FAQ's

There are so many questions to be answered when it comes to taking the right steps, and making the choices that will most satisfy your needs regarding your healthcare insurance. Below are many of the questions and answers.

In almost each instance, getting the answer to one question, opens the door to even more questions. Because of the complexities of health insurance nowadays, coupled with your unique circumstances and needs, you may want to call for a personal consultation.

There is no charge or obligation on your part. You won't be calling into a massive call center somewhere in the US.

Call me, Jeff Christiansen for a personalized consultation at 801-550-1800. 

Most Popular FAQ's

The Big “5” Questions about Medicare:

Q: What are Parts A, B, C & D?​​
A: Original Medicare is made up of Part A (Hospital Coverage) and Part B (Medical Coverage). Part C is an optional type of plan you can choose to enroll in (if available where you live) called a Medicare Advantage Plan (we'll discuss this later). Don't confuse a Medicare Advantage plan with a Medigap or Supplement plan (further discussed later). Part D is a prescription drug plan. Medicare doesn't actually provide a Part D prescription drug plan to you. They do regulate it, though. We'll discuss Part D further later on, but it is important to note that if you don't enroll in a creditable (Medicare's word for complete or viable) Part D plan when you become eligible to do so, you could incur an LEP (Late Enrollment Penalty - discussed in detail later on). If you end up with this penalty, you'll pay it every month the rest of your life, in most instances. There are a few exceptions, which we'll further discuss later on. For most people Part A doesn't have a monthly premium, though there are circumstances where a person would have to pay a premium for Part A. Part B has a monthly premium and most people are responsible to pay this monthly premium. In some circumstances a person can qualify for assistance to pay for part or all of Part B premium, based on annual income. Anyone can apply for assistance. If you don't qualify you'll be notified. Part D prescription drug plans generally have a monthly premium, but again, depending on your circumstances, there may be assistance available to help with that premium.

Hopefully, this is not too confusing. If you have questions and would rather talk with me directly, please call 801-550-1800.

Q: What are my supplemental coverage options?
A: An individual that qualifies for Original Medicare has a variety of options to supplement the coverage Original Medicare provides. Some may be covered by a retirement plan from their employer or union, as a retirement benefit. Others will enroll in a Medicare Advantage plan (Part C mentioned above, and discussed in detail later on). Some may choose to just enroll in a Part D prescription drug plan (mentioned above, and discussed in detail later on) and only have Original Medicare and Part D. While others may choose to enroll in a Medigap or Supplement plan. A Medicare Supplement does exactly what it's name says: It supplements what Original Medicare covers. For example, Part B of Original Medicare (Medical coverage) generally covers about 80% of the doctor, lab, or other medical bills. Without a supplement or some additional type of insurance coverage, you would be obligated in most instances to pay the other 20%. That's not too bad when the bill is only a couple hundred dollars. But, what if you have a bill that runs into the thousands, or tens of thousands, even millions of dollars? That could medically bankrupt many people. With a supplement plan in place, it could pick up most, or all, of those medically necessary charges. Most Supplement plans allow you to go to any doctor or facility that accepts Medicare, anywhere. There are a few plans that have some access or network restrictions. Also, you are guaranteed to be accepted into a Supplement plan when you turn 65 (some states even earlier), no matter your medical condition. In the state of Utah it is age 65. There are several plan types to choose from. Plans A through N for new enrollees nowadays, with some of those letters not available. Each plan follows a certain set of coverage benefits that are designed by Medicare. You have your pick of plans that are made available through private companies. Some private companies provide several plan options, while others just offer a couple. There is a monthly premium associated with each plan. The richer the benefits coverage, the higher the premium, generally. In some areas (counties or regions) a Supplement or Medigap plan may be the only way to get additional coverage that will help cover your share of Original Medicare billings. Part C Medicare Advantage plans are not always available in some areas (counties or regions) and may not be an option for your coverage (we'll discuss this later). In most cases, when somebody enrolls in and has a Supplement or Medigap plan, they also need to be sure and enroll in a Part D prescription drug plan along with the Supplement. By not doing so you are most likely going to incur the LEP (Late Enrollment Penalty) someday when you do choose to enroll in a Part D plan. Supplement plans in the State of Utah have a monthly premium that varies depending on the plan you choose, and the Part D plan has a separate premium that varies depending on the plan you decide to go with, also. Deciding how to structure your coverage is complicated and varies depending on each individual's circumstances.​

Needing help deciding what will be the right plan for you? Call me to discuss, or schedule an appointment at 801-550-1800.

