Sherah Beasley, Medicare Insurance Broker

Answer: So listen, if you're working right now and have employer coverage, and you're trying to decide if you should move to a Medicare plan or stay with group coverage, the most important thing to remember is that Medicare requires you to always have some sort of credible coverage. Credible coverage can be group coverage or employer coverage that is equal to or better than what Medicare would offer. If you have that, and if you're unsure if you do, you can always ask HR. Your HR department should know that. But if you're unsure, you can always call a licensed agent too, and we'll walk you through what you currently have and what your options are.

Because if you come off your group coverage too soon and turn Part B on, now you're paying that monthly premium for something that may not be necessary if group coverage was better or the cost was lower. Usually, it's not, but sometimes it is. The other thing is you don't want to wait too long to turn Part B on and also lose your group coverage, because now you have a gap, and that's when penalties start to accrue.

So again, work with a licensed agent to look exactly at what your needs are, what your plan is, when you plan to retire, how your group coverage is currently treating you, how much you're currently paying monthly, and how much you're paying out of pocket when you use the services. Then look at all your options in Medicare. Usually, we say 80% of the time, clients do better moving to Medicare when it's time, not staying with their group employer plan. But every client’s different, so make sure you work with a licensed agent to determine what's best for you.

Answer: So, you know somebody who wants to move to a Medicare Advantage plan because they've heard from their friends or neighbors that it's great. Listen, Medicare Advantage can be great for the right person. What's more important than wanting to move to a Medicare Advantage plan because of a bright, shiny object that's been dangled in front of you, like a commercial or even a buddy who says, "Hey, this is better because I get a food card or a grocery card," is looking at that plan and making sure it fits your needs.

Make sure your doctors are in-network and your medications will be covered appropriately. The coverage is what you need. Maybe you know that you need upcoming dental work; that's probably more important than a food card. If there's dental work that's going to cost $5,000, we need to shop plans based on those needs, not on what your friends say is better because it fits their needs. So, make sure you work with a licensed agent who can look at what that is for you and find the best plan with some really cool perks and benefits that fit your needs specifically.

Answer: Some Medicare Supplement carriers already offer perks or added benefits to “enhance” their plan offering for clients. They offer preventative perks like gym memberships, heart rate monitor watch devices or coverage for additional screenings.

If you haven’t already, you should partner with a private insurer, for your health coverage, as the level of care and coordination will almost always be of higher quality than a public insurer or government entity.

Answer: Medicare covers a wide range of preventive services and many of them are completely free (no copay, coinsurance, or deductible) if certain conditions are met and you see a provider who accepts Medicare (and is in your network if you’re on a Medicare Advantage plan).

Here’s a list of preventive services that are 100% covered under Original Medicare (Part B) at no additional cost to you:

- Annual Wellness Visit- Not a full physical, but a check-in to update your personalized prevention plan. It’s free once every 12 months, after your first year on Part B.

- Welcome to Medicare- One-time free visit within the first 12 months of enrolling in Part B. Includes a review of your health, safety, and screenings.

And most screenings will be approved by Medicare if eligibility is met and there is a medical need or concern to monitor something - like cancer screenings, heart and diabetes screenings, vaccines or other tests for things like vision/hearing/depression/etc.

Answer: Great question! Original Medicare - Parts A and B - do not have a stop loss or max out of pocket associated with the coverages and there’s a deductible and per day cost (for a hospital stay, specifically) that can add up very quickly, so you must protect yourself there.

You can purchase something called a Medicare Supplement (specifically a Plan G Supplement) to fill all gaps in coverage, after you pay a once per year $257 deductible. All Medicare approved services will then be covered at 100% after that for the remaining plan year, relieving you from that huge financial risk.

Answer: If you are an avid traveler or have a vacation home you spend several weeks or months out of the year at, you most likely would benefit more from Original Medicare, paired with a Medicare supplement plan (specifically a Plan G or Plan N).

These types of plans fill all of the large gaps in coverage (that having just Original Medicare) and have no limiting networks - if a physician or facility takes Medicare (no matter what state you’re in), you can be seen by that doctor without a referral or prior authorization being necessary.

Medicare Advantage plans have limitations on them like networks specific to the area you live around, meaning the network of providers/doctors you can see might be limited to your primary residence county or zip code.

Answer: This is a great question! Traditional Medicare and Medicare Supplements should be accepted anywhere in the U.S. that takes Medicare, but if the cruise ship is in international waters, coverage might not be afforded.

Additionally, some other parts of Medicare might extend to the emergency services or travel home from an emergency, like a Medicare Supplement or Medicare Advantage (MA) plan. Just keep in mind, if you do have a MA plan (specifically), it probably has a network you must stay within, so there’s not as much flexibility with your healthcare, when you’re on one of these types of plans.

So if you travel frequently or have questions about an upcoming trip, make sure you call our office so we can help you walk through your specific plans and needs.

Answer: Medicare is the 2nd or 3rd largest budget in the United States. It’s a very important part of our sustainability as a country, so I don’t believe it’s going anywhere anytime soon - the efforts, time and money dedicated to it.

With that said, the government is trying to crack down on fraud and waste, as they should, so this should extend the budget and help it go further. Over time, there might be more costs passed off to the Medicare beneficiaries, but the entire purpose of Medicare was to off-set high medical costs for the 65 and older population, so I’m sure there will always be a push to sustain its purpose.

Answer: It’s okay if you missed your window of time to sign up! You can still do so and the sooner you sign up, the better, for most people. Here’s why…

If you’re eligible for Medicare and don’t have other credible, qualified coverage, you will be charged penalties the longer you wait. So give us a call today so we can help you navigate the RIGHT time to sign up and HOW to do it. Our agency will walk you through the process every step of the way!

Answer: If you’re paying more for Medicare Part B (medical insurance) and Part D (prescription drug coverage) than other people you know, it’s likely due to something called IRMAA – the Income-Related Monthly Adjustment Amount.

IRMAA is an additional amount that people with higher incomes must pay on top of their standard Medicare premiums. It affects Medicare Part B and Part D. The Social Security Administration (SSA) determines if you owe IRMAA based on your reported income.

Your friends might have a lower reported MAGI, different filing statuses, or different income sources. Even similar incomes can result in different IRMAA outcomes depending on deductions, tax-exempt interest, or capital gains.

Answer: Advancements in wearable health technology are poised to significantly enhance patient care and facilitate faster diagnoses. By continuously monitoring vital metrics such as heart rate, blood pressure, glucose levels, oxygen saturation, and sleep patterns, these devices provide valuable data that can be shared with healthcare providers. This allows for more efficient coordination of care and timely follow-up.

Answer: Many times a face to face sit down conversation can clear up all the questions quicker and easier than a phone call. We want all our clients to know we will be here for you! Drop in and say Hi, or set up an appointment to review your coverages and benefits!