FAQ – Medicare & Health
Frequently Asked Questions about Medicare & Health
Medicare Open Enrollment FAQ
Health Plans: (For Drug FAQ’s Scroll Down)
Click on the question and the answer will appear.
What’s new?
Medicare Advantage Plans & Drug Plans:
(Insurance Co. is your PRIMARY)
There might be a few new changes with your Medicare Advantage plans. Please see your Annual Notice of Change to see how your plan is affected. If you would like to change your plan, then please call our office at 408-502-7080.
Medigap (Supplement) plans:
(Medicare is your PRIMARY)
If you have a Medigap (Supplement) plan, then the benefits will not change each year. Medigap plans never change their benefits since the plans are all standardized by Medicare.
Is there a charge for the initial or future consultations? Is there any obligation?
No. I get paid directly through insurance carriers, like your car and home insurance agent. The extra time I spend to give you the depth knowledge is to make you feel empowered that you are making the right decision. Also, I believe in helping the community. Thus, the more knowledge you have, the more you will be willing to share it with others.
Of course, there’s no obligation. We want you to feel as if you are talking to a friend or a family member. We want you to feel no pressure through our 3D SET process. You will always feel welcome to think about what you learn. You will learn a lot!
Will I save money if I go directly through the carriers instead of using an agent or broker?
No. This is not like real estate or going to a warehouse like Costco. Going through an agent or broker versus going through the insurance company directly is precisely the same cost down to the penny! How that benefits you is that you don’t pay any extra, yet you get personalized service throughout the year! It’s like having your own lawyer for free!
Why should I use a broker if I can do the research myself?
To be candid, if you could get a lawyer for free versus doing the research yourself, would you? If you could get an electrician to do work at no cost, would you rather do it yourself? Most do not realize there’s no cost in working with an agent. However, the underlining reason most of us rather do the research ourselves is that we don’t want a “sales pitch” or the “sales pressure” Isn’t that true?
Think about this fact: If you do your own research, and you look at different flyers or call the insurance companies directly, what will you learn? Yes, their plan. Will that carrier show you other carriers’ plans and benefits? Of course not. Well, isn’t that a sales pitch?
Perhaps you feel that reading on your own you won’t get the sales pressure. Let us show you how we are distinct through our 3D SET process. You will see how we can guide you, not sell you, by getting to know “your’ story first. We then keep things simple by our clear and concise education with full transparency. Since we represent over 30 carriers, we have the freedom of speech to be unbiased. Our going on 15 years of experience can also help you to avoid frustration and costly mistakes doing this on your own.
If I already have an insurance agent that sold me my other insurance policies, why should I go with you?
I treasure keeping relationships and staying loyal. However, let me illustrate the difference between being loyal and doing what’s best for you. If you have a knee surgeon you love, would you have that surgeon perform your heart surgery? If you have a plumber that you are amazed at, would you have that person do complicated electrical work for you? Does having a specialist in each field mean that you are not loyal? Of course not!
Likewise, why would you allow your car and home insurance agent, your life insurance agent, your Affordable Care Act/Covered California agent, or your financial advisor to perform a service as complicated as Medicare, Long-Term Care, or Income planning? No matter the field, we all can only have a few specialties.
Here at KC Independent Insurance Solutions, we don’t want to be a jack of all trades and a master of none. We want you to know that we focus specifically on those serious about planning for their retirement years. Our typical age group is 50’s and up. All our planning includes two simple gaps in retirement: Guaranteed Income and Healthcare planning. This allows us to help you by focusing on keeping up with all the rules and changes in the marketplace.
How long are the consultations?
This depends on the topic and your personality. I book enough time not to rush you or bore you. I created the 3D SET process to make you feel at ease so you can ask as many questions as you would like. The bottom line is, that you will feel engaged and in control of the meeting duration.
Why should I use a broker if I can do the research myself?
To be candid, if you could get a lawyer for free versus doing the research yourself, would you? If you could get an electrician to do work at no cost, would you rather do it yourself? Most do not realize there’s no cost in working with an agent. However, the underlining reason most of us rather do the research ourselves is that we don’t want a “sales pitch” or the “sales pressure” Isn’t that true?
Think about this fact: If you do your own research, and you look at different flyers or call the insurance companies directly, what will you learn? Yes, their plan. Will that carrier show you other carriers’ plans and benefits? Of course not. Well, isn’t that a sales pitch?
Perhaps you feel that reading on your own you won’t get the sales pressure. Let us show you how we are distinct through our 3D SET process. You will see how we can guide you, not sell you, by getting to know “your’ story first. We then keep things simple by our clear and concise education with full transparency. Since we represent over 30 carriers, we have the freedom of speech to be unbiased. Our going on 15 years of experience can also help you to avoid frustration and costly mistakes doing this on your own.
Do I need to change or renew my Medigap plan?
