Tell us about yourself:
I enjoy helping people understand the complexities of Medicare. Married (45 years) live in Atlanta with my college sweetheart and wife. Empty nester's but our rescue Doxie (Elsie) entertains us and serves as our burglar alarm. Our son lives in CA and is an engineer @ Google. Our daughter is an art teacher in DC.
Area of knowledge and what I know well:
Over 45 years working in the health insurance arena. 18 years on the carrier side, the balance as an independent agent. Specialize in Medicare benefits since 2010.
Bio
Live in Atlanta as an empty nester. Bring extensive knowledge in medicare and insurance to the community table! Just ask.
Ace Icon
The ACE badge is awarded to Online Community members who have been recognized by peers for their high value contributions.

Learn More

The Online Community ACE program enables you to be recognized by your peers for consistent, high value contributions to the Community.

Are you ready to become an ACE? Here's how:

  • Upload Your Profile Picture
  • Fill Out the "Tell us about yourself" Section
  • Share Your "Areas of knowledge"
  • Receive 25 Kudos (excluding Politics, Current Events forum) during rolling six month period
  • Be In Good Standing Without Community Violations For At Least 30 Days

All Activity

@GailL1 an employer group health insurance plan can be a secondary carrier, and those contracts can usually DO pay after Medicare (COB). They may, in some situations, pay claims denied by Medicare. And, they can also deny the claim. While true the OP...
somarco 01-13-2022 03:10 AM
0
Replies
0
Kudos
198
Views
@GailL1 I don't know how much was allotted to this drug's cost in the current 2022 Part B premium. I doubt if the number crunchers do either. My guess is, they throw darts at a chart.
somarco 01-11-2022 05:43 PM
0
Replies
0
Kudos
280
Views
@RamonV36315 Medigap plans are not obligated to pay claims denied by Medicare. If they did so, they would be a primary carrier, not secondary. If the therapist has opted out of Medicare, like many do, you should expect to pay as billed. Use this link...
somarco 01-11-2022 05:38 PM
1
Reply
0
Kudos
344
Views
@GailL1  MA plans do use their own money when they run out of what DC gave them. A few years ago Piedmont entered the MA market with an HMO that was richer than anything else in the area and they paid a higher commission than other carriers. It was d...
somarco 01-05-2022 06:13 PM
0
Replies
1
Kudo
1171
Views
@GailL1 you are really getting into the weeds on this one. All I know about Iora or OneMedical is what I see on their respective websites. From my perspective, rarely do the grandiose programs designed by DC think tanks work out as billed. Jonathon G...
somarco 01-05-2022 01:16 PM
1
Reply
0
Kudos
1206
Views
@GailL1 an employer group health insurance plan can be a secondary carrier, and those contracts can usually DO pay after Medicare (COB). They may, in some situations, pay claims denied by Medicare. And, they can also deny the claim. While true the OP...
somarco 01-13-2022 03:10 AM
0
Replies
0
Kudos
198
Views
@GailL1 I don't know how much was allotted to this drug's cost in the current 2022 Part B premium. I doubt if the number crunchers do either. My guess is, they throw darts at a chart.
somarco 01-11-2022 05:43 PM
0
Replies
0
Kudos
280
Views
@RamonV36315 Medigap plans are not obligated to pay claims denied by Medicare. If they did so, they would be a primary carrier, not secondary. If the therapist has opted out of Medicare, like many do, you should expect to pay as billed. Use this link...
somarco 01-11-2022 05:38 PM
1
Reply
0
Kudos
344
Views
@GailL1  MA plans do use their own money when they run out of what DC gave them. A few years ago Piedmont entered the MA market with an HMO that was richer than anything else in the area and they paid a higher commission than other carriers. It was d...
somarco 01-05-2022 06:13 PM
0
Replies
1
Kudo
1171
Views
@GailL1 you are really getting into the weeds on this one. All I know about Iora or OneMedical is what I see on their respective websites. From my perspective, rarely do the grandiose programs designed by DC think tanks work out as billed. Jonathon G...
somarco 01-05-2022 01:16 PM
1
Reply
0
Kudos
1206
Views
@GailL1 an employer group health insurance plan can be a secondary carrier, and those contracts can usually DO pay after Medicare (COB). They may, in some situations, pay claims denied by Medicare. And, they can also deny the claim. While true the OP...
somarco 01-13-2022 03:10 AM
0
Replies
0
Kudos
198
Views
@GailL1 I don't know how much was allotted to this drug's cost in the current 2022 Part B premium. I doubt if the number crunchers do either. My guess is, they throw darts at a chart.
somarco 01-11-2022 05:43 PM
0
Replies
0
Kudos
280
Views
@RamonV36315 Medigap plans are not obligated to pay claims denied by Medicare. If they did so, they would be a primary carrier, not secondary. If the therapist has opted out of Medicare, like many do, you should expect to pay as billed. Use this link...
somarco 01-11-2022 05:38 PM
1
Reply
0
Kudos
344
Views
@GailL1  MA plans do use their own money when they run out of what DC gave them. A few years ago Piedmont entered the MA market with an HMO that was richer than anything else in the area and they paid a higher commission than other carriers. It was d...
somarco 01-05-2022 06:13 PM
0
Replies
1
Kudo
1171
Views
@GailL1 you are really getting into the weeds on this one. All I know about Iora or OneMedical is what I see on their respective websites. From my perspective, rarely do the grandiose programs designed by DC think tanks work out as billed. Jonathon G...
somarco 01-05-2022 01:16 PM
1
Reply
0
Kudos
1206
Views
Public Statistics
Date Registered ‎07-20-2011 07:13 PM
Last Visited
Total Messages Posted 375
Total Kudos Received 171
cancel
Showing results for 
Show  only  | Search instead for 
Did you mean: 
Users