Medicare Supplement Vs. Medicare Advantage

medicare supplement vs medicare advantage text overlaying image of a splitting arrow going two waysPart A (hospital insurance) and Part B (medical insurance) pay for a lot of your healthcare needs, but they are not able to cover everything. Before your insurance kicks in, you’ll have to pay a deductible. After that, you’ll have to pay other fees, like coinsurance, which is a percentage of certain costs. Also, Original Medicare doesn’t cover routine services like eye, dental, and hearing care, so you may be paying more out of pocket costs than you think. Some people buy Medicare Supplement Insurance or a Medicare Advantage plan (also called Part C) to help pay for these costs. The way each one works is a little bit different so you will need to compare them to help figure out which one might suit you best.

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Medicare Supplement Plans

Medicare Supplement Insurance works with your Original Medicare plan. It helps pay for services that Part A and Part B don’t cover, like traveling outside the country and extra costs, such as when a doctor doesn’t accept Medicare. It can also help pay for your Part A deductible, which was $1,556 in 2022 and the 20% coinsurance you’ll have to pay for your Part B coverage. Keep in mind that Medicare Supplement Insurance isn’t a standalone plan, so you’ll need to sign up for Original Medicare first. Prescription drugs are another thing that Medicare Supplement doesn’t pay for, and you will need a third plan, Medicare Part D, for that.

 

Plans A, B, C, D, F, G, K, L, M, and N are the 10 different Medicare Supplement insurance plans that exist as of right now. Unfortunately, people who sign up for Medicare after January 1, 2020, will no longer be able to choose Plans C and F. Medicare Supplement plans cover 100% of your Part A coinsurance costs, which is the percentage you pay for services after you reach your deductible. Most plans also cover 100% of your Part B coinsurance and copayment costs.

 

If you choose Medicare Supplement, keep in mind that it will also cost you money every month. The amount depends on the plan, but each month it could be hundreds of dollars and some plans also have co-pays and deductibles.

How Much Does Medicare Supplement Cost?

How much you pay for your Medicare Supplement premium can depend on your plan, your age, and where you live. In general, the cost of your plan can go up the more coverage you choose. Some Medicare Supplement plans limit how much you have to pay out of your own pocket. For a clear idea of how much you’ll pay, check out our state-by-state Medicare Supplement Plan guides.

Medicare Supplement Eligibility

You’re eligible to buy a Medicare Supplement plan if you’re:

 

  • 65 years old or older.
  • Have signed up for Parts A and B of Medicare.
  • Currently living in a state where the policy you want is offered.

In some states, even if you are younger than the age of 65, you can get Medicaid if you have a disability or end-stage renal disease (ESRD).

Medicare Advantage

The Medicare Advantage (MA) plans are an alternative to Original Medicare. Private insurance companies are able to give them out. Under an MA plan, you’ll still get Parts A and B, but you may also get Part D and other benefits, like regular hearing, vision, and dental care, all in one policy. By law, Medicare Advantage plans cover the same kinds of care as Original Medicare. For example, hospital stays, doctor visits, and lab tests are all covered by Medicare Advantage plans. However, before the plan will pay for the costs, you may have to stay in the network or get a referral. You can choose any doctor who takes Original Medicare.

 

If you sign up for Medicare Advantage, your benefits will be handled by that private plan and Original Medicare will no longer cover you. You also won’t be able to sign up for a Medicare Supplement plan or a Part D plan that stands on its own. Many Medicare Advantage plans don’t charge a premium on top of what you already pay for Part B. You may still have a deductible, copays, and coinsurance, but most MA plans limit how much you have to pay out of pocket each year, this is known as the out-of-pocket maximum.

How Much Does Medicare Advantage Cost?

Premiums, deductibles, and other costs for Medicare Advantage can vary by plan and change every year. To stay in your plan, you must pay the Part B premium, which was $164.90 in 2023 and keep paying it. The out-of-pocket limit can also vary by plan, but once you reach it, the plan pays for all of your covered health services for the rest of the year.

Medicare Advantage Eligibility

To sign up for a Medicare Advantage Plan, you must:

 

  • Sign up for Parts A and B of Medicare.
  • Live in the area where the plan is available.
  • Be a U.S. citizen or are in the U.S. legally.

