Sterling Warmack, Medicare Insurance Agent

Answer: So there is no normal when it comes to Medicare Advantage. Because Medicare Advantage is provided by private companies to help pick up some of the coverage gaps that original Medicare has, it is just an option for people on Medicare to help them have more access to health care. Dental is one of the added benefits. It's not a required benefit by Medicare, which is why if you're on original Medicare, you will not have dental benefits or vision benefits. So it is an extra. With that being the case, when you see tumultuous times like right now in the Medicare Advantage industry, you might see less benefits available for dental coverage because it is an added benefit. It's an extra benefit that's not required to be met. Most dental plans on the Medicare Advantage will cover your cleanings yearly, typically two cleanings. Typically, X-rays are included. Typically, they cover like a pan X-ray biannually if necessary, and then they will cover minor oral procedures like cavities being filled or a chipped tooth being repaired. Typically, you will not see any coverage for implants, and that's throughout most of the country. But it can depend on the state you're in. You will see coverage for things like dentures because they will actually be able to fix your whole mouth at one time with that. So depending on the amount of dental coverage you have, if you have a couple thousand dollars of dental coverage, that will more than likely cover your dentures and any teeth removal you need. Whereas if you only have a couple hundred dollars, you may need to do kind of a step program to get your teeth fixed if you have multiple issues going on at a time. So it really just depends on your needs and what you're looking for. But pretty much in my state anyways, across the board, nobody covers implants for the Medicare Advantage dental programs. They're just very expensive and very involved. And I think that's a big reason that they're not covering them. So it's just something to keep in mind when looking for coverage. That is an added benefit, like I said. So it's not required by Medicare. So anything you're getting as far as dental coverage is kind of just a plus and not something that you're necessarily entitled to. So get what you can get that will cover your needs the best you can to help you save money. But otherwise, look for a Medicare Advantage plan that's going to cover your health care needs first.

Answer: Are some Medicare Advantage providers better than others? Well, that depends on your perspective. So whatever you're looking for, if you're looking for a Medicare Advantage provider that has a customer service department that's solely in the U.S., then you may prefer one provider over another. If you're looking for a Medicare Advantage provider that has better dental coverage or better vision coverage, you might find a better plan through one provider than you would the other. That doesn't mean the provider's necessarily better.

So there are regulations that regulate the Medicare Advantage industry. If you think one provider is going to be better than the other, that's not necessarily true because they all have to adhere to the same laws regarding Medicare Advantage plans. So it really comes down to that customer service element, like what you prefer for customer service, and some of that you're just going to have to experience.

So my best advice is to go with the plan that is going to work better for you for that year. And if you're not pleased with their customer service when you call in and ask questions or something like that, or you're not pleased with how it works when you go to the dentist to get a filling or go to the eye doctor to get glasses, then maybe try a different provider if they have a plan that's going to be just as good for you.

But ultimately, what you're really looking for is not which provider's best. You're looking for the plan that's going to serve you better than the other plans, depending on your specific needs. So just keep that in mind, that it's not necessarily good to be brand loyal, but to be looking at what is going to work better for you, regardless of who provides the service.

Answer: Is it better to get Medicare Part D or Medicare Advantage? Well, this all depends on your situation. So everyone's situation is different. There's no one right answer for everyone. That's why there's so many companies and so many options out there. And yes, it gets very confusing. But if you're in a situation where you need more coverage, you don't want to have to pay any co-pays at a doctor's office or hospital or for anything like that. More than likely, you're gonna go with a different coverage option for your Medicare health and physician visits, in which case you would need Medicare Part D.

But if you'd rather save some money and you don't mind paying the co-pays when you go to the doctor's because you don't go that much, or you'd like a little extra money back every month, a Medicare Advantage plan might be right for you. But really, there's no one answer that fits all. We can just say that this is better than that because it's really about what plan is going to work best for you and your personal needs, your personal financial situation, and what you need help with.

Like if you need over-the-counter help, if you need extra help monthly with, like say, paying your bills, if you can get financial assistance from the state, that may change your situation. So there's all kinds of scenarios, and they vary from individual to individual. Even if you live in a home with someone else who is getting Medicare, they may have something different that they need than you have.

