Stella Hattox, Medicare Insurance Broker

Answer: Plan G has less out of pocket for the member - at a higher premium.

Plan N - has some small out of pockets that reasonable at a lower premium. ( doctor visits have co-pays etc. )

Answer: It's best to enroll in Medicare to cover you while your traveling in area's that the VA may not be easily accessible. There are some plans that provide VA members additional coverage such as Dental and Vision at no extra cost and may even provide some reimbursement on your premium. It is a very valuable benefit and I have seen several VA members utilize their Medicare plan with relief that they had it.

Answer: The sooner you purchase a Long Term Care policy the better. I have seen people need their policy before retirement. Strokes and Cancer can hit a person at any age and can leave a person needing that extra care.

Answer: Plans that are designed to provide care targeted to chronic needs or low income retiree's. They provide benefits tailored to assist with those members needs.

Answer: It's best to stick with one. However, there are some agents that are not very ethical or they just represent one carrier. It's best to find someone that represents multiple carriers and handle a variety of plans, such as Long Term Care plans and Life insurance and Dental and prescription drugs. Otherwise you will end up with multiple agents which is not in your best interest.

Answer: Medicare and Medicare plans do not cover Long Term care. The medical services related to it are covered, but Long Term Care or custodial care is not covered. Most people purchase a Long Term Care policy.

Answer: Normally 3 weeks, however some make longer if missing or additional information is needed. Another factor is if you have moved and address was updated, or if information does not match your Social Security number, several different things can delay the process. Average is 3-4 weeks.

Answer: No, unfortunately it does not. There are situations where you can be "Guarantee Issue" into a Med Supp. Plan, but moving is not one of them.

Answer: That bait with extremely low initial enrollment premiums and later have a significant large rate increase. Be sure and ask your agent about the rate increases for the carrier .

Answer: Agents can sell during the Annual Enrollment Period (AEP) from October 15 to December 7.

They may also sell during the Med. Advantage OEP Period from January 1 to March 31.

Special Enrollment Periods (SEPs) allow sales when beneficiaries experience qualifying life events. ( example: moved to another state or county, etc.)

They can provide information and enroll beneficiaries during the Initial Enrollment Period (IEP) when they first become eligible. (They can assist with plan changes or enrollments when beneficiaries are newly eligible for Medicare),

Answer: Consider the following:

MLR measures the percentage of premium dollars spent on medical care versus administrative costs.

A higher MLR (generally 85% for large insurers) indicates more funds are directed towards patient care.

Insurers with high MLRs may offer better benefits and services to their members.

Lower MLRs could suggest more spending on administrative costs, potentially impacting coverage quality.

Overall, a higher MLR often correlates with improved healthcare access and quality for enrollees.

Answer: All those are good things to consider, but most important, you need to consider Financial Stability of the carrier.

Answer: Unfortunately, they may be faced with a lot of debt. You may want to look at a Medicare Advantage Plan that has a low Max Out Of Pocket. Traditional Medicare does not have a Max Out of Pocket.

Answer: Consider these factors:

Review the plan's premium and out-of-pocket costs annually for increases.

Check the plan's network of providers and any changes that may affect access.

Evaluate the coverage options and benefits to ensure they meet your needs.

Monitor the plan's star ratings, which indicate quality and performance.

Research the insurer's financial stability through ratings from agencies like A.M. Best.

Stay informed about any changes in Medicare policies that could impact your plan.

Answer: Findings suggest that the changes in MA plans’ benefit packages in response to the CHRONIC Care Act and their efforts to address SDOH will vary. Therefore, it is likely that MA enrollees will be differentially affected by the implementation of the CHRONIC Care Act.

Answer: No, not unless your applying for a Chronic Needs plan and do not have a Chronic Need. Majority of plans are guarantee issue regardless of health, however there may be other reasons for not qualifying.

Answer: Yes, in some cases. Med Supplements go throufh Underwriting, if you are currently being treated for a Chronic condition, they can decline you.

Answer: It depends on the plan you want and the illness. But yes, there are exceptions. You’re welcome to call and discuss your situation.

Stella

Contact me.

Answer: I highly recommend one. It depends on the plan you get. Some plans cover up to three or four admissions a year.

You’re welcome to contact and I can run you a quote.

Stella

Contact me.

Answer: You can always apply on line. Medicare.gov. If you have been on disability for a min of 24 months. Or call Social Security office.

Answer: It depends on the coding that the provider puts on the claim. Doctors have a list of what is covered under " Routine Physical". Also, Medicare has updated the Routine Physical coverage list of procedures. Please check with your provider to see " why" the test is being done. Is it medically necessary?

Answer: Enroll in Part A only. That is the cheapest premium cost, but not the cheapest coverage. You may be out of pocket cost for some expensive procedures not covered by Part A.

Answer: Mental health services, including therapy, are partially covered under Original Medicare. Specifically, Medicare Part B covers outpatient mental health services, but there may be coinsurance and deductibles involved. For inpatient mental health services, Medicare Part A provides coverage, but it has a 190-day lifetime limit in psychiatric hospitals. It's important to note that some services may not be covered or may be offered too frequently, which could result in additional costs.

To ensure full coverage, it's recommended to check with Medicare or consult with a healthcare provider to understand the specific services covered and any potential out-of-pocket expenses.

Answer: Making sure they understand all the benefits of thier plan. Sometimes a client focuses on ONE thing - example: I want free food -or money back... and miss out on important things like: is my medication covered on new plan, or does my doctor take it?

Answer: The best advise I can give is to get with your agent. They can put your medications in the system and advise you which carriers cover your medications the best. I would not enroll in a plan randomly with out a review of medications first.

Answer: With Traditional Medicare Plan, there is no guarantee. You may also be resposible for excess charges. That is the reason why doctors office have patients sign a " Patient Responsibility" form.

Answer: It depends on if your Plan G was a Guarantee Issue policy or Underwritten. Your agent should be able to answer that question for you.

Answer: I recently attended The Medicarians Seminar. AI was a major discussion. Technology has sped up claims processing and other systems utilization as of today and for future use.

Answer: YES, they pick up deductibles and co insurance. However, if Medicare does not cover it, the Supplement ( also known as Medigap) will not cover it either.

Answer: Advantage if PPO plan - It normally has higher co pays or higher out of pocket.

Medigap works with Medicare, if provider is not Participating with Medicare, patient may be liable for all charges or higher out of pocket. If Medicare does not cover it-Medigap will not cover it.