JMS Medicare Solutions

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.

This one has a more nuanced answer than most of the myths we've covered this month.
So, let's break it down.

Original Medicare does not cover gym memberships or general fitness programs.

However, Medicare does cover intensive behavioral therapy for obesity. If your doctor determines it's medically necessary, you may be able to get counseling and support for weight loss covered under Part B.

And here's where it gets interesting.

Many Medicare Advantage plans do include fitness benefits. You may have heard of SilverSneakers or similar programs. These are fitness benefits that come bundled with certain Advantage plans and give you access to gyms and fitness classes at little or no cost.

Whether your plan includes something like that depends entirely on which plan you have and where you live.

I was chatting with a neighbor recently who had just retired and was really motivated to prioritize her health. She had a whole list of goals. Morning walks along the Riverwalk, classes at the YMCA, maybe even joining one of those local recreational sports leagues or yoga studios that seem to be popping up everywhere.

She was excited to find out her new Advantage plan actually includes a fitness benefit that can help cover some of the costs associated with her goals.

Helping someone protect their health AND their wallet at the same time is genuinely one of the best parts of this job.

Not sure if your plan includes any fitness or wellness benefits? Is that benefit worth giving up your doctor?

DM me the word FITNESS and let's take a look at what you have and what might be available to you in Tennessee or Georgia.

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.

I wish this one were true. It would make life a lot simpler.

But Medicare plans can and do change. Every single year.

Every fall, during the Annual Enrollment Period from October 15 through December 7, insurance companies can make changes to their Medicare Advantage and Part D plans for the next year. Premiums can go up. Covered drugs can change. Which doctors or hospitals are participating can shift. Benefits can be added or removed.

That means a plan that was perfect for you last year might not be the best fit this year.

And here's the part that gets people. Most people don't review their plan during Annual Enrollment. They just let it roll over automatically. Which means they could be paying more than they need to or missing out on better coverage without ever knowing it.



Every fall here in Chattanooga and the surrounding area I make it my mission to reach out to every single client and review their plan. Because you deserve someone in your corner who actually pays attention to this stuff year after year.

Annual Enrollment is coming up faster than you think. Now is a great time to get a relationship started so you're not scrambling when it opens.

Tag someone in Tennessee or Georgia who has been on the same Medicare plan for years and might be due for a review.

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.

Okay this one might seem small. But for a lot of people, especially those with diabetes or circulation issues, foot care is anything but small.

So, let's clear it up.

Original Medicare does not cover routine foot care.
Nail trimming. Callus removal. Routine visits to a podiatrist just to keep things in check. Not covered.

Now here's where it gets a little more nuanced.
Medicare DOES cover foot care when it's medically necessary. If you have diabetes and need foot care related to your condition, that's a different story. If you have nerve damage or poor circulation that requires professional foot care, Medicare may cover it. But routine? No.

I recently was talking with a client here in Chattanooga who mentioned they had been putting off seeing a podiatrist because they were waiting until their Medicare kicked in to cover it. They had been dealing with a pretty uncomfortable issue for months.

We had a quick conversation about Medicare benefits, and I was able to point them in the right direction.

Little moments like that are honestly why I love doing this work in Chattanooga and the surrounding area. Sometimes the right information at the right time makes a real difference in someone's day.

This is one of the many coverages gaps I break down in my free Medicare Coverage Myth-Buster Guide.

DM me the word MYTHS and I'll send it straight to you. It's free and it's genuinely useful.

Okay this one might seem small. But for a lot of people, especially those with diabetes or circulation issues, foot care is anything but small.

So let's clear it up.

Original Medicare does not cover routine foot care.
Nail trimming. Callus removal. Routine visits to a podiatrist just to keep things in check. Not covered.

Now here's where it gets a little more nuanced.
Medicare DOES cover foot care when it's medically necessary. If you have diabetes and need foot care related to your condition, that's a different story. If you have nerve damage or poor circulation that requires professional foot care, Medicare may cover it. But routine? No.

I was walking through [local neighborhood/area] here in [City] and ran into a client who mentioned they had been putting off seeing a podiatrist because they were waiting until their Medicare kicked in to cover it. They had been dealing with a pretty uncomfortable issue for months.

We had a quick conversation right there on the sidewalk and I was able to point them in the right direction.

[Little moments like that are honestly why I love doing this work in [City]. Sometimes the right information at the right time makes a real difference in someone's day.]

This is one of the many coverage gaps I break down in my free Medicare Coverage Myth-Buster Guide.

DM me the word MYTHS and I'll send it straight to you. It's free and it's genuinely useful.

This one comes up a lot this time of year as people start making summer travel plans.

And it's a big one to get wrong.

Original Medicare does not cover medical care outside of the United States. With very limited exceptions, if you get sick or injured abroad, you are on your own.

Those exceptions are pretty narrow. We're talking situations like if you're on a ship within U.S. territorial waters or if a foreign hospital is closer to you than a U.S. one in a genuine emergency near the border. Not exactly the coverage you're picturing for your trip to the British Virgin Islands or to Europe.

I was chatting with someone here in Chattanooga at who was getting ready for a big international trip they had been planning for years. First retirement adventure. They had no idea their Medicare wouldn't travel with them.

We got them sorted out before they left. But it was a close call.

Here's what to look for instead. Some Medicare Supplement plans do include foreign travel emergency coverage. Some Medicare Advantage plans include it too, though it varies. And travel insurance is always worth considering for international trips.