No. Since 1992, these plans are all guaranteed renewable. As long as you continue making your payments there’s no need to do anything else! *
*See page 50 of the Official Government Guide:
Click below for a FREE copy of Choosing a Medigap Policy Booklet
2020 Choosing a Medigap Policy (2021 has not been published yet)
Do I need to change or renew my Medicare Advantage plan?
No, unless your plan sends you a notice that your plan is no longer providing coverage in your area, or you do not like the changes.
Please check your Annual Notice of Change to check changes on your plan. If you don’t mind the changes to your plan, then there’s nothing you need to do. If you would like to change your plan, please call our office at 408-502-7080.
Did Sutter/PAMF coming out with a new Medicare Advantage HMO plan?
Yes! Please call our office to learn more. Sutter is very similar to Kaiser. Both plans have the convenience of the one-stop-shop. Yet, the Sutter plan’s premium and copays are almost half that of Kaiser!
*However, if you join a Medicare Advantage plan and would like to change back to a Medigap, you must either have a “special event” or go through a “health underwriting questionnaire”.
*See pages 22-23 of the Official Government Guide:
https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf)
2020 Choosing a Medigap Policy (2021 has not been published yet)
Can I change to any plan during the Open Enrollment?
NO. Yes, you read correctly. The answer is NO.
October 15th to December 7th ONLY applies to Medicare Advantage plans (like HMOs) and Part D (Drug plans), but NOT to Medigaps (Supplements).
If you have a Medicare Advantage plan and would like to change to a Medigap, you must either have a “special event” or go through a “health underwriting questionnaire”.
I thought there are no more health questions, right?
This rule only applies to the ACA plans (Under 65 individual plans), Medicare Advantage plans, and Part D plans. These plans you can change annually during the Open Enrollment.
*Medigap plans have the right to require a special event or health underwriting. The only open enrollment Medigap plans have is when your Medicare is within 6 months of your Part B effective date.
*See page 50 of the Official Government Guide:
https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf)
2020 Choosing a Medigap Policy (2021 has not been published yet)
What’s the difference between a Medigap and a Medicare Advantage plan? Which is better?
What is your “1, 2, 3”? In our office, we educate you and help you find your “1,2,3”. There’s no such thing as a “better” plan or the “best” plan. What may be right for your friends might not be suitable for you. Below is an explanation on the differences between Medigaps and Advantage plans. Let us help you find your “1, 2, 3”!
Medigaps are also called Supplement plans. Medicare is the PRIMARY. You have the freedom to go any doctor or hospital that takes Medicare in all 50 states. No referrals required for specialist. These plans are typically around $50-$200 depending on age and plan selection.
Ideal for you if:
- You don’t want a network and want to see a specialist without a referral
- You want very little to no copays
- You don’t mind a higher premium
Medicare Advantage plans are plans where Medicare provides a monthly subsidy to the insurance company. Therefore, you assign your Medicare rights over to the insurance companies. You must follow the rules of the insurance companies, go only to the doctors on their list (HMO), and get a referral for a specialist. There are very few PPOs, and in most counties, only HMOs are available. These plans typically range from $0-$150 depending on the county and plan selection. Age does not change the price.
Ideal for you if:
- You want the lowest premium and added benefits like gym memberships, dental, vision, drug plan, transportation, and so forth.
- You don’t mind copays
- You don’t mind a network or getting a referral to see a specialist.
Will my Medigap plan change their benefits?
No. Since 1992 Medigaps are all “Standardized” except for in Massachusetts, Michigan, and Wisconsin.
For example, if you have a Plan F, then all Plan F’s are exactly the same. If you have a Plan G, then all Plan G’s are all exactly the same! *
*See pages 10-11 of the Official Government Guide:
https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf)
2020 Choosing a Medigap Policy (2021 has not been published yet)
Why does my Medigap premium keep going up?
All Medigap plans will typically go up every year. These plans are not subsidized by the government like the Medicare Advantage plans. So, as we get older, we become a higher risk to the insurance company, and they need to offset the risk.
The good news is that your plan benefits stay exactly the same. For example, if you have no copays now, then for the rest of your life you will have no copays!
There are three different “rating methodologies” that influences how the rates go up. These include:
- Attained Age
- Issue Age
- Community Rated
Rate increases usually range from 5% to 40%, depending on which rating methodology your insurance company chooses. To learn more, please call us at 408-502-7080.
*See pages 17-18 of the Official Government Guide:
https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf)
2020 Choosing a Medigap Policy (2021 has not been published yet)
If I have a Medigap and change to a Medicare Advantage plan, will I be able to enroll back into a Medigap again?
If you have a Medicare Advantage plan and would like to change to a Medigap, you must either have a “special event” or go through a “health underwriting questionnaire”. To see if you have a special event, please call us at 408-502-7080.
*See pages 22-23 for some examples from the Official Government Guide:
https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf)
2020 Choosing a Medigap Policy (2021 has not been published yet)
How do I schedule an appointment?
