Tommy Lawson, Medicare Insurance Broker
Tommy Lawson
Commonwealth Insurance Partners
Medicare Broker Licensed in KY, CT and IN
Contact Details
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Location
Louisville, KY
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.
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.
What are the red flags I should look for when interviewing agents? I want to make sure I'm not just getting sold to but genuinely advised.
Answer: I would look for someone who asks you more questions about your needs than anything else, like, do you travel often? are you having trouble paying for anything specific? When they show you top three options from different carriers is also a good indication that they are a good advisor.
What's a Medicare rule or regulation that's outdated or unfair to seniors?
Answer: The biggest thing that comes to mind is the late enrollment penalties for Part B and Part D. It's not a flat penalty, but it accumulates over time.
Why did I receive a Medicare Summary Notice, and what should I do with it?
Answer: This is essentially your EOB for Medicare. It's a summary of your Medicare claims within a three-month period for what Medicare paid for and what you may owe to a provider or facility. You should look it over and make sure it's correct before doing anything. The MSN is not a bill and won't ask you to pay Medicare anything, however, is a good reference to track out of pocket expenses that may have been charged by providers.
Can I change my Supplemental/Medigap plan at any time?
Answer: Yes, you can change plans any time you want. However, you will typically need to pass through the carriers underwriting process to do so.
What should I do if I find out that my preferred hospital isn't in-network with my Medicare Advantage plan?
Answer: Hopefully, you are within the 12-month trial period for your Medicare Advantage plan that allows you to switch to a different plan that may work better for you. If not, you may have to wait until open enrollment, Jan. 1st-March 31st, to change plans if a special enrollment period is unavailable.