Wagdy Saadalla, Medicare Insurance Broker
Wagdy Saadalla
The Lighthouse Financial Service LLC
Medicare Broker Licensed in NJ, AZ, CA, DE, FL, LA, NY, PA, TN and TX
15+ Years of Experience
Contact Details
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Serving
Lebanon, NJ
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Phone
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Website
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About Me
I have been serving individuals, families, and businesses in the insurance industry since 2010. My work has always centered on one mission: helping people protect their loved ones and their financial future. Over the years, my expertise has expanded across life insurance, disability income protection, long‑term care planning, health insurance for individuals and groups, and property & casualty coverage.
I began my career as a traditional insurance agent — often sitting around kitchen tables, having real conversations with families about life insurance and financial protection. I spent my early years with New York Life, then MassMutual, gaining a strong foundation in planning, underwriting, and client education.
Everything changed when I was introduced to the independent broker model. I realized I could serve my clients more effectively by representing their needs, not the interests of a single insurance company. That shift inspired me to launch The Lighthouse Financial Service, built on the belief that clients deserve unbiased guidance and access to the full marketplace of options.
Today, I focus heavily on the senior market, advocating for the 13,000 Americans turning 65 every day. As an independent broker, I help seniors compare Medicare Advantage, Medicare Supplement, and Part D drug plans, while also assisting with state and federal programs that reduce prescription costs and improve access to care.
The healthcare landscape has transformed dramatically since the Affordable Care Act. Employers have shifted toward preventive care, reduced hospital admissions, and new models of coverage. I work closely with physicians and hospitals to support better patient outcomes as the industry moves from fee‑for‑service to value‑based care. Social Determinants of Health are now recognized as major drivers of cost and quality, and addressing them is essential to improving long‑term health.
Through all these changes, my role remains the same:
to educate, guide, and provide
Educational Videos by Wagdy Saadalla
Which Medigap plans cover foreign travel emergencies, and how much do they pay?
Q&A with Wagdy Saadalla
Answer:
If you have SSI, then automatically you qualify for LIS or extra help and Medicaid.
Low income subsidy(LIS) or extra help has income and asset limitation to be qualified for and there is another problem called Medecare saving program. It’s a federal program manage by the state..
Answer: When you turn 65, You have to enroll in Medicare Part B, but if you work in a company offers Group health insurance for more than 25 enrollees, then you do not have to enroll in Medicare part B, you can delay.
Answer: Regarding Medicare advantage, it depends on the county the one you will move to not just only the state.
Answer:
. Check the Medicare Summary Notice (MSN)
If they’re on Original Medicare, their MSN shows:
• How many PT visits have already been billed
• What Medicare approved
• What the patient may owe
2. If they have a Medicare Advantage plan
Coverage can vary. They should:
• Look in their plan’s Evidence of Coverage (EOC) booklet
• Or call the number on the back of their plan card
Some plans require prior authorization after a certain number of visits.
3. Ask the physical therapy clinic
PT clinics check eligibility all the time. They can tell the patient:
• How many visits Medicare/ their plan has approved
• Whether more visits need authorization
• What the expected copay or coinsurance is
4. Doctor’s office can also verify
The prescribing doctor can confirm:
• Medical necessity
• Whether Medicare or the plan needs additional paperwork to continue
Answer: medecare does not cover dental vision or hearing it will come out of your own pocket, you have to purchase a policy to cover this for you if you have Medicare supplement, but if you have Medicare advantage, some of the plans will cover that benefit for you.
Answer: there is a different opinions regarding that matter, you have to ask your accounting regarding this issue
Answer:
you could be the night if you did not enroll when you became 65 you have seven months three months before the month of birth and three months after the month of birth, or two months after you lose your group coverage.
But you can submit an application and see if they will accept you or not.
Answer: Yes, you have to, unless one of them still working and has Group policy through his employer, and both of them on the policy, that will be the only exception.
Answer: How does this plan align with my personal lifestyle and future goals, and not just my health needs?
Answer:
Medicare cover only 80% after you satisfy your deductible.
There is deductible for part A $1,632 for 2025 but for 2026 has not been released, and Part B deductible $257 for 2025 and $288 for 2026.
For Medicare Supplement or (MedGap) there are plans from A to N this plans has been designed by Medecare, this plans are the same in every company, the difference is the name of the company and the price tag. When you get the Medicare supplement, you have to buy a prescription drug.
Plan G had only part B deductible, once has been satisfied you do not pay any co-pay or insurance, as long as the service has been provided to you covered by Medicare the insurance company will cover the remaining.
Plan N has Part B deductible, $20 copay for doctors, & $50 gor ER.
PLAN N will not cover Part B Excess charge , but Plan G will.
The Excess charges can go up to 15%.
Plan N is more affordable than Plan G.
Answer:
Working as a Medicare agent is a lot of responsibilities, working with Seniors, helping navigate through Medicare options.
Guiding with clarity: Helping someone understand their options.
Answer: it depends on what type of surgery you will do and the co-pay or co-insurance you have in your plan.
Answer: You can delay your social Security with no problems on your enrollment for Medicare, when you turn 65 you have to enroll in Medicare part B otherwise there will be a penalty of 10% for every month you’re late, there is exceptions if you work and have health insurance through your employer, credible coverage to Medicare then you do not have to enroll in part B
Answer:
HMO (Health Maintenance Organization) - Requires using in-network providers (except emergencies)- Referrals needed for specialists- Lower premiums Those who prefer coordinated care and lower costs
PPO (Preferred Provider Organization) - Flexibility to see out-of-network providers- No referrals needed- Higher premiums and cost-sharing Those who want provider flexibility
PFFS (Private Fee-for-Service) - Can see any Medicare-approved provider who accepts the plan’s terms- No network restrictions- May or may not include drug coverage Those who want freedom to choose providers
SNP (Special Needs Plans) - Tailored for specific groups: chronic conditions, dual-eligibles, or institutionalized individuals- Includes care coordination and drug coverage Those with specific health or financial needs
MSA (Medical Savings Account) - High-deductible plan + Medicare-funded savings account- No drug coverage- You manage spending Those comfortable managing their own healthcare spending
Answer: If the plan has out of network benifits, what will be the cost for that service for the domestic travel, but internatinally it will cover only emergency.
Answer:
Medicare will cover frequent colonscopies for cancer screening if you consider as a high-risk.
that you can do through the Medicare supplement or Medicaid advantage both of them they will cover
Answer:
emergency only and when you bring the bill, it has to be itemized.
That would be the only situation and that will be covered if you have Medicare supplement or Medicaid advantage
Medicare itself will not cover outside the US
Answer:
Yes for diabetic with A1C more than 6.9 , or if you have a heart Cardiovascular risk reduction
• Obstructive sleep apnea
• Type 2 diabetes B C
but for weight loss no
Answer:
Yes, there are, you will have to review your policy, and see if there any other company will do better, with lower cost.
premium deductible, co-pay, and so on
Answer: it depends on your plan. Some plants has travel advantage some they don’t you have to look at your plan.
Answer: For 2025 the max out of pocket for part D is $2,000 and for 2026 is $2,100 that has some good effects and disadvantages
Answer: You will need to do A Medical Power of Attorney is a legal document that allows someone (called the agent or healthcare proxy)
Answer: Medicare cover only 80%. The only time you will not pay anuthing if you have Medicare Supplement, but tjar after you had pay part B deductible. if you have Medicare advantage party, you’ll pay 20% of the cost.