Yasmine Lopez, Medicare Insurance Broker

Answer: I love getting to know my clients beyond just the paperwork. Hearing their retirement dreams — from cross-country road trips to more time with grandkids — reminds me why this work matters.

I especially enjoy the challenging cases — when someone feels stuck, overwhelmed, or told “there’s no good option.” That’s where I thrive: digging deep, asking the right questions, and finding solutions others miss.

More than anything, I like knowing I’ve brought peace of mind. Medicare can feel like a maze, but my clients know they have a guide who’ll walk with them, not just hand them a map and disappear.

Answer: Medicare Advantage can look like the easy choice — low or $0 premiums, bundled extras — but there are some serious tradeoffs that you may not realize until it’s too late.

Your doctor or hospital could disappear from your plan.

Provider networks are renegotiated every 1–3 years. That top-rated hospital or specialist you rely on? They could be out-of-network next year, and you’re left scrambling. If you live with a chronic condition, this can be devastating.

Chronic illness can drain your wallet.

If you're diagnosed with cancer, autoimmune disease, or need infusions or specialty drugs, you could hit the plan’s maximum out-of-pocket — up to $8,000+ per year depending on the plan — with no cap over time. And that's every single year.

You might lose your chance to find cost relief once you have a chronic illness.

Many people don’t realize you can’t just switch to a Medicare Supplement plan anytime. If your health changes and you now have pre-existing conditions, you can be denied a Supplement — and stuck in Advantage with higher long-term costs and fewer choices.

Bottom line: Medicare Advantage works for many — but it’s not risk-free. If staying in control of your care, costs, and providers matters to you, we need to talk through all the options first to understand the tradeoffs and your risk tolerance.

Answer: If you want freedom, flexibility, and control over your care — Original Medicare paired with a Supplement is hard to beat.

Here’s why:

Go anywhere, see anyone

With Original Medicare, you can see any doctor or hospital in the U.S. that accepts Medicare — no referrals, no network restrictions. Traveling? Snowbird? Second opinion at the Mayo Clinic? You're covered coast-to-coast.

Access to the best care

Many of the top-rated hospitals — like MD Anderson, Mayo Clinic, Cleveland Clinic, and Sloan Kettering — don’t contract with Medicare Advantage plans or only take a few. With Original Medicare, your options stay open.

No insurance company gatekeeping

Your care decisions stay between you and your doctor — not a health plan deciding whether your treatment is “approved.” No prior authorizations for every test or scan. You and your physician are in charge.

It’s the Cadillac of health coverage

When you pair Medicare with a Supplement (like Plan G), it’s one of the most comprehensive health insurance options in the U.S. Most medical services are fully covered, with little to no out-of-pocket costs and no surprises.

Bottom line: If you value flexibility, top-tier access, and long-term peace of mind — Original Medicare + a Supplement gives you the gold standard.

Answer: We’re already seeing the health effects of climate change — and in places like Utah, it’s personal.

Our air quality is consistently ranked among the worst in the nation. Between wildfire smoke drifting in from California, Colorado, and Idaho, and the toxic dust being stirred up as the Great Salt Lake continues to shrink, more Utahns are developing respiratory issues. Inhaler use is up. ER visits for asthma, COPD, and even heart-related complications spike during poor air days and heat waves.

I believe we’ll start to see pressure on Medicare to adapt — whether through expanded coverage for air-purifying medical equipment, preventative care related to respiratory illness, or more support for heat-related emergency services. As extreme heat and poor air quality become more common, Medicare policies will have to shift toward climate resilience — especially for vulnerable seniors. The cost model for Medicare will be impacted from these pressures.

This isn’t just about the future. It’s already happening — and as someone who works with retirees every day, I’m watching the impact firsthand.

Answer: I believe Medicare decisions should feel empowering — not overwhelming. That’s why I start with education, not sales.

Here’s my process:

Personalized Needs Assessment

Before anything else, I take the time to understand your unique situation — your health needs, budget, doctors, medications, and retirement plans.

Foundational Education

I provide clients with a short, on-demand video I created called “The Medicare Survival Guide: 5 Tips Every Retiree Needs to Know Before Enrolling.” It’s a 30-minute crash course that builds confidence and often sparks great questions before we even meet.

Clear, Honest Discussion

We review what Medicare covers — and what it doesn’t. I walk you through the key differences between Medicare Supplement and Medicare Advantage plans, and how to protect yourself from costly coverage gaps.

Tailored Recommendations

Based on your needs, I provide a thoughtful recommendation — with no pressure to enroll. My goal is to help you understand your options and feel confident making the right choice for you.

I serve as your Medicare guide, not a salesperson. You get a partner who’s here to simplify the process, eliminate surprises, and help you feel fully informed — every step of the way.

Answer: It’s not something I see often, but it can happen — especially in certain areas where fewer dentists accept insurance or where the dental network tied to the plan is limited.

If you're having trouble finding an in-network dentist, here are a few options I typically recommend:

Let’s check other Medicare Advantage plans in your area. Some plans have much broader dental networks than others — and we may find one that includes your preferred providers.

Consider a stand-alone dental insurance plan. If dental care is a priority and your Medicare plan’s network isn’t meeting your needs, we can look into stand-alone dental coverage that offers more flexibility.

Ask your current dentist about a cash-pay discount plan. Many dental offices offer membership or savings programs for patients without traditional insurance — and these can sometimes be more cost-effective than using insurance at all.

The bottom line: you have options, and I’m here to help you find the one.

Answer: Special Needs Plans are a type of Medicare Advantage plan designed for people with specific circumstances — and they can offer extra benefits and lower costs if you qualify.