Q: How do I maximize my benefits?
A: Great question that everyone is asking! Because your circumstances are different than another person's, sometimes even a family member that lives in the same household with you, your needs and plan choices could be different than somebody else's plan needs. Medicare treats each person individually. There is no signing up on a couples or family plan. You get to choose from a myriad of options the plan that you feel best meets your needs. How do you decide that? Studying the variety of plan types, benefit variations, network differences, optional benefits, related costs, and quality ratings are all very important points to examine. You can do this yourself by digging through the various company's plans, going directly to Medicare to find information, or find a trusted adviser that will consult with and help you make that important decision. This is where I shine as an independent agent. I represent many of the available plans in our region. Annually, I'm required to re-certify with each company and the federal government, in order to offer assistance and plan information. You don't pay anything extra for my services. I'm here simply to help you clearly understand your options, answer your questions, and help you make the decision that you think is best for you.

Would you like to talk face-to-face with an expert that has helped thousands find the answers and plans that are most comfortable for them and their circumstances? Please call me at 801-550-1800 to discuss how I can assist you.

Q: What if I plan to keep working & keep my coverage?
A: First of all, you're not alone. Because of healthier lifestyles and advances in the medical world, people are living longer. Many people are choosing to work longer and delay their retirement. In doing so, you may have access to employer benefits. It's good to evaluate your options, no matter what your plans are. Staying on your employer's benefits might be the right choice for you, once you weigh out and compare costs, benefits, networks, and more. There are many options available to you. Putting a plan together that spells out a time-line of things to do while you continue to work can be very important. It can possibly save you unnecessary expenses, maximize benefits, and avoid potential penalties. 

I can help you navigate your options and essential components of healthcare insurance after age 65. Call me at 801-550-1800. 

Q: What if I’m on Medicare, Disability & Medicaid?
A: You may be eligible for Medicare before age 65 if you qualify for it due to disability. It's possible that you could qualify for government assistance in paying for your medical expenses and some of your Medicare Part B premium, along with some plan premiums. You may already be set up with Medicare, and receiving financial assistance from the State through Medicaid or other programs, and Extra Help through Social Security. With those circumstances you have extra options available to you that can provide additional benefits not normally available and more flexibility with enrollment.

Part of my annual training and certification, along with years of assisting many clients who have both Medicare and Medicaid, put me in a unique position to help you with your needs. Please call today to discuss your circumstances at 801-550-1800.
        

                             Wow! There are lots of Questions about Medicare! Here are some more!

Q: How does drug coverage work? How do I calculate my drug cost?
A: Once you qualify for Medicare, you're required to have a creditable (Medicare's word for viable or complete) Part D prescription drug plan. This may come from purchasing a stand-alone Part D prescription drug plan. It might be included in a Part C Medicare Advantage plan. You might be using the VA to get your medications and medical services. You might also be saying, "I don't take medications, so I don't need or want a Part D plan". These questions and circumstances are some of the more popular concerns I hear on a regular basis. The important thing is to understand your options and the pros and cons of the choices you make. One of the most frequent exclamations I hear from people getting ready to go on Medicare is, " I didn't know that." How prescription drug plans work, penalties for not enrolling when you become eligible, understanding what to do if you have VA benefits, Tricare, or an employer/union plan because you're continuing to work, are all important concerns to know, understand, and create a plan that will best accomodate your wants and needs. I can help you understand all the components of a drug plan. Things like the various Tiers of medications, costs per tier, possible deductibles, the "Donut Hole", catastrophic coverage, benefits of using a company's mail order service, preferred vs standard pharmacy networks, late enrollment penalties, and much more, are all components of today's Medicare drug plans. 

I'll help you understand how the various drug plan components work and will affect you. Call me at 801-550-1800.