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Comparing Medicare Supplement and Medicare Advantage

There are several ways in which Medicare Supplement and Medicare Advantage plans are different. A Medicare Advantage plan (Medicare Part C) is an all-in-one option with low monthly premiums. Medicare Supplement plans provide extra coverage on top of Original Medicare for little or no extra cost. Let’s take a look at all of the differences.

Coverage

Medicare Advantage includes Original Medicare Parts A and B, plus extra benefits like routine dental, vision, hearing, and fitness services. While Medicare Supplement Plans help fill in Original Medicare’s “gaps” by paying for out-of-pocket expenses that Parts A and B won’t cover.

Enrolling

There are specific enrollment periods throughout the year during which you are able to sign up for a Medicare Advantage plan or switch to a different one. After turning 65 and enrolling in Medicare Part B, you are eligible to apply for a Medicare Supplement policy at any point after that age.

Providers

You may be required to use hospitals and doctors that are part of the Medicare Advantage network if you have Medicare Advantage. You are free to visit any doctor in the country who participates in Medicare if you have Medicare Supplement Plans.

Referrals

Medicare Advantage plans are more likely to require referrals to see specialists, while Medicare Supplement Plans do not require referrals at all.

Costs

Medicare Advantage has lower premiums but includes copays. Medicare Supplement Plans have higher premiums, but little to no copays.

Prescription coverage

Medicare Advantage Plans may include a Part D prescription drug plan with your policy. With Medicare Supplement Plans you’ll have to enroll in Medicare Part D separately to get this coverage.

Underwriting

Medicare Advantage has no medical underwriting and includes coverage for any and all health conditions. Medicare Supplement plans also have no underwriting as long as you enroll during your IEP. If you don’t enroll during this time, there is a possibility you will face underwriting.

Switching From One to The Other

You can’t change from Medicare Supplement to Medicare Advantage whenever you want. You’ll have to wait until the Medicare Open Enrollment Period, which runs from October 15th to December 7th each year. Before you sign up for a Medicare Advantage plan, you should tell your Medicare Supplement insurance company that you are dropping it. 

On the other hand, if you want to switch to Original Medicare and buy a Medicare Supplement policy, you should check with your Medicare Advantage Plan to see if you can drop out. If you can leave a Medicare Advantage plan and go back to Original Medicare, you can only do so during two enrollment times:

 

  • The Medicare Advantage Open Enrollment Period (MA OEP) between January 1st and March 31st.
  • The Annual Enrollment Period (AEP) between October 15th and December 7th.

You can usually sign up for a Medicare Supplement plan once you’re enrolled in Original Medicare. When you switch from Medicare Advantage to Original Medicare, you usually lose your right to “guaranteed issue” Medicare Supplement coverage. When you are 65 or older and signed up for Medicare Part B, you usually have guaranteed-issue rights for 6 months. If you don’t have guaranteed-issue rights, insurance companies may check your health status before they sell you a plan.

How To Choose

If you want to know what your costs will be, be able to choose any doctor, avoid referrals, and feel safe when traveling, then you will need a Medicare Supplement plan. If you are willing to trade a lower monthly premium and more benefits for copayments that can change, as well as strict doctor networks, and referrals, then Medicare Advantage may be a good choice for you. The best thing about working with agents is that no matter which option you choose, we’ll make sure it’s the best one for you. 

Working With an EZ Agent

We don’t offer Medicare Advantage, but if you’re looking for a Medicare Supplement Plan, it’s important to compare the benefits and costs of each one. That means you’ll have to do an abundance of research, which can take a while since you’ll have to call a lot of insurance companies to get price quotes. 

 

If you decide to work with an agent from EZ, you can compare prices in half the time. Working with a licensed agent gives you access to many Medicare Supplement Plan carriers and plans in one place. 

 

In addition to giving, you price comparisons, your agent can tell you how each plan is different. Also, your agent can help you compare out-of-pocket costs with premium costs to figure out which plan will save you the most money over time. Call us today at 877-670-3602 to start looking for a Medicare Supplement Plan. 

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Can a Medicare Supplement Plan Help Pay for Cancer Treatments?

A cancer diagnosis can happen to anyone at any age, but the older you are, the more likely you are to develop the disease. In fact, according to cancer.gov, the median age at diagnosis for breast cancer is 62, 67 years for colorectal cancer, 71 years for lung cancer, and 66 years for prostate cancer. If you have been diagnosed with cancer, you can fight it, but it will be tough – and expensive. The costs of treating cancer can add up quickly, even if you are enrolled in Medicare, because Medicare only covers some of your medical expenses; the rest you will be required to pay out-of-pocket. The last thing you want to worry about while battling cancer is money, but don’t worry – you don’t have to: a Medicare Supplement Plan can help cover the expenses that Medicare does not. So what kind of cancer treatments does Medicare cover, how much do they cover, and how can a Medicare Supplement Plan help?