Please fill out the form below or call us at (408) 502-7080
FREQUENTLY ASKED QUESTIONS ABOUT OUR CONSULTATIONS
CLICK ON THE QUESTION, AND THE ANSWER WILL APPEAR.
Medicare Advantage Plans & Drug Plans:
(Insurance Co. is your PRIMARY)
There might be a few new changes with your Medicare Advantage plans. Please see your Annual Notice of Change to see how your plan is affected. If you would like to change your plan, then please call our office at 408-502-7080.
Medigap (Supplement) plans:
(Medicare is your PRIMARY)
If you have a Medigap (Supplement) plan, then the benefits will not change each year. Medigap plans never change their benefits since the plans are all standardized by Medicare.
Is there a charge for the initial or future consultations? Is there any obligation?
No. I get paid directly through insurance carriers, like your car and home insurance agent. The extra time I spend to give you the depth knowledge is to make you feel empowered that you are making the right decision. Also, I believe in helping the community. Thus, the more knowledge you have, the more you will be willing to share it with others.
Of course, there’s no obligation. We want you to feel as if you are talking to a friend or a family member. We want you to feel no pressure through our 3D SET process. You will always feel welcome to think about what you learn. You will learn a lot!
Will I save money if I go directly through the carriers instead of using an agent or broker?
No. This is not like real estate or going to a warehouse like Costco. Going through an agent or broker versus going through the insurance company directly is precisely the same cost down to the penny! How that benefits you is that you don’t pay any extra, yet you get personalized service throughout the year! It’s like having your own lawyer for free!
Why should I use a broker if I can do the research myself?
To be candid, if you could get a lawyer for free versus doing the research yourself, would you? If you could get an electrician to do work at no cost, would you rather do it yourself? Most do not realize there’s no cost in working with an agent. However, the underlining reason most of us rather do the research ourselves is that we don’t want a “sales pitch” or the “sales pressure” Isn’t that true?
Think about this fact: If you do your own research, and you look at different flyers or call the insurance companies directly, what will you learn? Yes, their plan. Will that carrier show you other carriers’ plans and benefits? Of course not. Well, isn’t that a sales pitch?
Perhaps you feel that reading on your own you won’t get the sales pressure. Let us show you how we are distinct through our 3D SET process. You will see how we can guide you, not sell you, by getting to know “your’ story first. We then keep things simple by our clear and concise education with full transparency. Since we represent over 30 carriers, we have the freedom of speech to be unbiased. Our going on 15 years of experience can also help you to avoid frustration and costly mistakes doing this on your own.
If I already have an insurance agent that sold me my other insurance policies, why should I go with you?
I treasure keeping relationships and staying loyal. However, let me illustrate the difference between being loyal and doing what’s best for you. If you have a knee surgeon you love, would you have that surgeon perform your heart surgery? If you have a plumber that you are amazed at, would you have that person do complicated electrical work for you? Does having a specialist in each field mean that you are not loyal? Of course not!
Likewise, why would you allow your car and home insurance agent, your life insurance agent, your Affordable Care Act/Covered California agent, or your financial advisor to perform a service as complicated as Medicare, Long-Term Care, or Income planning? No matter the field, we all can only have a few specialties.
Here at KC Independent Insurance Solutions, we don’t want to be a jack of all trades and a master of none. We want you to know that we focus specifically on those serious about planning for their retirement years. Our typical age group is 50’s and up. All our planning includes two simple gaps in retirement: Guaranteed Income and Healthcare planning. This allows us to help you by focusing on keeping up with all the rules and changes in the marketplace.
How long are the consultations?
This depends on the topic and your personality. I book enough time not to rush you or bore you. I created the 3D SET process to make you feel at ease so you can ask as many questions as you would like. The bottom line is, that you will feel engaged and in control of the meeting duration.
How do I schedule an appointment?
Please fill out the form below or call us at (408) 502-7080
Drug Plans
Do I need to change my drug plan, and what changes are on my current plan?
No, unless your plan sends you a notice that your plan is no longer providing coverage in your area, or you do not like the changes.
Please check your Annual Notice of Change to check changes on your plan. If you don’t mind the changes to your plan, then there’s nothing you need to do. If you would like to change your plan, please call our office at 408-502-7080.
Anything else I need to know?
Feel free to call us if you have any additional questions or would just like to chat.
You can have the confidence to know that, as your trusted independent agent, we will always do our best to keep things simple, through our concise and detailed education, and give you all your options with full transparency.
We hope you enjoy our process, getting you SET for the new 2021 year!
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Our no pressure process give you the information you need to make informed, intelligent decisions.
By providing your name and contact information, you consent to receive calls, text messages, and/or emails from a licensed insurance agent about Medicare Plans at the number provided, even if you are on a government do-not-call registry. This agreement is not a condition of enrollment.
Not connected with or endorsed by the United States government or the federal Medicare program. This is a solicitation of insurance, and your response may generate communication from a licensed producer/agent.