JMS Medicare Solutions

Every summer I end up at Tony's Pasta Shop at least once and every single time I wonder why I don't go more often.

The service staff is courteous. The food is always fabulous regardless of what I order, but my favorite is the grilled vegetable salad. The view is nice, especially if you sit outside and upstairs, if you are there on a day when it isn't too hot.

There is something about places like this that just feel like summer. Good people. Good energy. Worth showing up for.

If you haven't been yet this season, consider this your nudge!

Have you been to Tony's Pasta Shop before?

Let's be honest for a second… Medicare can make perfectly intelligent people do some very questionable things. 😂

How many of these have you done?

⬜ Googled Medicare at midnight
⬜ Got advice from a neighbor who “knows somebody”
⬜ Said “I think I'm covered” without actually being sure
⬜ Called the 1-800 number and gave up after sitting on hold forever
⬜ Forgot where you put your insurance card
⬜ Asked your adult kid for help and instantly regretted it
⬜ Felt stressed about Medicare before you even needed to

Truthfully? Most people feel overwhelmed at some point. There's so much information out there and a lot of it sounds completely different depending on who you ask.

That's why having someone you trust to walk you through it matters.

How many boxes would you check? 👀

Or better yet… tag the person who would absolutely check off at least three of these. 😂

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

This is one of those things nobody thinks to check until it's too late.

Here's how it usually goes.

Someone has been seeing the same doctor for years. They go in for an appointment, get their care, and then a bill shows up that is way higher than what they're used to.

Why? Because their doctor quietly left their network and nobody told them.

This happens more than most people realize. Doctors negotiate contracts with insurance plans every single year. Sometimes those contracts don't get renewed. It happens for all kinds of reasons and patients are almost never the first to know.

The good news? It takes about five minutes to check.

Call the member services number on the back of your insurance card and ask "is [Doctor's Name] still in network for my plan?" That's it!

And here's why doing this in June instead of October matters. If you find out now you've got plenty of time to figure out your options calmly. If you find out during open enrollment you're making a big decision under pressure.

Not sure how to check? I'm happy to help!

DM me the word SUMMER and let's take a look together.

Have you checked your network recently?

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

A fairly frequent occurrence for me...

Friends and acquaintances gather. Everyone sits down to eat or just to talk. And somewhere between when beverages are served and the last of whatever food is enjoyed someone will ask something about their health care coverage.

And then it starts.
"I read something online that said..."
"My coworker's mom switched plans and saved a ton..."
"Have you thought about changing to..."
"I really think you should call someone about..."

They mean well. They really truly do. But by the end of the discussion you've got four different opinions, three things to Google, two people who definitely contradicted each other, and zero actual answers.

Sound familiar?!

Here's the thing. Medicare is not a one size fits all situation. What worked for your neighbor, your coworker's mom, or whoever your son read about on Facebook may have absolutely nothing to do with what's right for you.

You deserve real answers based on your actual situation. Not opinions offered at the dinner table.

That's exactly what I'm here for. One conversation with me is worth about fourteen family dinners worth of Medicare advice.

DM me the word SUMMER and let's get you some actual answers before the next family gathering!

Has this ever happened at your dinner table?

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

Here's a scenario I hear more than you'd think.

Someone walks into the pharmacy in January to pick up a medication they've been taking for years. Same drug. Same dose. Same pharmacy. And the price is completely different from what they expected.

Not because they did anything wrong. But because their plan's formulary changed.

Here's what that means in plain English.

A formulary is basically your plan's list of covered drugs. Every Medicare Part D and Medicare Advantage plan has one. And that list can change every single year on January 1st. Drugs can move to a higher tier which means higher cost. Some drugs can be removed from the list entirely. New requirements like prior authorization can be added.

Your plan is required to notify you about these changes. But let's be honest. That notice shows up in a thick envelope in October, and most people set it aside and never open it.

So, here's what I want you to do.

If you take any regular medications, it is worth a quick check to make sure they are still covered the same way they were last year. You can call your plan directly or I can help you look it up in about five minutes.

Because finding out at the pharmacy counter is the worst possible time!

DM me the word SUMMER and let's take a look at your current coverage together.

Has your medication cost ever changed unexpectedly at the pharmacy?

