Todd Bostic, Medicare Insurance Broker

Answer: My main reason for liking being a Medicare agent is, I was on Medicare, and if I can help someone on it that needs more benefits than what they currently have, that is a bonus to everyone, but I do not like anyone being told that they will get a $3000 food card if they are not eligible for it. I left a previous company because I was expected to tell people I could get them benefits that would be worth more than the $3000 food card, but I wouldn't deceive a person, so I left the company rather than lie.

Answer: Sometimes it just depends on the person, their age, and their health. If a person is young goes to the doctor a lot, get one at 65. I would also say it depends on finances, because you can also get an Medicare Advantage that doesn't cost anything and get an Indemnity plan to go with it to cover your expenses should you have any like hospital, ambulance, and there are some that cover doctors. But it all depends on your finances if you are not healthy.

Answer: That would be the "Donut Hole" as most people refer to it. I was on Medicare for 17 years, and I would ultimately hit it every year around August, but I noticed that it started to get earlier and earlier every year. However, starting in 2025, it was eliminated, and there isn't a "Donut Hole" anymore.

Answer: A couple of the changes that may be helpful is that the "Donut Hole" as it was commonly referred to, is eliminated. That should lower some higher cost medications, but if you are still having trouble with your medications being higher, you can pay them out over the course of the rest of the year now. Basically, if you get a medication in June, you can pay it out for the rest of the year, and it doesn't matter when you get it, you can pay it out over the rest of the year.

Answer: The difference in a Medicare Advantage Plan and a Medicare Supplement or Medigap plan is simply that you pay a premium every month for the Medigap plan, and you also have to purchase a drug plan, and if you want a dental, vision or hearing plan, you have to purchase that. With a Medicare Advantage plan, it typically comes with a drug plan in most cases, and a lot of times, it comes with a dental hearing and a vision plan. Sometimes it comes with an Over the counter benefit or transportation benefit.

Usually, in most cases the cost of the plan itself is very low, but the visits to doctors, labs, and hospitals all have a copay for Medicare Advantage, but a Medicare Supplement is all included. A lot of people that have a Medicare Supplement have one for security, so the debate on which is better between the two is up in the air. I will suggest the one you can afford, or the one I feel like you need, not the one that will make me the most money.

My Client is more important to me.

Answer: You get to talk to a person face to face, and you can see their honesty. I have been in telesales, and was NOT happy doing it. I feel like I couldn't show my honesty because I couldn't sit down next to you.

Answer: Every year there is what is called an Annual Enrollment Period (AEP), and if you missed that, there is an Open Enrollment Period (OEP). There are other enrollment periods available if you move, or if you lose coverage, or other times, but those are the 2 main ones.

Answer: Your plan probably does cover knee replacement, but it also requires your insurance to approve it first. So, simple answer is "yes" it will be covered, but they want to ok it first. There might be an extenuating circumstance that would prevent them from covering it.

Answer: If you move to a rural area, you would be eligible to change plans for 2 months. You can call any broker, and let them know you just moved to the area, and they will help you find a plan that will meet your needs.

Answer: I don't recommend one over the other, what I do is give my clients both options, and let them make the decision for their self so it's an informed decision and they know I didn't force them into a decision.

Answer: There are some generic medications that do cost more, but not many, and with the 2025 changes, it has affected the cost of prescriptions this year.

Answer: You can change you Medicare Coverage between October 15 and December 7 every year as many times as you want, and whichever plan you are on December 7 is the plan you have beginning January 1 for the following year. The first time you switch to a Medicare Advantage plan you have options if you are switching from a Supplement. You have what is called a "Trial Right" You have 12 months to switch back to the same plan you were previously on and you don't have to go through underwriting. If you wait longer than 12 months, you have to go through underwriting.

Answer: Medicare Advantage plans do have a copay for emergency transportation. You will receive a bill for whatever the companies plan cost are if you have to use an ambulance, whether air or ground.

Answer: I believe working with an agent close to you allows you the opportunity to be able to sit down face to face with an agent, instead of having to decide based on a conversation. But based on which is better, there’s really not a a reason other than trust to pick one over the other.

Answer: If she switches to a PPO, she will be able to keep her doctors, but an HMO, she will need to double check to make sure that the plan accepts her doctors. Not all HMO's accept every doctor. My advice is to double check with the doctor to make sure that they accept the plan.

Answer: There are some Medicare Advantage plans that offer international coverage in case of emergency. I would double check with your agent to make sure you have the plan you are needing to get the coverage you are wanting.