So you might want to be on the same plan to make it easy, but that may not work for the both of you. So this is why it's really important to consult with someone, an independent agent. You can talk to Medicare. They have 1-800-Medicare, or you can go to Medicare.gov as well. But your local agent is gonna know what's available to you in your area, and they're gonna know what is going to work best for you by reviewing over what physicians you prefer to go to, what hospital systems that you usually use, what pharmacies you prefer, what kind of medications you take, how often you need certain types of exams. Like if you get an MRI every year, you might want a different plan.

So it's really important if you can find an agent local in your area to talk to. They should be able to help you without charging you any additional money to help you figure out what plan is going to be best for you.

Answer: You may be eligible for special enrollment period depending on your area. The change from SSI to SS also should qualify you for a special enrollment period. Need to talk to a local insurance agent, more information is probably needed to be relayed to see what can be done for your particular situation.

Answer: The first thing I tell clients who are completely new to Medicare is to be sure to sign up for Medicare part A and Medicare Part B if they are losing employer coverage. You cannot get a supplemental insurance plan or a Medicare Advantage plan without having both part A and Part B of Medicare.

Now if a client does not intend on getting any other insurance coverage and intend to stay on original Medicare then I will go over the details of what Part A covers as far as Hospital, emergency, and hospice care. And then I go over what Part B covers as far as physician care.

After covering all these details we will talk about Part D which is prescription coverage. It is essential to go over all the coverages and enrollment periods when a person becomes initially eligible for coverage as not taking one of the coverage options often results in a late enrollment penalty later on when and if the person decides to take coverage.

Most late enrollment penalties occur due to late enrollment into the prescription coverage Part D. Some of these late enrollment penalties are minimal but if too many years have passed since a person was eligible to enroll in one of the parts of Medicare, the penalty can be quite a large sum that is added on to the cost of Medicare coverage.

I've had both friends and family members who have run into a late enrollment penalty for their Part D coverage, because when they enrolled in medicare they did not need prescription coverage. So when later on they needed a medication, or in some cases a more expensive medication, they had to get prescription drug coverage with a significant penalty that was cheaper than paying out of pocket for the medications they required at that point.

Bottom line, when in doubt find an agent and ask them questions. Just because someone talks with you about a details of medicare and the incidents of your coverage options for your area does not area into any plans with them.

Answer: If you are moving from one state to another, and you are currently enrolled in a supplemental insurance plan or an advantage plan that is available in the area that you're moving to, the plan will move with you.

If you are moving to an area where the plan you are currently on is not available, you will be given a special enrollment period during which you will be able to enroll in a new plan.

If you are eligible for the special enrollment period you will also be eligible to enroll in a supplemental insurance plan without having to answer a healthcare questionnaire which is called guaranteed acceptance.

I have had several clients use the opportunity that is presented upon moving outside of a coverage area to move from a Medicare Advantage plan to a supplemental insurance plan because they would otherwise be denied to pre-existing conditions such as diabetes, heart disease, or cancer.

This special enrollment period actually allowed one of my clients to enroll in a supplemental insurance plan that ended up saving them thousands of dollars very quickly due to unexpected health obstacles.

Answer: Having an agent that works in your state is going to be more familiar with your state by Nature. They have the advantage of understanding the types of things you have to deal with regarding healthcare as they are likely using the same types of Hospital systems that you are.

I am familiar with every hospital in the area where I live as well as several other hospitals throughout the state. But if someone were to speak of Hospital systems and other states I'm probably not going to have any idea about where they're located, how far reaching the system is, if there's other options in their area, Etc.

Also being a local agent I have the pleasure of having met many independent pharmacists, other such providers so that I can say honestly that I understand where an individual is coming from if they say they would rather not use a provider or would prefer to only use a certain provider.

However, I will not discount the fact that being able to work with an agent virtually is advantageous in many situations. I do not always meet with my clients in person and often handle issues with my clients either over the phone or over email. This not only makes easier and more convenient for my clients, but it also makes it quicker for me to get them answers.

I do prefer to meet with my clients in person though, especially for making any major plan changes so that we can go through all the details verbally while looking at them on paper. I find this simplifies the process that is otherwise quite complicated.

