Tasha Riggs, Medicare Insurance Broker

What is the biggest mistake seniors make when enrolling in Medicare?

Answer: Getting information from Friends and Family and not an expert in the field.

Your friends and family understand what they have but they don't see the whole picture and how it works as a whole. Get advice from a true broker who has access to All or a majority of the plans. Not an agent who is selling only one or two products.

What is one of the the most common misconceptions people have about Medicare?

Answer: People hear that Medicare advantages are all HMO and need referrals. That is not true. They are also PPO's and the networks are VERY large. You can travel and even go out of country and you do not need referrals!

How will the new 2025 Medicare Part D out-of-pocket cap impact seniors and prescription drug costs?

Answer: You may have to pay more upfront costs for drugs. You may need to pay a drug deductible.

I would run the cost of your drugs each year to see what it will cost.

What's the process for signing up for Medicare if I'm already on disability benefits?

Answer: The Medicare card will automatically come to you if you have disability benefits. You do not need to do anything!

How can I lower my Medicare Part B premium if my income drops after retirement?

Answer: You can apply for LIS. Limited Income Subsidy.

Some Medicare advantage plans will help pay for part B if you really need it.

What's the best way for seniors to protect themselves from Medicare-related scams?

Answer: Meet an agent at their office. Look at their google reviews. Get references.

Do not work with a person who randomly calls you. No one is legally allowed to call you unless you give them your consent.

How can I verify if a Medicare Advantage plan's advertised benefits are legit?

Answer: Many advertising is a marketing tactic to get you to call them. I would avoid calling numbers on TV and avoid answering calls you did not request. I would find an actual broker with good reviews on google to speak to. Some of those benefits are available and some only for certain clients. If you ask from April to September they cant pressure you into a sale since it is not open enrollment so that maybe a good time to ask questions with out being pressured.

Should there be stricter regulations on Medicare Advantage marketing and sales practices?

Answer: No. The regulations make is harder for honest people and the seniors. The issues is that the dishonest people are NOT following the rules. Calling Seniors with permission to contact forms. They are signing them up without Scope of Appointments.

The high pressured scammers are the problem and not following any rules. I get calls every 10 minutes from people trying to pressure me and make false claims about insurance and I am a broker!!

Why is the new $2,000 out-of-pocket maximum for drug costs important?

Answer: It is good to know if your drugs get super expensive that you can not spend more than 2,000 in a year. There was no cap before and the donut hole was financially hurting people.

I love the 2000 cap!!

Are Medicare Advantage plans really "free," or is that just clever marketing?

Answer: Yes a majority of Medicare Advantages are free.

Medicare advantages you pay a copay as you use it.

Many of them come with dental, vision, hearing, over the counter items, and some healthy foods!!

Does Medicare cover eye exams, or are seniors left paying too much?

Answer: Medicare supplemental or original Medicare is Only health

Medicare Advantages have all the extra bells and whistles. Most of them have Eye wear coverage.

If the Eye exam is for a medical reason it will be covered under all plans

Do Medicare Advantage plans really save seniors money in the long run? Why or why not?

Answer: Medicare Supplements premiums go up every year and so do the drug cards. You pay that larger premium each year weather your sick or not.

On Medicare advantages, most of them premiums are No cost and you pay Copay as you use them. The Copays control the costs and the copays cap out each year. Less than 1% ever hit the max copay or max out of pocket on a Medicare advantage plan.

You may have a few bad years but not every year and over time Medicare advantages do save you money. Not just on premiums but they also have extra dental, Vision, hearing and over the counter items that Original Medicare does not.

What do seniors often misunderstand about Medicare's coverage for long-term care?

Answer: They believe Medicare Covers Long term care. It does not. After 90 Days in a Skilled Nursing or Hospital and you are not getting better you will need extra assistance above what your health plan will cover.

I'm on Medigap Plan G, and I'm curious how my upcoming knee replacement surgery will be billed. Does the plan cover it all after my deductible?

Answer: Yes!! Once you meet the deductible you will have 100% as long as the providers you are seeing accept Medicare. Physical Therapist may not may not take Medicare so make sure they are contracted with them.

Why did I receive a Medicare Summary Notice, and what should I do with it?

Answer: The notice is used to Notify beneficiaries of decisions on a claim made for Medicare.

I would open it and see what claim they are talking about. If you have questions I would call them.

Will I be penalized if I do not enroll in Medicare when I turn 65?

Answer: Yes

Part A is free and it is a 10% penalty if you don't sign up for that

Part B cost 185 a month.