Q: How do Medicare and Social Security work together?
A: Social Security manages sending your Part A (Hospital) and Part B (Medical) to Medicare when you are qualified and ready to go on Medicare, along with your Medicare Claim (ID) number. If you are going to go on Medicare when you turn 65, and if you are already receiving your Social Security benefits, about 3 months before the month you turn 65, Social Security is going to automatically enroll you in Parts A & B of Medicare. If you're going to continue to receive employer or retirement health insurance benefits after age 65, you may not need to enroll in Part B (Medical), and save that monthly premium. Before you call Social Security and tell them you don't want Part B (because you're still working and getting employer benefits, etc.) check with your current plan administrator to ensure that they don't require you to carry Part B once you reach age 65. Also, when you reach the age of eligibility for Medicare (usually age 65), and if you're not receiving Social Security benefits yet, and you plan to go on Medicare the month you turn 65, you'll need to call, go into their office, or go online to www.ssa.gov and enroll in Part B manually. If your plan is to not start receiving your Social Security benefits until your full retirement age (around 66 years old) or later, then Social Security will bill you directly for your Part B premium, usually quarterly, or you can call them and make other arrangements. It's very important to make sure your Part B premiums are paid on time. If your Part B coverage is dropped for lack of premium payment, you not only will lose your health insurance plan (you have to be enrolled in Parts A & B to be enrolled in a Medicare plan, along with being a permanent resident, and not having ESRD - End Stage Renal Disease) but you won't be able to enroll in Part B again until the next Part B enrollment period which is from January 1 to March 31 each year, and your Part B coverage will not actually start again until the July following your re-enrollment. In other words, don't ever let your Part B lapse for non-payment. Also, keep in mind that if you move, you need to call Social Security to update your address information, not Medicare. Social Security will update your information in their system, and it goes from them to Medicare. If you lose your Medicare card with your Medicare Claim (ID) number on it, you'll have to call Social Security or go into their office to order a new card. If you call Medicare, they won't give you that information. They will send you to Social Security. If you need to contact Social Security you can call them at 800-772-1213 Monday through Friday from 7AM to 7PM. If you have questions, complaints, or appeals about your Medicare plan or Medicare benefits, you can call Medicare 24/7 at 800-633-4227.

Need help navigating what you need to do and when and how to start Original Medicare (Parts A & B), call me at 801-550-1800.

Q: What if I don’t enroll properly? Are there penalties?
A: Yes. There are penalties and delays in coverage if you don't enroll in Medicare Parts A & B, and Part D prescription drug plans properly and in a timely fashion, according to their rules. If you fall into these circumstances where you have a penalty, it will be calculated and added to your monthly premiums, and will be due for as long as you stay in Part B and/or Part D, which likely could be for a lifetime. If you happen to be receiving both Medicare and Medicaid, then those penalties are waived. If you're on disability and receiving Medicare benefits prior to age 65, and happen to be paying a late enrollment penalty, that/those penalties go away once you reach age 65, and which time you arrive at your 2nd initial enrollment period. It's like the slate has been wiped clean and you can start over, along with receiving other options in some states that you didn't have prior to age 65. I can't emphasize enough to be sure to enroll properly in Part B and D when you're eligible, especially if you don't have other creditable coverage that would qualify to take the place of Part B and D. The consequences of not enrolling properly, and staying enrolled properly, can be very costly. If done properly and maintained properly, you shouldn't have to worry about penalties.

I am here to assist you by putting a plan together to ensure you're properly enrolled in all facets of Medicare, and other insurance plans. Please call me to discuss how I can help you negotiate these rules, at 801-550-1800.

Q: How do I choose from so many plan possibilities? What will they cost?
A: Besides Original Medicare there are two main ways you can get additional coverage to help cover the costs that Medicare doesn't cover: Option 1) A Medicare Supplement (or Medigap) plan, along with a separate Part D prescription drug plan, or Option 2) would be a Medicare Advantage Plan (known as a Part C in Medicare). Supplement plans in the State of Utah, in addition to your Part B premium (starting at $135.15) with Medicare, range from $60 to $150 per month at age 65 when your enrollment is guaranteed, plus the cost of a Part D prescription drug plan that ranges from around $20 to $100 per month. Medicare Advantage plans are not available in every county in Utah, Idaho. Where they are available, there are usually several options. Plan premiums range from $0 (that's right - zero), to around $74 per month. Some Medicare Advantage plans include the Part D prescription drug plan with them, and others don't. Depending on your circumstances you may not need a Part D plan as part of your coverage. For example, those who are enrolled in and use VA for their drug coverage and other benefits, don't incur a penalty for not having a Part D prescription drug plan. VA meets that requirement. With dozens of choices available when it comes to Supplement and Medicare Advantage plans, and many different price points, and varying benefits packages, it would be advisable to sit down and spend some time looking at your options, understanding the pros and cons, and being able to make some plans of your own for health care coverage.

Please call to set up a time to meet and discuss your specific needs and interests at 801-550-1800.

Q: Do I qualify if I have pre-existing health problems?
A: There are very simple rules of qualification for a healthcare insurance plan in Medicare. You must be a permanent resident of the area where you are purchasing your plan, be enrolled in both Parts A & B of Original Medicare, and not have ESRD (End Stage Renal Disease - permanent kidney failure). As long as you meet those criteria, other health conditions are not going to keep you from enrolling in a plan. Just in case you do have ESRD, Original Medicare is set up to meet your medical needs.

