Sean Macbean, Medicare Insurance Agent

Answer:

There are many ways to report suspicious Medicare billing errors:

1. Medicare.Gov has a contact number that you can report.

2. The biller can be reached directly and take your information directly.

3. (CMS) Center for Medicare Services also has a phone and email contact number for reporting.

Check your statements for additional contact information for reporting billing issues.

Answer:

This refers to Medicare being the primary insurance biller 80% and your supplements being the balance or 20%.

Yes, your supplement is sometimes referred to as secondary coverage.

Answer:

To protect you from excess charges, all Medicare Advantage plans have a max out of pocket charge, ( MOOP).

Your co-insurance, co-pays, and deductibles all count toward this number.

Once you reach your (MOOP) limit, your MA plan will cover 100% of your costs. In 2025 it was an average of $9,350.

In short, meeting your deductible, means your plans full coverage has kicked in, however, does not remove additional costs.

The system is designed with multi-layers of co-pays, co-insurance, and premiums. Once you reach your (MOOP)

Maximum, your plan will pay for 100% of your covered costs.

Answer:

In 2024 the prescription do-nut hole was reduced from just under $5k to $2k., meaning people will qualify for perscription discounts sooner.

Drug Tiers as follows:

ADV plan:

Tier 1-2. $0

Tier. 3. $47

Tier. 4. $100

Tier 5. 25%

Tier. 6. TBD

Med Supplent:

Prescription Deductible$

Answer:

The dates for Medicare selection are widely published in most media cycles.

Because if you've missed (AEP) annual enrollment period of 10/15 to 12/7 or (OEP) open enrollment period of 1/1 to 3/31 for Medicare Advantage plans.

Unless you qualify for an SEP, your only option is a Medicare supplement, which all, requires underwriting.

Answer:

The easiest way for prescription verification is thru Medicare.Gov website.

You can plug your drugs into the selector and it will pick the best plan & coverages for you.

In lieu of that, your Agent, Pharmacy or Doctor may have additional input for you.

Answer:

Hospital Indemnity plans can be selected from 3 to 31 days. The dollar values are $50 - $600 per day.

Most people select (6 days) at ($600 per day) or a $3,600 reimbursement directly to the insured. ( 5 days hospitalization and 1 day to pay for years premium)

If you use up the 6 days in a year, you are responsible for those as out of pocket costs. Your days should be selected by health history, family genes, and doctors input.

Do yourself a favor; more is better than not enough. Nobody likes paying these OOP costs.

Answer: ........

True. Medicare Advantage plans are increasing thier market share as people start to understand how they work and the benefits which are attached.

Medicare supplements are not going away as the older population are not comfortable with the Co-pays, and uncovered costs that Medicare Advantage have.

My opinion; 5 years ago 20% were on Medicare Advantage plans now it represent 70% of the coverage of Medicare recipient's.

Answer:

An experienced and reputable Agent, during his meeting will ask a series of verification questions and if he/she detect any reason to bring in a child or relative into to conversation and decision process, will do so.

It does neither party any good, not to be on the same page. It is to important of a decision not to share information to ensure everyone supports a decision.

Answer:

Meet with a reputable and experienced Agent, who can match you up with the exact plan for your age, area doctors, and health situation.

Not all Medicare plans are created equal.

Answer:

All Medicare Advantage Plans, have these traits:

1. Most, have a zero monthly premium.

2. All Medicare Advantge plans have a 5 day hospital gap, requiring you to pay out of pocket $325 -$495, each day, depending on your exact plan.

3. Most, offer drugs, dental, vision, and hearing (which are specialist) and could cost you $10 -$50 per visit, dependant on your exact plan.

4. Most have various Co-Pays for everything outside of preventive care costs. These co-pays can be expensive.

5. To protect yourself, you should purchase a hospital indemnity plan which reimburses you directly for:

1. Ambulance charges

2. Hospital observation

3. Travel to hospital

4. Outpatient surgery or therapy

5. Chiropractic or therapy

6. Skilled nurses coverage

7. Mental health coverages

*All of these and more can be selected.

Answer:

There are several basic methods of verification:

A. Medicare.Gov website will identify your exact plan and benefits through a Summary of Benefits (SOB) document.

B. And experienced Agent, could be a lot of help to you, as they should know the carriers, hospitals, and doctors in your area, and can help steer you in the right direction.

C. Contact the carriers directly for information, but be cautious if they transfer you to a telesales person.

You don't want to have an 800# as an agent, or get sold a plan they are getting paid extra to sell you over the phone.

Answer:

When you turn 65, you get a no cost Retirement physical which helps prepare you for any possible future issues.

Answer:

NOT TRUE.