Part D for Drugs : The fine is 1% each month so 12% each year

I would go to www.ssa.gov 3 months before apply for A and B

If you want to keep your work plan you do not have to sign up for B. However, even though you can keep your work plan and it maybe no cost, Medicare has stronger coverage and your costs when you use it will be lower.

I would find a local broker you can trust and talk to them.

I am also always available so you can talk through it to see which way is best for you

I've heard about Medicare fraud. What steps can I take to protect myself from scams related to Medicare?

Answer: If you did not request information about Medicare do not answer the phone for random people who call you out of the Blue about Medicare.

Only talk to people that you signed a written agreement for them to talk to you.

I would also google their name they work for. Not the insurance company name and their personal name to see if they have a reputation.

For instance, If you google my personal name you will see great reviews about me and my team.

If you google each medical company you will get mixed reviews.

You have to know and trust the person who is giving you recommendations.

How does the Part D "catastrophic coverage" phase work once I hit the out-of-pocket max?

Answer: Once you hit the 2,000 max out of pocket everything is Covered 100%

There is no Catastrophic phase anymore No donut hole

Does Medicare cover health care services on a cruise ship?

Answer: Many plans come with 50,000 in medical travel insurance. If you have that then yes.

I have some clients buy extra coverage depending on the type of travel

I picked the plan with the lowest premium, but now every doctor visit feels like a surprise bill. Should I have gone with a higher premium instead?

Answer: If I knew what you have I could understand what you have.

If you got a supplemental with a high deductible then you will be paying 20% of your bills until you hit 2700.

If you have a medicare advantage and it is no cost you should not have any surprise billing. It should only be the copay shown. I would have to look at your plan to understand what is happening

If a senior is turning 65 but still working, should they enroll in Medicare or delay it?

Answer: Depends on the plan. Most my clients go on Medicare even if it costs more because the coverage is stronger. For instance a Plan G is only a 257 deductible then you have 100% Coverage.

I'm retiring next year - do I need to do anything with my Medicare?

Answer: You need to get a Medicare advantage or a Medicare supplemental. You don't want just Medicare. You would be responsible for 20% for all bills with no end in site.

What should I do if I miss the Medicare Open Enrollment period, and I want to change my plan?

Answer: Medicare Advantage has enrollments from Oct 15 to Dec 7. Then from Jan 1 to March 31 you get one more chance to change.

Medicare Supplemental or Medigap is all medically underwritten so you can apply anytime as long as you know you can qualify.

I tried calling Medicare and got transferred five times. Is there any way to get straight answers from them?

Answer: 1-800-Medicare

If I understood your questions I bet I could guide you or answer them directly

Do you have a broker? Call them and maybe they can guide you

I picked a Medicare Advantage plan because of the dental and now I found out it only covers cleanings. Why didn't anyone tell me this upfront?

Answer: Most Medicare advantages cover more than cleanings. If you worked with a broker you needed to ask them how the dental works and what they will Cover. You can also call me and I can advise

I'm getting conflicting information about whether Medicare covers my specific medication. How can I get a definitive answer?

Answer: It will depend on your plan that you pick. The cost and coverage will be different based on the Drug card you buy or the Medicare Advantage plan you buy.

What's the most important question I should be asking about Medicare that I probably haven't thought of yet?

My friend said she got a free annual physical with Medicare, but my doctor billed me. What's going on?

Answer: Per Law all preventative is free. I am not sure why your doctor would bill you. My guess is they did not code it as preventative but as diagnostic.

I use several prescription apps and digital therapeutics for my chronic conditions. Does Medicare provide any coverage for digital health tools in cases like mine?

Answer: Yes. As long as your providers contract with Medicare. It is up to the provider to be contracted by Medicare to take their payments

What is the trap of Medicare Advantage plans?

Answer: There is no Trap. Medicare advantages have to cover the exam same things as Medicare. It is a law. Medicare advantage is a Guarantee issue and gave give you extra benefits that Medicare supplements can not. Medicare supplemental is only medical.

Medicare Advantage can have coverage for Dental, Vision , hearing, Over the counter and healthy foods if you qualify.

I'm a low-income senior who can't afford my prescription drugs even with Medicare Part D. What specific assistance programs should I apply for?

Answer: You should go to www.SSA.Gov and apply for part D Extra Help program.