As with all aspects of healthcare insurance coverage, there are few simple answers. I would love to help you decipher what will meet your needs. Let's schedule a 1 on 1 meeting to discuss your needs. Call me at 801-550-1800.

Q: Are there Dr, Hospital and Pharmacy Networks?
A: In many instances there are networks that you'll need to pay close attention to. With other plans, you are able to go to anybody, anywhere in the US that accepts Medicare. Some Supplement (Medigap) plans allow you to go to anybody and any facility that accepts Medicare, anywhere in the US. Other Supplement plans have network restrictions within your permanent residence area. Medicare Advantage plans in the State of Utah generally are either an HMO or PPO plan which certain network rules. Because each private insurer is able to design their Medicare Advantage plans according to their desires, there are many variations of these two basic plan options. Most HMO plans have a network that you need to stay in. If you go outside of an HMO network, there's a good chance the insurer will not cover the charges. Some HMO networks are limited in facility and Dr. coverage, while other HMO networks are quite extensive. With a PPO plan you generally have more flexibility to go to Dr's and facilities anywhere that accept Medicare. You'll generally pay much less if you stay inside a given plan's PPO network, but you do have the option to go outside the network. Before you make a decision on what you think will be best for you, let's spend some time and look at the various options, rules, other determining factors.

Call me at 801-550-1800 to arrange a time to explore your options.

Q: Are there deductibles, co-pays, co-insurance & more?
A: Some Supplement (Medigap) plans don't have deductibles, co-pays, or co-insurance. That makes getting your healthcare insurance needs easy to understand and take care of. Keep in mind that supplement plans with this kind of complete coverage generally are the most expensive plans. Other Supplement (Medigap) plans have co-pays, deductibles, co-insurance, and other limits. Premiums can vary considerably depending on the richness of the plan benefits you choose to go with. When it comes to going with a Medicare Advantage plan, they usually have some kind of a deductible in the plan (many times associated with the more costly tiers of prescription drugs), co-payments for most services, and sometimes co-insurance (where you pay a percentage of the service). Medicare Advantage plans also have what we call a "Maximum-Out-Of-Pocket" limit in the plan. These kind of plans have to be approved by Medicare each year in order for us as agents to offer them. The private companies that want to create and offer Medicare Advantage plans have the daunting task each year of evaluating all of their benefits, costs associated with using those benefits, networks, and optional benefits, staying within certain maximum limits that a plan can charge a client each year, and making it attractive and affordable for you the prospect/client. A lot of thought goes into these plans each year. No question private companies are in the business of being profitable, but you'll find with time that their primary concern is creating plans and services that will help you have a positive experience with your healthcare insurance needs. Personally, knowing many of the people at the companies that design and implement these plans each year, I have to give them kudos for the conscientious and difficult, hard work they do to create products that will be pleasing and beneficial to you. They understand that they're normally only going to hear from you when you're sick, or not feeling well. That is an especially difficult time for you. They understand this and have hopefully put plan benefits, services, and procedures together that will create a positive experience for you. As an agent I represent the companies when we meet. My intentions are no different. I want to ensure that you receive the benefits and services in stellar fashion.

Let's meet to discuss your needs, answer questions about the various plan options, and help simplify getting your healthcare insurance needs met. Contact me at 801-550-1800.

Q: How do I keep up with all the changes? Are there free resources?
A: Great question. From Medicare to the private insurance companies that design and provide these products for you, down to us agents in the field, we are committed to helping you understand your plan benefits, options, networks, and help provide you with the education and information you need to be able to make informed decisions. You can call Medicare directly at 1-800-Medicar (1-800-633-4227, TTY 1-877-486-2048. You may qualify for "Extra Help" through Social Security. You can call them to see if you qualify at 1-800-772-1213, TTY 1-800-325-0778. You can also call Medicaid at the State of Utah to see if you qualify for additional financial aid through the state at 801-538-6155 or toll free at 1-800-662-9651. Another resource that you're entitled to is "Medicare and You 2019". It is a booklet that you can order from Medicare by calling or going to Medicare.gov,  or pick up at the Social Security Office. All of these calls and resources are available to you at no charge. Same with my services. I don't charge an additional fee for my services. I am paid commission when you sign up with me, for which I'm grateful, and that is provided by the private companies I represent, and according to Medicare guidelines. The cost of your plan, if it has an associated cost, doesn't change because I assist you with your enrollment. It stays the same.

Q: Is there a reliable, independent rating system?
A: Yes, there is a "Star Rating" system provided by Medicare for all Medicare approved Medicare Advantage (Part C) and Part D prescription drug plans. It can be found at Medicare.gov and in the back pages of "Medicare and You 2019" booklet. Supplement plans operate differently and don't have the same rating system. Though, there are things you can look for with Supplement plans to determine if you're more comfortable with the plans provided by one company verses another.

