William Lawler, Medicare Insurance Broker

What benefits are there to working with a Medicare Agent near me vs remote/virtual?

Answer: Working with an agent that is near you is convenient if you need to meet him/her face-to-face. If this is not important to you, an experienced agent can do everything you need from a distance (remotely). The greatest percentage of Medicare Agents work remotely and have never met their long-time clients in-person. Working remotely saves a tremendous amount of time for both the client and the agent.

How do you educate clients who are completely new to Medicare?

Answer: I help clients who are new to Medicare by taking the time to explain what Medicare is, what Medicare does and how it applies to the client. I email a primer on Medicare to clients early in the process which helps them understand Medicare and how to proceed.

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

Answer: The new $2000 out-of-pocket maximum is important because it will save people on Medicare millions of dollars in drug costs. Once the $2000 maximum is reached, there is no cost for drugs the rest of the year.

What's one piece of advice you wish every senior knew before picking a Medicare plan?

Answer: It is very important to list your medications and review each health plan for your drug costs. Drug costs can vary greatly depending on the health plan you choose. Also, make sure your doctor accepts the health plan you are considering.

Am I eligible for a Special Enrollment Period if I lose employer coverage?

Answer: Yes. When you lose health coverage through your employer, you have 60 days to enroll in Medicare Part B and choose either a Medicare Advantage plan or a Medigap plan.

What's the most misleading Medicare Advantage ad you've seen, and how do you explain the reality to clients?

Answer: Beware1 There are a lot of scams out there! Ads will offer you money or Flex cards. But when you click on the link they offer, you are asked for your zip code to see if you qualify. Guess what? Surprise! Your zip code does not qualify. But, since you`re here, why not enroll in my health plan? Beware!

What do you enjoy most about working with Medicare clients?

Answer: I enjoy connecting with people and helping them understand what Medicare is and what it will do for them. Most people don`t know diddly about Medicare and it is very gratifying to help them. I explain the basics, help them apply, and help them find a supplement plan that best suits their needs. All at NO COST to the client!

What role do annuities play in retirement planning?

Answer: Annuities can play an important part in retirement planning. If a client is concerned about their investments in the stock market, an annuity is a perfect, safe alternative. Annuities offer a guaranteed rate of return and a guaranteed monthly income. Your money will be there when you need it.

Is Medicare Part A enough for hospital coverage?

Answer: Medicare is an 80/20 health plan, where you are responsible for 20% of hospital costs. If you enrolled in Part B and also enrolled in either an Advantage plan or Medigap plan, more of the costs would be covered.

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

Answer: Original Medicare does not pay for eye exams, but a Medicare advantage plan does pay for eye exams, usually at $0.

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

Answer: If you are retiring and losing your health coverage through work, you need to make sure you enroll in Part B within 60 days so that you mat enroll in a Medicare Advantage or Medigap plan.

What does Medicare Part B cover? Is it enough?

Answer: Medicare Part B covers doctors, outpatient, medical equipment, but it does not cover hospital, which is Part A.

What's the difference between a Medicare broker and a Medicare agent?

Answer: While an agent may be captive and only represent one health care company, a Medicare broker represents many different health care companies, and therefore, a broker can find you the best plan to fit your needs.

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

Answer: You will only be penalized if you do not enroll in Part B when first eligible and then try to enroll at a later date. You can postpone enrolling in Part B if you maintain creditable health coverage through your employer.

Is Original Medicare or Medicare Advantage better? Why do you recommend one over the other?

Answer: I would recommend Advantage with Original Medicare(OM) rather than OM alone. Advantage covers costs that OM does not. Advantage plans cover drugs, vision, dental and hearing costs that OM does not.

I'm turning 65 next month and the amount of Medicare mail I'm getting is overwhelming. How do I sort through all this?

Answer: Ignore all the Medicare mailings you are receiving. Find yourself a knowledgeable Medicare broker who can help you find the best health plan that suits your needs.

My diabetes medication is super expensive, and I've heard horror stories about Part D not covering what people need. Should I go standalone Part D or get it through a Medicare Advantage plan?

Answer: I am diabetic and I am on a Medicare Advantage plan. Insulin costs are capped at $35/mo. Other meds, like Ozempic, are not inexpensive, but they are available.

What's the cheapest way to get Medicare coverage if I only need basic hospital care?

Answer: The cheapest way to get hospital coverage is with Part A. Part A covers hospital charges at a 80/20 coinsurance rate. Medicare pays 80%, you pay 20%. Be aware, there is NO CAP on your 20%.

I've been on disability for years and am about to turn 65. Do I automatically get Medicare because I'm on Social Security, or do I need to do something?

Answer: Yes. After you`ve been on disability for 24 months, you should be automatically enrolled in Medicare in the 25th month.

Why is regular Medicare better than an advantage plan?

Answer: Regular Medicare is not better than an Advantage plan. The main reason Original Medicare (OM) is considered better than an Advantage plan is that it is accepted by most hospitals and doctors whereas an Advantage plan is limited to a network of care.

I don't understand how my friend pays nothing for their plan and I pay over $200-are these plans just totally random by ZIP code?

Answer: No. Plans are not random by zip code. Without further information, it seems you may have a Medigap plan with a monthly premium and your friend has a Medicare Advantage plan with NO monthly premium.

What's the most cost-effective way for a healthy 65-year-old to structure their Medicare coverage?

Answer: Enroll in a Medicare Advantage plan that has prescription drug coverage, vision, dental and hearing coverage for a low or no monthly premium. There is a maximum-out-of-pocket (MOOP) per year which differs with each plan.

Is it true that Medicare pays for dental implants?

Answer: NO. ABSOLUTELY NOT. Original Medicare (OM) does not cover any dental. Dental coverage can be purchased separately.

Hey, I keep hearing about Medicare Advantage plans everywhere. What's the real deal with those compared to regular Medicare?

Answer: Original Medicare (OM) is a government administered 80/20 health plan. An Advantage plan covers some of the costs not covered by OM plus prescription drug, vision, dental and hearing coverage. Advantage plans are available at low or no monthly premium.

What are the reasons why I should work with a Medicare agent?

What's the trade-off between a Medicare Advantage PPO and HMO when it comes to flexibility?

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

Why do some seniors end up paying lifelong penalties for Medicare Part B or Part D?

Answer: Seniors who end up paying lifelong penalties must do so because they neglected to enroll in Part B when they were originally eligible. There is a monetary penalty for each month they were eligible, but did not enroll in Part B unless they had creditable health coverage through employment.

I'm turning 65 in three months but still working with employer coverage. Do I need to sign up for Medicare right now or can I wait?

Can you explain what "creditable coverage" means and when it applies?

Answer: Creditable coverage is health care coverage that is equal to or better than Medicare health coverage. For instance, group health coverage through employment is usually credit able coverage.

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

Answer: Annual physicals are always free with Medicare. Perhaps your doctor is not in network? Your agent should always check and ascertain that your primary care physician is in network.

What's the best way to avoid surprise bills for lab tests under Medicare Advantage?

Answer: The best way to avoid surprise bills for lab work is to contact your insurance company`s member services. Make sure the proposed lab tests are covered by your health plan.