Pless Insurance

What can Jon Pless do for me?

Jon has years of experience in matching clients with the best insurance products for their needs and budget. He specializes in Medicare plans. Matching Medicare plans with each client’s prescriptions plans, pharmacies and physicians can be complicated. Plus, Medicare plans and client needs change from year to year! Jon works hard to ensure that each client is matched with what they need, and what they can afford.

I’m confused about Medicare Advantage and Medicare Supplement plans. Can Jon Pless help?

The short answer is “Yes.” Here are some fast facts about Medicare Advantage:

Medicare Advantage transitions your primary insurance to Part C, so it becomes your primary (and usually only) insurance plan for the year.
Most Medicare Advantage plans have the ability to combine Parts A, B and D into Part C.
Medical and Prescription benefits are included in Medicare Advantage.
This has been described as privatizing Medicare.
Medicare Advantage plans are generally HMO and PPO plans, which means they participate in networks that you’ll need to know before you enroll.

About Medicare Supplement Plans:

Medicare Supplement plans are secondary to your Original Medicare Plan (which is different from Medicare Advantage.)
Remember: Medicare Supplements pay AFTER Original Medicare, whereas Medicare Advantage plans pay INSTEAD of Original Medicare.

It seems like Medicare plans change every year. How can I keep up?

Medicare plans do change yearly! That’s why Jon dedicates time to each of his clients for a yearly review, to make sure you’re enrolled in the best plan for your needs.

Medicare (Part C) Advantage Plans and Medicare (Part D) Drug Plans change every year on January 1.
During the AEP (Annual Enrollment Period) of October 15 to December 7, Jon helps clients review and change plans to optimize benefits and costs.
Medicare Supplement benefits don’t change from year to year, BUT most Medicare Supplement Plan premiums increase as you age.
Medicare Supplement plans don’t have specific enrollment dates, which means you can change at any time. You may need to go through underwriting for this. Jon can help.

I keep reading about HMO and PPO … What is that?

HMO = Health Maintenance Organization.

PPO = Preferred Provider Organization.

HMO and PPO both mean a network of physicians, hospitals and other healthcare providers that participate in your plan, but there are differences between the two types of networks.

HMO plans:

Require that you choose a primary care physician, who would then refer you to a specialist as necessary.
Visits to healthcare providers outside your HMO are usually NOT covered by your insurance plan.

PPO plans:

Do not require a designated primary care physician.
You are free to visit any provider you want, whether they are in-network or not.
However, providers who are not in network might be more expensive for you.

Can I just contact Medicare directly? Why should I use Jon Pless as my agent?

Using a local, independent agent like Jon means you get in-person, detailed assistance with all your Medicare concerns--at no extra cost to you. Your premiums remain the same whether you choose to interact with Medicare directly or work with Jon, but Jon can help you navigate the complexities of Medicare in a way that makes sense to you.

Will Jon Pless charge me for his services?

No. Jon is paid by the insurance companies, so there is no cost to his clients for his services.

It’s outside the Annual Enrollment Period … Can I still buy Medicare Insurance?

If you need insurance outside the dates of October 15 to December 7, you can still buy Medicare insurance in specific circumstances.

Your Initial Enrollment Period begins three months before your 65th birthday and ends three months after your 65th birthday.
You may also be able to buy Medicare insurance in these cases: losing employer coverage; moving outside the current service area; losing Medicaid and/or extra help with prescriptions