To better understand the Star Rating system with Medicare, please call me at 801-550-1800.

Q: What about dental, vision, hearing, wellness and other benefits?
A: Many of the plans available offer preventive dental, vision, hearing and wellness benefits. There are also many free-standing plans available for strictly dental and vision that provide much greater benefits. Generally, these plans come with their own monthly premium, have a variety of options and limitations, and can be enrolled in anytime during the year. 

To look at your options when it comes to dental, vision, hearing and wellness benefits, call me at 801-550-1800.

Q: What if I’m retiring and have a 401k?
A: Separate from Medicare health insurance plans, you may find yourself in a situation where you will want or need to transfer your 401K funds into another financial vehicle. I am able to help you evaluate several options. As a licensed insurance agent, I'm trained and certified to help you evaluate fixed annuities and how they might serve your financial needs and interests. I am not an financial planner, and I don't invest your money into the stock market, mutual funds or other similar products. There is a good place in your retirement portfolio for both. I won't try to sway you or take the place of your financial planner. On the other hand, I can help you understand the benefits and intricacies of fixed annuities. 

Let's set a time, separate from our discussion about health insurance to show you how fixed annuities can be of benefit to you in your long term retirement plans. Call to set up a time at 801-550-1800.

Q: How will my spouse be covered?
A: You may find that when you're ready to go onto Medicare, that in doing so it might leave your spouse without insurance coverage. You may both be on an employer plan, and if the plan is in your name, when you decide to drop it for Medicare coverage, your spouse may not be able to stay on that plan. She might have the right to go on Cobra coverage for up to 18 months. So, what do you do for her coverage? I can help her get into an ACA (Affordable Care Act) plan. She may, or may not qualify for subsidies to help with her premium, co-payments, deductibles and annual maximum out of pocket expenses. Each household's situation is different. I can quickly help you understand your options, the associated cost, and how to enroll. This information has proven to be invaluable to couples in these circumstances, in order to help with putting together the timing of when you want to enroll in plans.

Call me to find out what your options are at 801-550-1800.

What about other languages? What if I need an interpreter?
A: Along with English, I speak Spanish fluently and have many Spanish speaking clients. Every person is entitled to have an interpreter and materials provided in their native language. If you would like to have that help, I can contact the company and make arrangements. The companies provide language interpretation services for dozens of different languages. If you would like, when we meet I can show you a chart with all the different languages. There are also services available for the deaf and blind. Our mission is simple, it is to make sure that you understand your options and are assisted in getting enrolled in the plan that you desire. If by chance you are in a situation where you need to have another person help you with your enrollment, that person needs to be a legally authorized individual that has a POA (Power of Attorney) for healthcare. Most law firms will be able to help you get that put together quickly and affordably. 

I can assist you with special conditions and language needs. Call me at 801-550-1800

​How do I get personalized attention from a trustworthy agent?
A: That's a fair and honest question. Spend a little time with me on the phone. Interview me. Let's meet and get to know each other before we get into the nitty-gritty of healthcare insurance. My mission is to make sure you're comfortable and satisfied with the information and decisions you make about your healthcare insurance needs. I have no problem recommending you to somebody else if I feel they can serve you better. Also, if I find you're in circumstances that are better for you, than what I am able to offer, I have no problem recommending that you stay put. I know how I am when I meet with people who are offering me products and services. I don't like to be sold! I can't stand to be pushed or compelled to make a decision. That type of pressure turns me off and I'm done with that kind of conversation. I think most of the people I deal with respond the same way. My mission is simply to provide you with facts, options, scenarios and how the costs will affect you. If that serves your needs and you choose to do business with me, I'm very grateful. If you feel like you need to go a different direction, or with somebody else that you've met with, I fully understand, and will not make you feel uncomfortable.

To get a taste of my special brand of customer service, please give me a call at 801-550-1800.

Invest some time now. The right choices could mean $100’s or $1000’s of dollars difference to you!
Get personalized, local, independent help as you prepare for Medicare.
There is no extra cost or obligation to you!
 
Call Jeff (801-550-1800) for your complimentary review.
I’m committed to serve you!
“Over 13 years of insurance experience!”
Not Affiliated with Any Government Agency. Independent Health Insurance Broker. No Cost or Obligation to You.

Call 801-550-1800 for personal consultation

Jeff Christiansen
Independent Health Insurance Agent

Call 801-550-1800, or Text
Email: gogetjeff@gmail.com

257 W 1120 N
American Fork, UT 84003