Life insurance serves many masters within healthare:

A. Death Benefit

B. Driver for Long-term care (LTC)

C. Surender Cash Value

Answer:

If you can afford it, it is always a good idea to purchase additional coverages, as you spend pennies to pay in dollars for most of these types of plans.

Answer: . . ................

Most people do not understand the importance healthcare in the finacial planning process:

A. Healthcare is the corner stone of preparing for your headache needs which average over $300,000 lifetime retirement dollars.

B. Life insurance plays a key role in the planning process, as it not only covers the death benefit, but also can be a key driver for LTC.

C. Retirement income, is THE MOST IMPORTANT aspect of retirement, as without it. It is difficult to pay for good Healthcare. Recomended is a Tax Deferred Guaranteed Annuity; which pays you a lifetime income.

D. Gap Coverage Policies; Dental/ Vision/ Hearing, Hospital indemnity, and Accident Coverage are staples that costs pennies compared to dollars when needed.

Answer:

Contact a good Agent (full-time at least 5 years in industry who is a producer/ broker) he/she should have the knowledge and experience to find a loophole or SEP, to help you.

Answer:

There are several things you can do to reduce the high costs of prescriptions:

A. Go to your Doctor for Samples.

B. Use a GoodRx discount card.

C. Apply for Extra Help through Medicare.

D. Purchase your perceptions from Canada ( 20%) savings on average.

E. Check out the prescription program of an advantage plan, there are special plans for people with Heart, Diabetes, and Veterans, called SEPs.

Answer:

There is an entire process that will determine maximizing your social security.

However, EVERYONE is different with different requirements. The simple rule of thumb is:

A. Don't take it, if you don't need it, as you will be giving up 30% at 62 years old.

B. If you really need it to make ends meet, take it - it's your money.

C. Some people who don't need it do take it and invest it. This is not recommended unless your are getting a "guaranteed" return of 5% or greater.

Do not invest in ANYTHING tied to the S&P 500, you do not have time to recover any lost money's. If you lose 50% you must earn 100% to break even - not going to happen.

Answer:

The way Social Security works today is you will get your husband's check, ( which is usually higher) but you will forego yours, which normally means your total income will be decreased.

Answer:

Many people do not select Medicare Part B because of initial cost and health.

However, in the long run it costs them more:

A. Unable to change Medicare plans, because it requires both Parts A&B.

B. Latter in life the services required without Part B, are then treated as " out-of-pocket costs, and can be extensive.

Do yourself a favor and sign up for both Parts A& B, in the long run, you'll be glad you did.

Answer: This is a more profound question than it seems. I will answer it briefly by explaining the criteria you should look for in each one.

Company:

- Find a local company that has been in business for at least 20 years and focuses on Helping Seniors with their healthcare needs.

- Find a company that trains its agents well and supports them.

- Find a company that is a broker and offers many products and services, rather than being captive and only offering one product.

Agent:

- Find a full-time agent with at least 5 years of experience.

- Find a Local agent who will meet you face-to-face at your home or their office.

- Find an agent who is well-versed in multiple products and selections.

- Find an agent that is focused on saving you money.

- Find an agent who is a Health to Wealth expert to offer you the best services.

There are many more criteria for both the company and agent, but if you focus on these basics

You should do well.

Answer: Each of these plans is different. They may have other coverage limits, deductibles, co-pays, or costs.

It is essential to meet face-to-face with your agent annually and let them help you pick the right plan for your healthcare needs.

Answer: I have been in this related industry for over 25 years and still enjoy meeting people, helping them save money, and improving their healthcare plans.

We pride ourselves on our clients' longevity, which is related to our world-class customer service. We continue to send thank you cards, birthday cards, newsletters, and place two wellness calls per year. We are not the right partner if you're not looking for a relationship and just a transaction.

Answer: Most Medicare Supplements and Advantage Plans cover these foreign hospital costs when you travel inside of 30 days.

For travel more than 30 days, we recommend adding additional travel and health coverage.

Answer: Since everyone's healthcare situation is different, we take a custom approach to help you design a plan that works best for you.

We review these plans annually and adjust them as needed.

Answer: We have a proven process called "Retirement by Design," in which our clients participate in designing their own retirement plans, from Health to Wealth. Through this process, we will discuss:

* Estate Planning:

- Wills

- Trusts

- Beneficiaries

- Tax Mitigation Strategies

* Retirement Planning:

- Health Coverage:

- Medicare Supplements or Advantage Plans

- How Life Insurance can provide LTC or provide basic final expenses

- How can we provide you with a guaranteed income

- Cover your LTC needs with a program that works for you.

There is no cost for our consultations.

Answer: Everyone has different needs. Let's set up a no-cost consultation to determine what is right for you.