There are so many great questions, it's hard to narrow it down to the most important question. Is your Agent sitting down face to face with you to review all of your questions either at your kitchen table or their office? I am a visual learner myself and I know I would prefer to sit down to review all of the many different options people have. This process can be overwhelming and I simplify the full process and walk through the timeline you need to be aware of!
The question you aren't asking might just be what options give me most control of my healthcare? The opposite question is important as well, What might limit my healthcare? With Advantage plans you have to stay in-network for your care and often there are prior authorization hoops to jump through.
With Medicare supplements there are fewer prior authorizations and when there is one they are generally just looking for Fraud, Waste, and Abuse. What they are not looking for are ways to protect their profits. They aren't looking for how they can squeeze more money out of the system to pay their CEO or have more money for their marketing budget.
Yes, there are times when an Advantage Plan is the right fit. It does depend on your budget and the amount of control you have really depends on the company you go with. In general though I think you retain more control of your healthcare with traditional Medicare and a supplement.
If I am still working and have employer coverage, what are my options? Do you know that you can continue to work and drop your employer coverage and take on Medicare? You can also delay your Medicare and keep employer coverage without any penalties!
Why am I not working with a Licensed Medicare/Health Insurance Broker?
I say this because Medicare can be so confusing and complex that it requires you go to school and obtain a license to fully and accurately comprehend it.
In addition to that, Medicare changes every year so it also requires continuing education as well as successfully passing exams each year.
Knowing this, a Licensed Medicare Broker works on your behalf, free of charge, and has a legal fiduciary duty to do what’s in your best interest.
Plus, any good Broker will make sure you understand your options, explain why some may be more advantageous than others, and service your policy for the life of you being enrolled in Medicare.
So to be able to obtain that level of expertise at no cost, I state again. The most important question you should be asking about Medicare that most haven’t thought of yet is….
“Why am I not working with a Licensed Medicare/Health Insurance Broker?”
This might sound a bit cliche since it's coming from an agent, but I would ask: "What are the reasons why I should work with an agent?" Over the years I've had many clients and come across many beneficiaries who are confused and overwhelmed with relentless, intrusive, and misleading advertising. It has become worse that it's ever been in the last year alone. As an agent, it's my job to understand what's happening in the industry so you won't have to! Trying to understand and navigate everything is like trying to get a college degree without the help of a teacher. I'm here to help relieve the burden, and it costs you nothing to use me!
The most important question to ask depends on your specific situation and budget. But a great place to start is: Which Medicare plan best meets my healthcare needs and budget? From there you have plenty of options. That why working with a licensed sale agent can help in these important decisions.
I think one of the most important questions to ask is if the plan will allow me to continue to travel anywhere and be covered.
If there is no network, you can travel any where in the United States and be covered. HMO's and PPOs are not universal in their ability to allow you to go anywhere and get coverage.
When choosing your Medicare coverage, it’s essential to consider how the plan will meet your current and future needs. Understanding enrollment periods and your ability to switch plans is key. Many people mistakenly believe they can switch from a Medicare Advantage plan to a Supplement plan during the Annual Enrollment Period—without realizing that medical underwriting is required for that change.
So, an important question is "Do I understand the Medicare Plan enrollment periods and requirements?
The most important question I would ask is How are my Medications and preferred Pharmacy going to be covered. (which plan would be best to cover my Medications and Pharmacy).
A thorough needs analysis is critical when choosing a Medicare plan.
Does this new coverage with Original Med cover me outside of the United States.
Answer: No, Original Medicare Part A & Part B does not cover Medicare Beneficiaries outside of the United States. Except for limited coverage near the U.S. border.
Should I enroll in a Medicare plan or stay on my group health insurance plan? Many people think Medicare is too confusing and they don't want to deal with it now. They feel very comfortable with their group plan because that's what they are used to. So many families I've spoken with over the years got better coverage on Medicare and paid less, saving $$. People may be missing out on better coverage and savings if they don't take time to compare and talk with a broker about their options.
Are you already drawing social security, because if so it's automatic. If no, you must call Social Security 800 772 1213 or go online, www.socialsecurity.gov and create a logon and apply.
Where do i start the process? Will Medicare provide me with the coverage I may need if I get sick and or have health issues. Can an agent explain Medicare so I understand it clearly?
