) of time for you to get onto Medicare.

Please note that COBRA coverage is not considered credible coverage by Medicare, so you will still need to apply for Medicare if you are offered Cobra.

Once your employer coverage ends, or your COBRA coverage begins there is a limited time you have to get your Medicare coverage before you will be penalized.

Please reach out to a professional Medicare Broker so they can help navigate you through the process.