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About somarco

Conversationalist

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.

All Activity

POSTS
KUDOS
SOLUTIONS
TAGS

Medicare & Insurance

Re: PDP "Prior Authorization"

Not really back . . . just popped in after getting a kudo notice from a post 5 years ago. I have enough going on without monitoring this board like I once did. You are a good friend and this board won't be the same without you. Best to you!

somarco 12-10-2025 05:24 AM

1

Reply

0

Kudos

397

Views

Medicare & Insurance

Re: PDP "Prior Authorization"

Prior authorization is only needed when using a drug plan . . . not needed when paying cash. . . the Part D prior authorization may be required by your drug plan. If so, the Rx cannot be filled until your doctor contacts the drug plan carrier to aut...

somarco 12-09-2025 09:24 AM

2

Replies

2

Kudos

482

Views

Medicare & Insurance

Re: Direct Contracting: Turning Regular Medicare into Medicare Advantage

@GailL1 government motivation behind this move is saving "taxpayer" dollars, not improving care. DC wants to get out of the health care financing business by transferring the risk to private insurance carriers. That is also why CMS is so heavily prom...

somarco 03-01-2022 05:51 AM

1

Reply

2

Kudos

19667

Views

Medicare & Insurance

Re: Direct Contracting: Turning Regular Medicare into Medicare Advantage

Google this . . . "accountable care organizations go bust" Medicare approved 32 pioneer accountable care organizations in December 2011; of which 19 remained active through 2015.[7] When the program concluded in the end of 2016, only nine of the ori...

somarco 02-28-2022 04:38 PM

1

Reply

1

Kudo

19710

Views

Medicare & Insurance

Re: Less than 20 employees?

@WilliamN605255 If the employer has less than 20 employees and isn't part of a multi-employer or multiple employer group health plan, then Medicare pays first, and the group health plan pays second.Part B is for outpatient health care. As indicated a...

somarco 02-25-2022 07:27 AM

0

Replies

0

Kudos

2645

Views

Medicare & Insurance

Re: PDP "Prior Authorization"

Not really back . . . just popped in after getting a kudo notice from a post 5 years ago. I have enough going on without monitoring this board like I once did. You are a good friend and this board won't be the same without you. Best to you!

somarco 12-10-2025 05:24 AM

1

Reply

0

Kudos

397

Views

Medicare & Insurance

Re: PDP "Prior Authorization"

Prior authorization is only needed when using a drug plan . . . not needed when paying cash. . . the Part D prior authorization may be required by your drug plan. If so, the Rx cannot be filled until your doctor contacts the drug plan carrier to aut...

somarco 12-09-2025 09:24 AM

2

Replies

2

Kudos

482

Views

Medicare & Insurance

Re: Direct Contracting: Turning Regular Medicare into Medicare Advantage

@GailL1 government motivation behind this move is saving "taxpayer" dollars, not improving care. DC wants to get out of the health care financing business by transferring the risk to private insurance carriers. That is also why CMS is so heavily prom...

somarco 03-01-2022 05:51 AM

1

Reply

2

Kudos

19667

Views

Medicare & Insurance

Re: Direct Contracting: Turning Regular Medicare into Medicare Advantage

Google this . . . "accountable care organizations go bust" Medicare approved 32 pioneer accountable care organizations in December 2011; of which 19 remained active through 2015.[7] When the program concluded in the end of 2016, only nine of the ori...

somarco 02-28-2022 04:38 PM

1

Reply

1

Kudo

19710

Views

Medicare & Insurance

Re: Less than 20 employees?

@WilliamN605255 If the employer has less than 20 employees and isn't part of a multi-employer or multiple employer group health plan, then Medicare pays first, and the group health plan pays second.Part B is for outpatient health care. As indicated a...

somarco 02-25-2022 07:27 AM

0

Replies

0

Kudos

2645

Views

Medicare & Insurance

Re: PDP "Prior Authorization"

Not really back . . . just popped in after getting a kudo notice from a post 5 years ago. I have enough going on without monitoring this board like I once did. You are a good friend and this board won't be the same without you. Best to you!

somarco 12-10-2025 05:24 AM

1

Reply

0

Kudos

397

Views

Medicare & Insurance

Re: PDP "Prior Authorization"

Prior authorization is only needed when using a drug plan . . . not needed when paying cash. . . the Part D prior authorization may be required by your drug plan. If so, the Rx cannot be filled until your doctor contacts the drug plan carrier to aut...

somarco 12-09-2025 09:24 AM

2

Replies

2

Kudos

482

Views

Medicare & Insurance

Re: Direct Contracting: Turning Regular Medicare into Medicare Advantage

@GailL1 government motivation behind this move is saving "taxpayer" dollars, not improving care. DC wants to get out of the health care financing business by transferring the risk to private insurance carriers. That is also why CMS is so heavily prom...

somarco 03-01-2022 05:51 AM

1

Reply

2

Kudos

19667

Views

Medicare & Insurance

Re: Direct Contracting: Turning Regular Medicare into Medicare Advantage

Google this . . . "accountable care organizations go bust" Medicare approved 32 pioneer accountable care organizations in December 2011; of which 19 remained active through 2015.[7] When the program concluded in the end of 2016, only nine of the ori...

somarco 02-28-2022 04:38 PM

1

Reply

1

Kudo

19710

Views

Medicare & Insurance

Re: Less than 20 employees?

@WilliamN605255 If the employer has less than 20 employees and isn't part of a multi-employer or multiple employer group health plan, then Medicare pays first, and the group health plan pays second.Part B is for outpatient health care. As indicated a...

somarco 02-25-2022 07:27 AM

0

Replies

0

Kudos

2645

Views

Public Statistics

Date Registered	‎07-20-2011 07:13 PM
Last Visited
Total Messages Posted	203
Total Kudos Received	112

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