What Does Original Medicare Cover?

doctors and nurses in scrubs in an operating room with someone on the table
Medicare will cover surgery for cancer at 100%, but only 80% of any outpatient surgeries.

Coverage For Surgery

Surgery for cancer usually involves removing a tumor and nearby lymph nodes, except in cases of blood cancer or cancers that have already spread. Medicare will cover any medically necessary surgery for cancer: Medicare Part A will cover inpatient surgery, while Medicare Part B covers 80% of any outpatient surgery. You will be responsible for the remaining 20% of the Medicare-approved outpatient amount, as well as for meeting your Part B deductible.

Coverage For Radiation

In high doses, radiation can kill cancer cells by dividing and killing them, which can help shrink tumors. Radiation therapy can be done externally or internally to treat specific parts of your body. Medicare Part A will cover radiation treatment for hospital inpatients, and Medicare Part B will cover 80% of treatment for outpatient and in clinics. You will be responsible for 20% of the Medicare-approved Part B amount, well as for meeting your Part B deductible.

Coverage For Chemotherapy

Chemotherapy is administered orally through pills, or liquids, as well as through an IV into the muscle. Medicare Part A provides coverage if you are a hospital inpatient, and Part B will cover chemotherapy in an outpatient setting, doctor’s office, or clinic. You will be responsible for 20% of the Medicare-approved amount, as well as for meeting your Part B deductible.

How Can A Medicare Supplement Plan Help?

As noted above, Medicare covers all medically-necessary cancer treatments, but not 100%. If you are getting inpatient treatment, you will have to meet your Part A deductible and pay coinsurance if your hospital stay is longer than 60 days; if you are receiving outpatient services, you will pay 20% of the Medicare-approved amount, after you meet your Part B deductible. Cancer treatment can be very expensive, so you might find you need help filling the coverage gaps in Medicare, and a Medicare Supplement Plan can do that. 

Medicare Supplement Plans can cover your Part A deductible, and coinsurance costs, as well as your Medicare Part B copayment, coinsurance, and deductible. There are 10 different plans to choose from, and depending on which plan you choose, you could get anywhere from 75% coverage of your medical expenses all the way up to 100%. Each plan offers a range of coverage at different price points; if you are battling cancer, your best option is to get the plan with the most coverage possible, so you will only have to worry about paying your Medicare Supplement Plan monthly premiums. money bags, one green and the other two tan coloredMedicare Supplement Plans can help save you money and keep you from stressing over medical bills for your cancer treatments, leaving you with more time and energy to focus on your health. EZ can compare all 10 Medicare Supplement Plans and find the one that will meet your financial and medical needs. Our agents work with the top-rated insurance companies in the nation, which makes comparing plans easy, quick, and free – our services come at no cost to you, because we just want to help you save more money so you can focus on your health. To get free instant quotes on plans that cover your doctors, simply enter your zip code in the bar above, or to speak to a local licensed agent, call 888-753-7207.

Does Medicare Cover Colonoscopies?

Colorectal cancer is the second leading cause of cancer-related deaths in men and women in the U.S. It is estimated that about 1 in 20 people will be diagnosed with colorectal cancer in their lifetimes. This number is high in part because 1 in 3 people are not up-to-date on their colonoscopy screenings. Colonoscopy screenings are the most effective way to detect and prevent colorectal cancer. Getting regularly screened is especially important for older adults, because if you are 65 or older, you are at a greater risk of dying from colon cancer. Fortunately, Medicare covers colonoscopies at specific time intervals, based on a person’s risk for colon cancer.

doctor in blue gown holding a black tube with a light on the end of it.
During a colonoscopy, a thin, tubed camera is inserted inside the body so that doctors can view the lining of the colon.

What Is A Colonoscopy?

Colonoscopies are safe, common procedures. According to the CDC, over 25 million colonoscopies took place in 2012. During this procedure, a thin, tubed camera is inserted inside the body so that doctors can view the lining of the colon. There are two types of colonoscopy:

  • Screening colonoscopy– a routine procedure performed to see how healthy the colon is and to check if there are any polyps that need to be removed.
  • Diagnostic colonoscopy–  performed to check for irregularities because a person is having intestinal issues.