There's no one question. Everyone's situation is unique. A better approach to your situation is to understand how your plan works for you. What are the premiums? Copays and coinsurance? Is there a deductible? Are my medications covered? What's NOT covered? I recommend a comprehensive analysis of current circumstances and future needs. I would suggest this be done with an independent broker to maximize your choices.
When you are new to Medicare, I would always look into all options available to you. And I would always go through a licensed, experienced broker who is contracted with all the major companies. That way you are not limiting your choices both for now and in the future.
If researching a Medicare Supplement plan, ask to review the rate plan to see what the rates are for ages 77 plus. Its important to know the year they become a standardized rate by age. This is where many age rated plans become competitive for the enrollee.
While most people don't like to get too deep into the weeds of how Medicare works, I believe all Medicare reciepients should ask how it works (the breakdown of Parts A, B, C, D, Medi-gaps & Prescription Drug Plans). Since there are no group plans for Medicare, you & your broker should be determining what's best for your individual health care & financial budget and not your best friend's or even your spouse / partner. What's good for the goose isn't always what's good for the gander. Once you know how it works and narrow down the best way forward for you, make sure all your doctors and prescriptions are covered.
There is so much more to this question than just premiums. Of course, premiums are a part of it. Usually, Part A will be premium-free because you've already paid for it through payroll taxes, but there is a premium for Part B and Part D, and if you made more than a certain amount, the premium might be even higher than what most people pay.
Beyond Parts A and B of Medicare, you will need to choose how you want to receive those benefits. Do you want just Medicare A and B? Do you want to add a Medicare Supplement plan to Original Medicare for additional coverage? What about Prescription Drugs? Or do you want to forgo Original Medicare for a Medicare Advantage plan? Each option comes with different costs, risks and rewards. It's important to understand each option before you decide which is best for you. Then you still need to choose an insurance company!
Once you've decided on a plan and know what premiums you will pay, there are your deductibles, coinsurance, copayments and fees for the covered services you receive. Did you know that with Original Medicare, there is no out-of-pocket limit on how much your claims could cost? Usually, Medicare Advantage plans will have a maximum out-of-pocket amount, but that could be thousands of dollars. Medicare Supplements limit your out-of-pocket risk, but they often have higher premiums. Unless you have a low income and qualify for Medicaid, you will pay more than just the basic premiums for Medicare Parts A and B.
Confused yet? That certainly is not my goal, but I do want to convey to you that Medicare is complicated. This is why having an experienced Independent Insurance Agent who specializes in Medicare Insurance is so important.
Between Medicare Advantage and Original Medicare with a Med Sup Plan and a Rx plan, which will best meet my specific healthcare needs in the long term? It is important to get a full understanding of the benefits and downsides of both options before choosing.
What is the unintended consequences of my actions what am I not seeing that could hurt me later . So I complete compliant presentation of MAPD and Med Supp is vital not just the one the agent pushes you because it is good for them ,so willingness to take time with you till all the questions are answered.
I think the most important question a person should be asking about Medicare is how will MediCare cover things if I develop a serious medical problem. Which plan will be easier for me to get the care that I need if I develop a serious medical problem a Medicare supplement or a Medicare advantage plan?
That answer would be different for each person depending on circumstances. I recommend finding a local advisor that would sit down & go over everything with you in detail. I go over everything, in detail, with each person because most of the time people don't know what questions to ask. I look at initial consultations as informative/educational appointments.
The most important question to ask is "Are you happy with your healthcare coverage?" It's also important to ask if the client wants to increase benefit amounts or reduce any co-pays they may have.
I would ask about what the major differences are between Medicare advantage and Medicare supplement. I would ask about what are the differences in prior authorizations, networks, coverage while traveling, max out of pockets amounts, & co-pay amounts. I would also include, if you had to have chemotherapy or radiation treatment for cancer; What would it cost you and is that covered under a Medicare advantage and or Medicare supplement? I would also ask if your agent is a broker and what carriers are they licensed or appointed with and can they run comparisons and comparative quotes for you?
How will my current health needs and medications be covered under the different Medicare plans?
Medicare has multiple parts (A, B, C, and D), and understanding how each part covers your specific needs—especially if you have ongoing health conditions or take regular medications—can save you a lot of time, money, and stress.
If you are turning 65, the first questions to ask are, what choices are available to me and which of those choices best suite my lifestyle and healthcare needs.