You will need bank statements and tax return information and any retirement benefits to see if you qualify. If you want to talk to someone at Social Security the number you can call is :

1-800-772-1213

You can even look at Medicare.Gov and research Medicare part D extra help. I would also consider looking at LIS : Limited income subsidy. It may help with copays and premiums

Why is regular Medicare better than an advantage plan?

Answer: I cant say that it is. If you have Original Medicare then you pay 20% of your bills and no drug coverage. If you get a supplement or Medigap to cover the 20% and a drug card then it will Cover your 20%. However the premiums are higher and they do go up every year. It is only medical coverage. ( no dental or vision) It allows you go to anyone who accepts Medicare.

Medicare Advantage has to cover the exact same things as original Medicare. So they myth that they cover less is not accurate. It is a law they have to cover the same things but they also cover more. An example is many have Dental , Eye , hearing and over the counter coverage that original Medicare does not. They come in forms of PPO's so you can use them anywhere that accepts Medicare and you can use them out of state and country. The network is typically large. The Doctors now have to bill the carrier you picked and not Medicare. It does NOT replace Medicare. Nothing can replace your Medicare.

Some States vary on this. Some states and counties just don't have access to Medicare advantage. In that instance, you will need a medigap.

The Medicare Advantage is also Guarantee Issue : Which means everyone is accepted regardless of medical back ground. Supplemental or Original Medicare you have to be medically approved or healthy to be accepted unless you are in your original enrollment period.

I need a hearing aid but I've heard Medicare doesn't cover them. Is there any way around this?

Answer: Medigap or original Medicare will only Cover Medical bills. Medicare Advantages will cover hearing exams and some of the hearing aids. Some of the companies own hearing companies so they can offer the aids at a MUCH lower cost.

If you want to keep original Medicare you can buy and DVH plan. Dental Vision Hearing and get a discount. I have had clients get a good deal at Costco as well

Who can help me figure out this Medicare "maze and alphabet soup" it's so confusing.

Answer: I can help you!!!!! I agree it is super confusing because you learn insurance a certain way for 65 years. Medicare is totally different. I always tell people its the best thing about turning 65 because the coverage is so much better!

Call me at 303-587-4521 for any personal help. That is my direct cell phone. No big company. Just me

My Medicare Advantage plan advertised dental coverage, but it barely covers anything. Is this normal?

Answer: No that is not normal. You must have just picked a plan with lower coverage. There are many plans that will Cover up to 2000 in dental and you can pick any dentist.

When open enrollment occurs I would change plans that have all your doctors, drugs and better dental coverage.

I picked a Medicare Advantage plan last year, and I'm not sure if my hearing aids are covered. How do I figure this out?

Answer: Call customer service on the back of your card or call your broker who set you up. They will have that answer.

I want to be proactive about my health. What preventive services should I be taking advantage of with Medicare?

Answer: All of them!!! Look at your brochure for your plan. I would get all my preventive that fits who I am and get it all done. Its worth it!

How can I select the right healthcare company and representative to work with?

Answer: Do a back ground check on the broker you are working with. Do a google search, Check out there referrals and network of people they work with. Make sure they have access to a majority of the medicare plans so they are not biased and sign you up with only the ones they work with

Will Medicare cover asthma and other breathing conditions?

Answer: Yes they do. All medically needed items will always be covered. Ask your doctor what is best for you. They can even do a peer to peer review with your carrier to make sure you get the treatments you need

Will Medicare cover everything my current employer plan does?

Answer: Generally speaking Medicare tends to cover more benefits than employer coverage.

Even if your employer pays for your premiums the coverage when you use it , is typically far superior. The network of doctors is very very large. I

I need home health care after my surgery, but Medicare denied coverage. What are my appeal rights?

Answer: My concern would be why did they deny it.

Home Health Care is a Skilled Nursing Code.

Doctor has to certify that you are home bound and that you need a nurse to come in and do basic MEDICAL needs for you. Example is wound care or Medicine care and PT.

They don't stay very long. They come in and do the medical care needed and leave.

They would have to have a reason why you can come to them to get approved.

It is also only approved for 30 days and can be extended if the doctor approves it. It has to be recertified every 60 days. It is meant for short term and that you are healing and getting better.

If you need it all the time and your not getting better then that will be under Long Term Care. That is a separate policy and not covered by Medicare.

If you want to file an appeal here is the link:

https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals

I just moved from New York to Florida and have Original Medicare with a New York Medigap plan. Do I need to change my coverage?

Answer: No you do not need to. You only have to change the drug card.

You have a qualifying life event so you can explore all options in your area