Scott Sims, Medicare Insurance Broker

Answer: Currently in April, we can't change plans unless we move or have some other Special Enrollment Period, like having a chronic condition (change Medicare advantage plans). So it depends on what time of the year you are talking about. If we are talking currently in April, then we would need an SEP.

Answer: If you like Medicare advantage, you can change between advantage plans every year. If you are on Medicare supplement, some states have the "Birthday Rule" which allows you to change to another supplement carrier with no underwriting 30-60 days within your Birthday. In many circumstances someone has a 12 month trial period with Medicare advantage. That means we can give an advantage plan a, "test run", if you will. We have 12 months to move from advantage to supplement without answering health questions (underwriting).

Answer: Since we now have a $2,000 cap on medications for Part D Medicare per year, this person should only be responsible for $2,000 of out of pocket costs. Insurance carrier will pick up the rest of the cost for the year for Part D drugs.

Answer: While there isn't a specific Medicare program dedicated to smartphone apps for medication management, Medicare Advantage plans (MA) can cover digital health solutions, including those that support medication adherence, and some apps are specifically designed for Medicare beneficiaries.

Answer: You can always appeal. According to the Medicare Rights Center, 80 percent of Medicare Part A appeals and 92 percent of Part B appeals result in coverage for the beneficiary.

Answer: I think that Medicare should stay right where its at. 65 and older, or younger with disability. I don't feel it should be for everyone.

Answer: I have met with a local concierge Dr and she requested that if working with Medicare advantage, PPO plans would be a good fit since they are not in-network with the Medicare advantage plans. As of recently, one of the local health plans told me their HMO plan does work with concierge. So it sounds like they are more flexible now, don't need a PPO is what I've been told!

Answer: I think it's their right to make commercials. If they are giving false information and misleading people to think that all plans come with $1,800 in grocery benefits every year, they need to make those things clear. I just make simple commercials and educational videos, which seem to work!

Answer: Yes, Medicare will cover different inhalers and meds associated with asthma. It can be covered through Part B and/or Part D Medicare. Some equipment will be covered as durable medical equipment.

Answer: With so many plan changes this past year, many people who just let their plan roll into next year have been surprised by benefit changes. I make it clear when I sit down with clients and help them, let's make sure we have a chat or meeting when you get my postcard in the mail in September. These plans can change every year, it's important to review! Drug deductibles have changed this year for many plans, big deal!

Answer: I love when people come to me confused and leaving my office with understanding and a plan. It's taken many years to get to the point of Medicare knowledge. Not having to reach out to broker managers or other agents for questions is something I take pride in. I enjoy helping people and making them laugh. Many of the folks I help are good, fun people!