If you are 65 or older, you should be asking if the healthcare plan(s) you have are being utilized. Are there benefits you are missing or now need based on a change in health or lifestyle.
What type of plan is right for me (Medicare Supplement or Medicare Advantage Plan)? Are my doctors in the network and are my prescriptions covered? What plan(s) allow me to travel (snowbirds)?
The most important question should always be concerning your benefits and what you actually have for example like, what carrier are you with Aetna? Humana? Etc.. do you have original. medicare and PPO or do you have Medicare advantage plan? You should also keep track of the special dates that you can make necessary changes if needed.
What are the most important things you need out of your medical plan? Are my doctors in network with the plan? Do I have the best drug coverage with this plan? Do you have an agent ready to put in the work to make sure you’re getting your full benefits from a plan?
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.
When should I start the process of enrolling in Medicare, and what are my options to add additional coverages to make up the 'gap' that Original Medicare leaves.
Do I want to stay on employer coverage or enroll in Medicare and get a secondary? This is important because many times employer coverage has a lot of gaps and actually costs more than Medicare. I can help you compare...
Should I review my Medicare Advantage Plan each year, even if I like the plan that I have? Are all Medicare Advantage plans the same, if not what areas are significantly different?
Many people have asked me, "What is the best Medicare Plan?"
That has more to do with you, and less to do with the plans that are available. Do you have more than one place you call home? Do you see providers in multiple states? Do you have any chronic conditions? Do you qualify for Extra Help or Medicaid? Do you currently pay a premium for your health care? Do you feel things like Dental, Vision and Hearing are of great importance to you? Are you able to pay additional for those added benefits? Do you have an employer subsidy? Are you currently part of a managed care program, (HMO/PPO)?
The bottom line is, there is no "Best" plan. There are many good options that depend on your personal needs, finances, and location. Not all plans are available in all locations. Not all members qualify for all plans. A good agent will take the time to have that conversation with you so that you are able to make an informed decision. Call centers tend to believe one size fits all. They want to get you through the process as quickly as possible so they can move to the next call. Some agents look at commission rates while others look to put you in something more permanent but will have annual rate increases. Ask questions and work with someone who knows those answers. There is never a fee you pay to the agent, so don't feel like you need to navigate the maze on your own.
One of the most important questions you might not have thought to ask is: 'What happens to my Medicare coverage if my health needs change over time?"
Many people focus on what Medicare covers when they first enroll, but it's crucial to understand how your coverage might need to adjust as your health needs evolve. For example, Medicare offers different parts (A, B, C, D), and over time, you might find that you need additional coverage, like supplemental insurance (Medigap) or a different plan that better aligns with your needs. Additionally, asking about the flexibility of your plan, how it handles new treatments, specialist care, or prescription drugs, can save you from gaps in coverage or unexpected costs down the road. Knowing these details ensures that you’re not just covered today, but also set up for the future, as your healthcare needs change
"It's a little bit funny... This feeling inside...."
Should we be living in the now? Absolutely! It is essential to our and those we love's mental well being. It directly impacts our internal health. And...
When it comes to Medicare, seniors logically tend to focus on monthly premiums or whether their current doctor is in-network. That's what matters today, right?
But the real game-changer is understanding how each choice—Medicare Advantage vs. Medicare Supplement, drug plan tiers, enrollment timing—can either protect or limit you down the road.
Consider these questions:
What will happen with my insurance plan if my health declines?
What if I move? Travel more? Need specialized care?
What are the long-term ramifications of Copays, co-insurance, deductibles and maximum out of pocket limits?
The importance of creating a long lasting relationship with your insurance agent is that Medicare isn’t just a set-it-and-forget-it decision. Your agent is your guide to how you’ll navigate aging, health, and independence. Your agent should be helping you get prepared.
The most important question that most individuals spend almost no time thinking about is - What is most important to me today? The differences between Medicare Supplement and Medicare Advantage are significant - both serve a very important purpose. You need to be able to talk through your current needs and establish what value does each one bring to me and then decide for yourself what is better. So many of us are used to being told by our employer what our benefits are going to look like and then we have to adapt. You have the opportunity to choose what you need and work with a Broker who will fill that need. As a bonus, ask your broker how many carriers they represent - make sure that you are not working with someone who has limited your options by only working with one carrier.
For Medicare Advantage plan beneficiaries: Are all my doctors, hospitals in the network and are all my medications covered and how much will my costs be?