Answer: It depends on what type of heart monitoring you are in need of. If you need heart monitoring for a period of time to check on the condition of your heart that would be covered under Medical.

If you need something like a blood pressure cuff that would be considered a medical device and your typical copay would be 20% on that. If you needed to see a physician more often for heart monitoring then that would be covered under your healthcare plan at whatever copay you had for a specialist unless you had supplemental insurance which would then cover those doctors visits at 100%.

I am sorry the answer is a little confusing but the question is a bit vague as there are many different kinds of monitoring you could be referring to. However there are some Medicare Advantage plans that will pay for a smartwatch device that does heart monitoring.

Answer: Many adva names pla s provide cleanings at no cost as what is considered a preventative dental service.

Often other dental services are covered at a percentage , although some other plans provide a monetary allotment to go towards Advanced Dental Care.

Most advanced plans do exclude some services and require them to be paid for out-of-pocket but the exceptions are few.

Answer: For annual moment you will simply need your Medicare card and/or number, you will need a list of your medications you're currently taking, and a list of your primary care physician, specialists, dentists, and Vision providers.

All of these are required for your representative to ensure they have you on a plan that will cover all of your medications and doctors.

If you are looking for someone to help you navigate your options this annual enrollment. And you live in the upstate of South Carolina contact me now to schedule your appointment.

Appointments must be scheduled at least 48 hours in advance and an email will need to be provided to book an appointment.

Answer: Rehabilitation facilities are covered by Medicare. However assisted living is not considered Rehabilitation, typically. Assisted Living may be fully covered by Medicaid for low income individuals however those individuals would have to qualify for The appropriate level of medicaid needed for the assisted living facility. There are additional insurance coverage options you can purchase that would help cover the cost of longer term care... However the specifics of what you would need for your state and the facility that you are interested in Would need to be obtained from the facility itself, As not all facilities accept medicaid.

Answer: Original Medicare and Supplements do not cover over-the-counter medications, Dental benefits, Vision Benefits, Hearing benefits, Prescription (Drug) coverage, and additional benefits like food cards or gym memberships.

All of these additional benefits are called supplemental benefits that you can purchase independent of your medicare coverage.

If you want these benefits but cannot afford the additional coverage, you may consider a medicare advantage plan that often includes most, if not all, of this coverage.

If you have any additional questions regarding coverage in the Upstate of South Carolina, please contact me to schedule an appointment today!

Answer: There are many reasons to work with a local Medicare agent, but here's some of my favorite reasons.

Having a local Medicare agent means they live where you live. This means when you're going through hardships related to the weather, the economy, or just heavy traffic... your agent can relate and advise you with the knowledge only a local agent can provide.

Having a local Medicare agent also means that you can meet with them in person. With so many spam calls of AI Representatives or people with heavy accents that you can understand, it's nice to know that your agent can sit down with you face to face and speak with you in an environment where they cannot only answer your questions clearly but they can also show you how things work and walk you through the enrollment process every year if you need it.

Having a local Medicare agent also means they're probably keeping the same hours you are. So if you have a problem at 12:00 in the afternoon your local Medicare agent is likely going to get your message at 12:00 in the afternoon and be able to answer your question before the end of the day.

The last thing that's so great about having a local Medicare agent means that they're not just a voice on the phone. When I find out my clients are going through a particularly rough time I like to drop something by their house to cheer them up and let them know that I'm there for them to help them with their Medicare needs as they Traverse a difficult situation. I'm always still available via email or text message or phone but I've had several clients Express how please they are that I'm local and have provided that one on one experience with that extra level of care.

Answer: It depends on your situation.

If you spend enough of your income on medical expenses you can deduct the amount that you spend from your taxes every year if you spend seven and a half percent of your income on medical bills.

If you are self-employed, you may also be able to deduct medicare premiums from your taxes.

Another situation where you might be able to deduct your medicare premiums from your taxes is if you have a higher IRMAA. If you don't know what that is your local representative can go over it with you, but you probably don't have a higher IRMAA(higher than average income).

If you think you may qualify for deducting your medicare premiums from your taxes please consult a tax professional.