One of my favorite things about this work is having conversations like that one before someone gets on a plane, not after something goes wrong.

Got a trip coming up this summer? Let's make sure you're actually covered.

DM me the word TRAVEL and let's take a look at your options before you go!

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 might be the myth that costs people the most money.

Because if you believe all Medicare plans are the same, you might just pick one randomly. Or go with whatever your neighbor has. Or choose based on a TV commercial you saw at 2am.

And that can be a really expensive mistake.

Here's the reality.

Even within the same type of plan, the details can vary dramatically. Premiums. Deductibles. Drug formularies. Networks. Out of pocket maximums. Which doctors are covered. Which medications are covered and at what cost.

Two people living right here in Chattanooga on the same street could have very different needs and the plan that's perfect for one of them could be completely wrong for the other.

I had a client in North Georgia who came to me after choosing a plan on their own. They picked it because it had a low premium. What they didn't realize was that their specific medications weren't covered at a preferred tier on that plan. They were paying hundreds more per month in drug costs than they needed to.

We fixed it. But it took until the next enrollment period to make the switch.

This is genuinely one of my favorite parts of the job. Sitting down with someone and actually digging into the details. It feels like solving a puzzle and the prize is saving someone real money.

Don't just pick a plan. Pick the right plan.

Tag a friend or family member in Tennessee or Georgia who is coming up on Medicare and might need to hear this.

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 are halfway through Myth Busting May and I have to say, the response has been amazing.

I've heard from some of you here in Chattanooga and beyond who had no idea about some of these gaps. And that's exactly why I do this.

So I want to hear from you today.

Which myth we've covered so far surprised you the most?

Was it finding out Medicare isn't free? That dental, vision, and hearing aren't covered? That missing your enrollment window means a permanent penalty? That prescription drugs aren't automatically included?

Drop the number in the comments that surprised you most.

1️⃣ Medicare isn't free
2️⃣ No dental, vision, or hearing
3️⃣ Late enrollment penalties
4️⃣ No automatic drug coverage

[I'll be honest, when I first started learning about all of this in number 3 was the one that got me too.

There are still 16 more days of myths to bust. And some of the ones coming up are real eye-openers.

Make sure you're following me, so you don't miss a single one!

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 one surprises a lot of people. And it makes total sense that it does.

You sign up for Medicare. You assume your prescriptions are covered. Why wouldn't they be?

But Original Medicare, Parts A and B, does not include prescription drug coverage.

Drug coverage comes from Part D. And Part D is a separate plan that you have to actively choose and enroll in.

Here's where it gets a little tricky. ⤵️

Even if you don't take any prescriptions right now, skipping Part D when you're first eligible can come back to bite you. Just like Part B, there's a late enrollment penalty for Part D if you go without creditable drug coverage for 63 days or more.
And just like Part B, that penalty sticks around.

I was catching up with an acquaintance here in Chattanooga a while back and they mentioned they had skipped Part D because they weren't on any medications. Totally understandable thinking. But not the right move.

A few years later they were on several prescriptions and paying more than they needed to every single month because of that penalty.

The good news is that Part D plans are generally pretty affordable, especially if you get into one early.

This is one of the things I cover in my free Medicare Coverage Myth-Buster Guide. All the parts, all the gaps, all in one place.

DM me the word MYTHS and I'll send it your way today!

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 7 organizations which offer 54 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.

Let's talk about enrollment windows. What happens when you miss one?

It's not just an inconvenience. It can follow you for the rest of your life.

Here's how the late enrollment penalty works for Part B.

For every 12 months you were eligible for Part B but didn't sign up, you pay an extra 10% on your premium. For the rest of your life.

So, if you waited two years when you didn't have other qualifying coverage, your premium goes up 20%. Forever.

On top of that, you could face a gap in coverage while you wait for the next enrollment window to open. And as we all know, life doesn't wait for enrollment windows.

I got a call from someone here in Chattanooga a few months ago who wants to retire and assumed their coverage just rolled over into Medicare automatically. It doesn't. By the time folks' figure that out they may have already missed their window by a few months.

This can be a tough situation. And the penalty becomes unavoidable.

If you're not sure where you stand with your enrollment timeline, please don't wait.

DM me the word PENALTY and let's make sure you're not walking into something that's going to cost you every single month.

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 7 organizations which offer 54 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.

I hope all the moms out there had a Happy Mother's Day. 💛

I want to talk about something a little different today.

A lot of the people I work with aren't just figuring out Medicare for themselves. They're helping their mom. Or their grandma. Or their aunt who just turned 65 and has no idea where to start.

And one of the most loving things you can do for the women in your life is make sure they actually understand what they have.

Because here's what I see all the time. Mom has been on Medicare for a few years. She picked a plan when she first enrolled because she had to pick something. But nobody ever really sat down and explained it to her. She's not sure what's covered. She doesn't know if she's overpaying. She just hopes for the best when she goes to the doctor.

That doesn't sit right with me.

If that sounds like your mom, your grandma, or someone you love here in the Chattanooga area, this is a great time to change that.

I remember when I helped my own mom understand her coverage for the first time. The look on her face when she realized she had options was everything.

Share this post with the mom in your life who could use a little clarity. And if she has questions, I'm happy to help.

DM me the word MOM and I'll make sure she gets the answers she deserves.

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 7 organizations which offer 54 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.