There are two main types:

Dual Eligible SNP (D-SNP)

These plans are for people who qualify for both Medicare and Medicaid.

Medicaid programs vary by state (they might be called something like Utah Medicaid, Medi-Cal in California, or TennCare in Tennessee), but they’re all designed to help individuals living at or near the federal poverty level.

D-SNPs often include added support like help with transportation, dental and vision, and reduced prescription costs.

Chronic Condition SNP (C-SNP)

These plans are built for people with certain chronic medical conditions — like diabetes, heart disease, or COPD. Some areas may offer plans for other conditions too.

To qualify, your doctor will need to confirm your diagnosis.

These plans often include extra care coordination and benefits tailored to managing that condition effectively.

Bottom line: If you qualify for a Special Needs Plan, you may get better coverage and care designed around your specific needs — and I can help you see what’s available in your zip code.

Answer: Starting in 2025, Medicare Part D will introduce a major change: a $2,000 annual out-of-pocket cap on prescription drug costs. This amount can change annually. There are benefits and trade-offs associated with this change.

The Good news:

This is a huge win for many seniors — especially those taking expensive medications. No matter how high your drug costs are, once you’ve spent $2,000 out of pocket, you’ll pay nothing more for the rest of the year. For people managing cancer, diabetes, autoimmune conditions, or other chronic illnesses, this could save thousands of dollars annually and dramatically improve access to needed medications.

The Trade-off:

To make this new cap possible, many plans are increasing their deductibles and adjusting copays at each tier. That means:

Seniors who previously had lower annual drug costs may now see higher upfront costs

Tier 1 and 2 generics might become slightly more expensive. Plan premiums could rise in some cases.

We may say more pressure on drug costs that could result in higher premiums for drug plans and Medicare Advantage plans with drug coverage or potentially higher deductibles to offset these costs.

Answer: Too often, Medicare Advantage plans are marketed like a game show: “Look at all the extras — dental! Vision! Hearing aids! A free gym membership!” And while those perks sound great, they can distract from what really matters: your access to quality care when you get sick.

The truth is, these extra benefits can be limited in scope and value — and vary widely between plans. A flashy dental benefit might only cover cleanings and x-rays, while implants are still mostly out-of-pocket. A fitness benefit is nice, but not if you can’t see your preferred cardiologist when you need them.

The most important feature of any Medicare Advantage plan is its provider network:

Does it include top hospitals in your area?

Will your specialists still be covered next year?

Can you get care without a hassle if you're diagnosed with something serious?

Extra benefits should be viewed as icing on the cake, not the reason you choose a plan. I always tell my clients: Pick the plan that protects your health first. If it also includes great extras? That’s a bonus — not the priority.

Answer: This can be very confusing for most. Especially as a drug can be a different tier on a different plan. Think of drug tiers like shelves in a store.

The bottom shelf (Tier 1) has the cheapest stuff — mostly common generics, and they usually cost just a few dollars.

The next shelf up (Tier 2) still has generics, but maybe not the preferred ones, so they’re a little more.

Tier 3 and 4 are where you find brand-name drugs — the ones you see on TV. These cost more.

And Tier 5? That’s the top shelf — the really expensive medications for serious conditions, like cancer or autoimmune diseases. Those are the priciest of all.

So the higher the tier, the higher your cost.

That’s why I always check which “shelf” your medications are on before recommending a plan — so we know your drugs on the formulary and what the estimated costs will be. Remember that these are estimates...no agent will be able to dial in exact costs. The tools are not precise enough to offer this as much as I would like to.

Answer: “What won’t Medicare cover — and how could that affect me if something serious happens?”

Most people focus on premiums, copays, and the extras like dental or vision. But the real heart of Medicare planning is understanding the gaps — the stuff that isn’t covered or could leave you vulnerable when life takes a hard turn.

Here are the hidden questions I wish more people asked upfront:

What if I get cancer or need infusions — how much will I actually pay?

What hospitals and specialists can I access if I get seriously ill?

What does Medicare cover if I can’t take care of myself — like needing help at home, in rehab, or in a facility?

Will I still be able to change my plan if my health declines?

If something happens tomorrow, is my coverage built for the big stuff — or just the basics?

These aren’t fun questions, but they’re the ones that matter most. My job is to walk you through them before they become urgent — so you’re protected, confident, and fully informed.

Answer: Short answer: No. This is one of the biggest misconceptions about Medicare — and one of its biggest weaknesses.

Medicare only covers up to 100 days in a skilled nursing facility, and only if you meet very specific conditions:

You must have had a qualifying hospital stay

You need daily skilled care (not just help with bathing or eating)

And after 20 days, you’ll start paying a daily copay. After 100 days, you pay everything. Medicare, Medicare Advantage, nor Medicare Supplement will contribute anything towards skilled nursing after 100 days.

This is where families often face emotional and financial pressure.

Round-the-clock care at home or in a facility can cost over $150,000 per year, and it’s not unusual for someone to need that care for months — or years.

What can you do instead?

I strongly recommend planning ahead with Recovery Care or Short-Term Care insurance — affordable policies that cover up to a year of skilled nursing, or home care giving you time, flexibility, and relief when it's most needed.

For longer-term coverage, there are:

Hybrid life insurance or annuity policies that include long-term care benefits.

State Medicaid planning strategies (for those who qualify) may be available to some.

The key is planning before a crisis hits — and that’s what I help my clients do. It’s not just about picking a Medicare plan — it’s about protecting your future dignity, choices, and peace of mind.