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

Summer is basically here and I am already making plans!
Here's what's on my list this year:
⬜ 4th of July celebration
⬜ A morning on our back porch with nowhere to be
⬜ Enjoy a trip to Pittsburgh to see my husband's family
⬜ Dinner at Tony's Pasta Shop with people I love
⬜ A hike to Glen Falls
⬜ Spend time with my 3-year-old granddaughter

Summer goes fast and I don't want to blink and miss it!

What should I add to my list?

Quick question for anyone on a Medicare Advantage plan.

Do you know what your service area is?

If the answer is "I'm not sure" or "what does that mean," you are in very good company. This is one of the most common things people don't know about their plan until it actually affects them.

Here's what it means in plain English.

Medicare Advantage plans are offered by private insurance companies. And unlike Original Medicare, which works pretty much anywhere in the country, Advantage plans operate within a specific geographic area. Your county. Maybe a few surrounding counties. Sometimes a whole region.

Inside that area? Your plan works the way you expect it to.

Outside that area? It gets complicated fast. Depending on your specific plan, you might pay significantly more to see a doctor. Or you might only be covered for true emergencies. Some plans have very limited coverage the moment you step outside their boundaries.

And here's the thing. Most people find this out when they're already somewhere new and already need care. That is not a fun moment.

The good news is there's one question you can ask your plan right now that will tell you everything you need to know.

Call the member services number on the back of your card and ask this exactly:

"If I need non-emergency care outside my service area, am I covered and what will it cost me?"

That's it. One question. Five minutes. And you'll know exactly where you stand before summer gets going.

Not sure what plan you even have or where to find that number? That's what I'm here for!

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

June is here and I am ready for it! 😎

If you're like most people I talk to, your summer is already starting to take shape. A trip here, a family gathering there, maybe a few weekends you're actually looking forward to.

And somewhere in the middle of all that planning... your Medicare coverage probably didn't make the list.

Totally normal. Honestly, most of the time everything is fine!

But here's what I've seen happen more times than I can count.

Someone heads into summer feeling great about their coverage. Then something comes up. A doctor visit. A prescription refill. An unexpected trip to urgent care. And they find out their plan changed in ways they didn't know about. Their doctor quietly left their network. A medication they've taken for years now costs three times what it used to.

Not because they did anything wrong. Just because nobody told them.

I've been serving Chattanooga and the surrounding area for 3 years and this is genuinely the most common thing I help people with. Not complicated Medicare questions. Just the small stuff that slips through the cracks when life gets busy.

So, this month I'm walking you through everything worth knowing before summer gets going. No jargon. No scary what-ifs. Just clear, honest information so you can enjoy the next few months without anything catching you off guard.

So let me start with the most important question!

When is the last time you actually looked at your Medicare plan?

Within the last month or longer than that?

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

We've spent almost the entire month busting myths and talking coverage details.

Today I want to get a little personal.

People ask me sometimes why I do this. And the honest answer is that it's never really been about selling insurance to me.

It's about the moment someone goes from being confused and overwhelmed to clear and confident. I feel I really made a difference when that moment happens in my office, on a phone call, at a community event, in a local restaurant here in Chattanooga, and sometimes just in a random conversation with someone that I meet.

And it never gets old.

I got into this work because I needed flexible work hours to help care for my mom and my granddaughter. A former colleague urged me to use my nursing background, my years of experience in health insurance and Medicare in particular to become a health insurance agent. It was a great decision.

The Medicare system is genuinely complicated. It doesn't have to feel that way for the people trying to navigate it. That's the gap I try to fill every single day.

I've learned that most people don't need someone to sell them something. They need someone who will sit down with them, listen to their situation, and help them understand their options without any pressure.

That's what I try to be for every single person I work with.

If you've been following along this month and you've found any of this helpful, I'd love to hear from you. A comment, a share, or even just a reaction on this post means more than you know.

And if you know someone here in Tennessee or Georgia who could use a straight-talking Medicare resource in their corner, I hope you'll send them my way.

I'm not going anywhere. 😊

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

Do you have Medicare related questions that you need answers for?

As part of a marketing event sponsored by HealthSpring, I will be at the Walgreens located at 4039 Dayton Blvd in Red Bank on June 2 from 11:00-1:00pm. I can answer questions, review benefit information or discuss your specific coverage needs with you.

If there is someone you know that has questions, please pass this information along to them.

Disclaimer: This is an advertisement. Not affiliated with any government agency, including Medicare. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.