Tommy Lawson, Medicare Insurance Broker

About Me

Navigating Medicare can be complex, but you don't have to do it alone. I specialize in providing personalized Medicare guidance to help you make informed decisions about your healthcare.

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Q&A with Tommy Lawson

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

Answer: Is my current health plan a HSA plan? If so, you will need to discontinue your and, possibly, your employers HSA contributions at least 6 months before applying for Medicare. Don't try to full the system...you cannot fully fund your for the entire year either. You are able to prorate your contributions depending on when your initial enrollment period begins, but make sure you talk to an agent or financial advisor when thinking about Medicare.

-Tom Lawson

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

Answer: I wouldn't say free, some Medicare Advantage plans do have a premium, however, most are at $0 premium per month. When enrolling in a MA/MAPD you are agreeing to a more traditional cost sharing model with possible deductibles, copays, coinsurance, and a max out of pocket. Medicare Advantage works for a lot of senior. As long as you assure your doctors are in network and your medications are covered at a rate you feel works for you, it can be a great way to save precious dollars.

My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?

Answer: It means there is no longer a coverage gap that you are 100% responsible for paying. As long as your medications are covered on a carriers formulary, no matter how expensive the copay or retail cost may be, you have a maximum out of pocket on prescriptions of $2000 for the year.

My Advantage plan says I need a referral just to see a dermatologist. I thought PPOs didn't require that - was I wrong?

Answer: Usually, but it depends on the language of the plan you are enrolled in. Sometimes, even PPO plans, require referrals to dermatologists do to cost and, likely, something the plan feels your primary care physician could take care of.