Answer: First thing I do is I sit down and talk to them and ask them if they have any questions that I can answer and help them with. I want to ease their mind so they aren't confused about anything going forward.

Answer: Medicare Advantage does have some coverage for hearing aids, and you can also buy additional coverage for hearing aids if you want it.

Answer: They don't make sure all of their medications are covered, they say they only take 1 or 2 medications, and then the agent signs them up for an inexpensive plan that doesn't cover all of their medicines. The Agent needs to verify all of the seniors medicines are covered at the least expensive cost for them, and then when you add the meds, the agent should still be able to tell you the most cost effective plan available to you over the course of a year, not just a month.

Answer: Sometimes, agents will switch you to benefit themselves, so you need to make sure that if you switch, it will benefit YOU to. Open enrollment is usually the last time before the Annual enrollment period that you will be able to change plans unless you move or have a special election period. Make sure everything is right for you when you switch and you aren't switching just to get some benefits like some extra dental or vision if you need to see a specialist.

Answer: One of the most common misconceptions about Medicare is that the only way you can get Medicare is if you are 65. People that have been on disability for 2 or more years can get Medicare as well.

Answer: With an HMO, you are limited to in network doctors, but the cost is usually less, however, specialists usually require a referral from your primary care doctor. A PPO will give you more flexibility and is more like a Medicare Supplement when it comes to which doctors you can see. The downside to a PPO is that they usually have less benefits and the costs are usually higher for doctors, hospitals, and labs. But you also, in most cases, get less benefits because you are allowed to see more doctors.

Answer: You can contact CMS, and you would not get in any trouble as a matter of fact, it would actually be helpful if you did.

Answer: If you call an insurance carrier directly, they will only recommend one of their products for you, and try to keep you on what you have, a broker usually has more than one carrier and can give you multiple options.

Answer: Sometimes agents can find another special enrollment if you miss the open enrollment. You can talk to the agent about what you might be eligible for.

Answer: People new to Medicare sometimes aren't aware that they can only enroll at certain times of the year and you must enroll in a plan that would be beneficial to them during their initial enrollment and they are Guaranteed to get into a Medicare Supplement if they want, where someone thinking about switching has to go through underwriting if they are currently on a Medicare Advantage plan and want to get a Medicare Supplement. I believe the more education you have the better it is for you.

Answer: There are 2 types of Special Needs Plans, or SNPS for short there is the Critical Care Special Needs Plan, or CSNP, and there is the Dual Special Needs Plan, or DSNP.

The CSNP is typically for people that have a critical illness like diabetes, or heart problems or on dialysis. Not all people with those conditions qualify and some plans have other conditions that allow people to qualify. In some cases it comes with a small monthly food allowance and specialist are usually less than typical MAPD plans.

The DSNP is for people that have both Medicare and Medicaid. DSNP plans have many benefits including a food card in most cases. Depending on the level of Medicaid a person is on, drugs, doctors, hospital visits, and many other benefits can be quite lucrative. However even if you have a low level of Medicaid, you can get a monthly food card.

Answer: The best advice is to compare the work insurance versus the Medicare coverage you are wanting to get, but from my experience, typically you will get more benefits from your work insurance.

Answer: I would do some research and see if your plan is making changes you can’t live with, if they are leaving your area or dropping your doctor, definitely change, but all of the cosmetic changes are just personal preference.

Answer: Get their NPN#. Once you get their license number check, for example in Texas you could check the Texas department of insurance to verify that their license is in good standing.

Answer: You just need to notify 1-800-Medicare that you want to delay your enrollment, otherwise you will be penalized.

Answer: You will just enroll in Medicare when you turn 70, and you will not be penalized for the delay. Waiting to enroll in Medicare is not uncommon.

Answer: To be totally honest and transparent, I’m not a fan of it. Companies have found a loophole that allows them attack seniors in a way that I don’t agree with.

Answer: Original Medicare only pays 80% of your costs for Hospital and Doctors unless you have a Medigap plan. It doesn’t have any benefits like Dental, Vision, or Hearing either, you have to purchase that along with a prescription drug plan. MAPD plans have all of that included, but you have a copay for most services in most plans. Basically a Medigap plan is like a prepaid plan that gives you gold treatment. A MAPD plan is pay as you go. If you don’t use it you don’t spend much if anything.

Answer: I wish they knew to be careful about who you talk to on the phone, telephone agents are going to try to convince you that they have the best thing since sliced bread and all you have to do is take the plan.