When a colonoscopy is performed, the patient will normally be put under general anesthesia.

How Much Does It Cost?a sign that says "costs" in red over a pile of 10 dollar bills.

Many factors go into determining the price of a colonoscopy. This includes the location where it is done, what kind of anesthesia is used, and whether any tissue samples have to be sent to a lab for testing. The average cost of a colonoscopy is almost $4,000. If you have private insurance, the procedure will be covered after you meet your deductible. Medicare also covers colonoscopies, but how they are covered depends on whether they are considered a screening or a diagnostic procedure.

What Medicare Covers 

Because a screening colonoscopy is considered a preventive service, Medicare Part B will cover it. Medicare will cover all screening costs as long as the doctor accepts Medicare assignment. This means that your doctor agrees to accept the Medicare-approved amount as full payment for the procedure.

Medicare will cover the cost of screening colonoscopies:

  • Once every 24 months (2 years) if you are at high risk of colorectal cancer because of family history or history of colon polyps or inflammatory bowel disease.
  • Once every 120 months (10 years) for patients who are not considered high-risk.

Your screening will be covered in full whether or not you have met your deductible. white paper with a calculator and a hand pointing at both.

Only the screenings themselves are covered, so if your doctor finds a polyp or takes tissue samples during the colonoscopy, then you will have to pay a portion of the bill. You might owe:

  • 20% of the Medicare-approved amount
  • A copay if you’re in a hospital getting the procedure done

Medicare Supplements can help pay for the additional 20% of out-of-pocket costs if a polyp is found or if you require more  than just a screening. Before scheduling your colonoscopy, contact your Medicare Supplement Plan insurer and find out just how much they will cover if a polyp removal is necessary. 

A colonoscopy is an important screening test that can help catch colorectal cancer early and possibly save your life. There’s no reason not to get one done if you are over 65, because Medicare covers the cost, and a Medicare Supplement Plan can help pay for any other costs associated with getting tested. If you are looking for a Medicare Supplement Plan, we will help compare the different plan types in your area. We will help you find one that meets your health and financial needs. To get free quotes, enter your zip code in the bar above, or to speak to an agent directly call 888-753-7207. No obligation. No hassle. Just free quotes.

When Can You Sign Up For Medicare Supplement

Medicare Supplement plans do not have annual enrollment periods, so it is important to know when to apply for one. The Medicare Supplement initial enrollment period is the time to sign up for a plan.  It is important to utilize this period if you need help paying Part B costs, or if you have pre-existing conditions you need covered. During this time, you have guaranteed issue rights. This is your guarantee that companies will cover your pre-existing conditions without extra charge. What most people do not know is that you can also obtain guaranteed issue rights during a special enrollment period.

  • Must be 65 and already be enrolled in the original Medicare Parts A and B to qualify

    Th best time to sign up for a Medicare Supplement plan is during the 7 month period of your 65th birthday.
    Th best time to sign up for a Medicare Supplement plan is during the 7 month period of your 65th birthday. 3 months before your birth month, and the 3 months after.

Best time to enroll

The best time to enroll in a Medicare Supplement plan is during your Medicare Supplement Initial Enrollment period. This six-month period starts on first day of the month that you are both 65 or older and enrolled in Medicare Part B. Throughout this period, you can enroll in any Medicare Supplement plan offered in your service area with guaranteed issue. This means that insurance companies are not allowed to deny you or charge you more due to pre-existing conditions.  If you have medical issues or disabilities, it’s especially important to take advantage of this period.

Special Enrollment Period

Guaranteed issue right means that companies must sell you a policy at the best available rate, regardless of your health status and cannot deny you coverage. If you miss your initial enrollment period, you can apply for a Medicare Supplement plan with guaranteed issue rights during a special enrollment period. The situations to be eligible for a special enrollment are:

  • Your Medicare Supplement insurance company goes bankrupt and you lose your coverage, or your Medicare Supplement policy coverage ends through no fault of your own.
  • You’re enrolled in Original Medicare and your employer coverage is ending.
  • You drop a Medicare Supplement policy or leave a Medicare Advantage Plan because the company did not follow the contractual obligations, commits fraud, or misled you.
  • You have Original Medicare and a Medicare SELECT plan and you move out of your plan’s service area.
  • You’re enrolled in a Medicare Advantage plan or PACE organization and move out of the plan’s service area, or your Medicare Advantage plan leaves the Medicare program.
  • You joined a Medicare Advantage plan, and within the first year of joining you want to switch to Original Medicare and Medicare Supplement.

