Medicare: An Interview With a Broker
I'd always looked at Medicare as something I didn't need to think about until much later, so I didn't pay much attention to the details. What I did do, as I worked with clients going through divorces and dealing with health care issues, is always have a broker or two available to help my clients. As long as they got the information they needed, I counted that a win and moved.
Medicare coverage for cancer patients
Fast forward to 2017 and my de novo stage IV metastatic breast cancer (MBC) diagnosis and I had to assimilate a whole other body of knowledge. While I do have private health insurance through my husband's employment, I now have Medicare Part A since I passed the five (5) month waiting period for Social Security Disability and then the twenty-four (24) month waiting period for Medicare.
Talking to a medicare expert
In light of me having Medicare and both of my parents reaching age 65 and eligibility for Medicare by age, recently I've had to look more closely at Medicare and what it includes. As I've learned in the past, finding a person who is on our side yet doesn't cost us anything, is key. So I found a broker who specializes in Medicare.
Medicare expert interview
Based on my experience, I highly recommend Vivana Artau, as a skilled broker who has assisted me and my parents along with many other Floridians in selecting the right supplemental policies at the right time to manage all of the intricacies of a terminal illness. I sat down recently with Vivana to pick her brain a little and create a bit of a roadmap in thinking about Medicare; however, I'd always recommend working with someone when you need to make these decisions. It's complicated and only someone who is fluent in Medicareese can assist you with navigating it -- it's truly a different language!
Q: Let's start with the best place online to get information? Is there a good website?
A: Medicare.gov is the website maintained by the government and has all the official information created by the office as well as forms and online access. I always recommend clients create their online account and check it frequently, especially as they sign up.
Q: How many parts of Medicare are there?
A: The primary parts of Medicare are A, B, C, and D. The supplemental policies change regularly and are connected to the different letters in the alphabet but we haven't used all the letters of the alphabet yet.
Q: Would you break down the specific parts of Medicare?
Medicare Part A is hospital insurance. Part A generally covers inpatient hospital stays, skilled nursing care, hospice care, and limited home health-care services.
Premium-Free Part A Information: you usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called "premium-free Part A." Most people get premium-free Part A.
You can get premium-free Part A at 65 if:
- You already get retirement benefits from Social Security or the Railroad Retirement Board
- You're eligible to get Social Security or Railroad benefits but haven't filed for them yet
- You or your spouse had Medicare-covered government employment
- If you don't qualify for premium-free Part A, you can buy Part A
Medicare Part B helps cover medically-necessary services like doctors' services and tests, outpatient care, home health services, durable medical equipment, and other medical services. Part B also covers some preventive services. Medicare Part B has a premium.
Medicare Part C, also called Medicare Advantage, includes the coverage benefits of Medicare Parts A and B. Medicare Part C plans can also offer prescription drug benefits and other additional coverage (like vision and dental). In total, Medicare Part C can cover things like:
- Medicare Part A (hospital insurance)
- Medicare Part B (medical insurance)
- Medicare Part D (prescription drugs)
- Health and wellness programs
Medicare Part D, also known as Prescription Insurance, offers coverage for prescription drugs. The prescriptions covered are dependent upon the plan you select and can be found in your plan’s drug formulary.
Q: How much does Medicare Part D cost?
The estimated average premium is $33.19 per month with a deductible ranging from $0.00 to $415.00.
Q: Is access to doctors and services different in different areas of the country?
A: Access to the number of doctors and services varies by area; although Medicare plans must cover doctors in each category in the plan’s service area. In a populated area like Miami with a large population of retirees, there are usually multiple options in each category; however, in other areas, that won't be the case.
Q: Is there anything specific you'd recommend for a cancer patient?
A: Every client has specific circumstances and preferences that play a role when it’s time to pick a plan. The most common we look at are the following:
- Prescription List
- List of Doctors
- List of Hospitals
Each year during the Annual Election Period Medicare beneficiaries can evaluate their current plan and decide if they want to keep it for the next year. Some clients do qualify for Special Election Periods during other times in the year in which they can also change their current plan.
Q: Do you charge your clients anything?
A: No, we don't charge individuals any amount of money to guide them through this process of selecting the best combination of Medicare policies to meet their needs. The insurance company pays us a commission for our services.
Find an expert and pick their brain!
And there you have it, a general overview of the process of selecting the best combination of Medicare parts to make up your health insurance policy when Medicare is an option. The bottom line, find an expert, and pick their brain to make sure you are making the best possible decisions!
Do you have an MBC mentor/mentee?