For Medicare Supplement plan and Part D beneficiaries: What are my options when my Medicare supplement plan premiums increase?
When can I review and change my Medicare Part D plan?
How will potential changes in my health impact my future Medicare needs, and what are the long-term cost implications of those changes?.
In addition, it is very important to ask:
How do the different Medicare supplemental plans, like Medigap or Advantage plans, truly affect my out-of-pocket expenses in various healthcare scenarios?.
What are my options for Medicare. Advatgae and /or supplement plans. How do they work and what are the ramifications if I chose meducate ivory supplement and vise verse.
The most important question is which plan is best for you. You need to check if a Medicare advantage or a Medicare supplement will best fit your budget.
Do I want to be tied to a network to receive care or do I want the freedom to see the providers I choose? Would I rather pay a higher premium with lower out of pocket costs or would I rather pay a lower premium and pay copays as I utilize services?
The most important question is related to election periods. When are the election periods and how do Medicare recipients qualify for the different times?
What does Medicare Cover and what does it not cover? I know most people do not read their "Medicare And You" book and still it can be a lot of information to understand. Working with someone like myself is a really smart move. I know the ins and outs of Medicare like the back of my hand. I also have access to most insurance companies in the area to ensure that your health coverage is the right fit, since Medicare is not a one size fits all.
Can you explain to me the main differences between Medicare Advantage and Medicare Supplement plans? How can I determine which type is more appropriate for me?
Understanding Medicare and how it works can be confusing to many. If you're going to choose a Medicare replacement or Medicare Advantage, you'll want to understand the difference between Network types, what is a PPO, HMO and HMO-POS for example, and more importantly, what does that mean to me as a health care consumer.
You should be asking about what matters most to you when it comes to your coverage. Be it affordability, ability to see providers, benefits you’re most interested in etc. Sharing your most important quality about the coverage you’re looking for helps us agents tailor your experience to you, and greatly increases your chances of being completely satisfied with your coverage choice.
What is my main priority it selecting a plan. Is it the most comprehensive coverage to last throughout my life time or is it maximize savings. Remember, approximately 80% of your health insurance usage comes after the age of 60. So knowing your priorities really assist a broker in helping you find the best plan for you.
How important is it for you to have access to facilities and doctors. Some Medicare plans require you to use facilities and doctors that are in a network, usually close to your primary residence location. Other plans allow you to use doctors and facilities that don’t require a network and usually allow for nationwide coverage.
Be certain to ask your agent or broker what services they offer throughout the year and how they plan to support you as you transition to Medicare. It can be very complicated and confusing and a good agent or broker, such as myself, will give year round support!
When do I enroll and what type of plan is best for me and my health needs and financial situation? Also do I have to answer health questions when I apply for plans to go along with Medicare.
Does medicare pay for my perscription drugs? Yes it will cover generic drugs listed in the formulary let's look up your medicine.
Which company has the bes plan for me? It depends on if you are firm on keeping your doctor and other needs you have like dental, hearing, and if you are low income your needs will need to be discussed.
What are my current and future healthcare needs, and how will the decisions I make today affect the coverage I might be need in the future. As you think about this, know that Medicare doesn't provide coverage for everything and you may need to consider additional coverage such as: Cancer/Critical Illness, Hospital Indemnity, or Recovery and Homecare coverage. Build your Medicare Planning around protection packages. This is why we say Medicare is the intersection of your healthcare and financial wellness!
Is my state a guaranteed issue state for Medicare supplements? It's a very good idea to know how your particular state deals with Medicare Supplements. Many states only guarantee a person can enter a supplement without underwriting at extremely specific periods. If you fall out of those period you may be in for a shock when you try to enroll. My home state of CT for example is a guaranteed issue state year round and never requires underwriting. That means, a person can get on a plan pretty easily but the cost of those plans are definitely higher than non-guaranteed issue states. A good broker will know how a person can go onto a supplement when a person has just basic Medicare, when a person has Medicare Advantage, and when a person moves off or is cancelled from a private plan.
When is the right time to begin using medicare for my health insurance? Everyone's needs are different and need guidance from an agent. This decision will affect their healthcare options in retirement.
Would I qualify for subsidies like the Connecticut Medicare Savings program? Many of my clients that are single and/or married do not take advantage of this great benefit. It can bring there costs down significantly. We can do a quick cost analysis to see if you may qualify.