You will run into problems if you try to buy a Medicare Supplement policy outside of your protected enrollment periods. Companies can refuse to sell you a policy, or will only let you buy one if you meet certain medical requirements. If an insurance company does agree to sell you a policy you will need to pay a higher monthly premium. You will also need to wait six months before the plan will cover pre-existing conditions.

A Medicare Supplement plan will help save you money.
A Medicare Supplement plan will help save you money by offering more coverage than Original Medicare.

What it covers:

All Medicare Supplement plans cover at least part of:

  •         Your Medicare Part A and Part B deductibles
  •         Skilled nursing facility costs after you run out of Medicare-covered days
  •         Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  •         Medicare Part B coinsurance or copayment
  •         Part B excess charges
  •         Part A hospice care coinsurance or copayment
  •         Blood (first 3 pints)

Additional Information:

  • After January 1, 2006, Medicare Supplement plans are not allowed to include prescription drug coverage. If you would like prescription drug coverage, you can join a Medicare Prescription Part D plan.
  • The cost of your Medicare Supplement policy depends on the type of plan you buy, the insurance company, your location, and your age.
  • A standardized Medicare Supplement policy is guaranteed renewable even if you have health problems, as long as you pay your premiums on time.
  • People who have a Medicare Advantage plan cannot get a Medicare Supplement plan.
  • A Medicare Supplement policy only covers one person.  If you and your spouse both want Medicare Supplement, then you must each purchase separate policies.
  • You can buy a Medicare Supplement policy from any insurance company that is licensed to sell one in your state.

Need help deciding if and when you can sign up for a Medicare Supplement plan? Here at EZ.Insure we are dedicated to helping you find the plan that is right for you.  You will speak directly with one of our trained agents at any time by calling 888-753-7207, or emailing us at Replies@EZ.insure. If you want to see quotes now you can put your zip in the bar above to get started. We will help you with any questions or concerns you have, free of charge!

 

Traveling Outside of the US? Consider a Medicare Supplement for Coverage

Retirement is the perfect time to begin traveling and enjoying your freedom. Original Medicare will cover your medical needs while traveling within the United States and American territories- Puerto Rico, Guam, and the Virgin Islands. Medicare’s network of doctors and hospitals are large around the U.S. However, the moment you decide to travel internationally, Medicare will not cover you in case of an emergency or other medical needs you might have. This is when a Medicare Supplement will be useful, because it will save you money and give you the coverage you need while abroad.

What a Medicare Supplement Plan Covers

Medicare Supplement plans cover travel bills outside of the U.S.
Medicare Supplement can prepare you for any medical bills accrued while overseas.

Standard Medicare Supplement plans C, D, F, G, M, and N provide foreign coverage. These plans will cover emergency care during the first 60 days of your trip, and pays about 80% of the charges. For example, Medicare Supplement Plan F will be cover up to $50,000 in foreign medical bills. In order to begin coverage for these plans, you must meet your $250 deductible first. This coverage of $50,000 is available to you every time that you travel outside of the U.S. and its territories, it is not just a one time deal.

During your Initial Enrollment Period there is no underwriting, meaning you will not have to worry about pre-existing conditions used against you for pricing. This bonus is something to think about and consider, especially if you do have major pre-existing conditions. Having these benefits while outside of the country will protect your wallet and your health. It is always better to be safe and protected than pay thousands out of pocket later. Not to mention, Medicare Supplement plans will cover more than just international travel medical fees. These plans will help reduce costs of copayments, coinsurance and deductibles that Original Medicare does not cover.

Need help?

It is better to travel and actually have fun without this worry in the back of your mind. Accidents can happen, even if you are careful, which is the reason this coverage is essential to have when outside of the U.S. If you are considering traveling outside the U.S., interested in a Medicare Supplement plan, or just have questions regarding what is offered and the difference between all the plans, EZ.Insure can help. EZ.Insure has highly trained and knowledgeable agents in Medicare Supplement plans. An agent will be able to assess your situation and find you the most affordable Medicare Supplemental plan that suits your needs. To get a quote, you can enter your zip code in the bar above, email replies@ez.insure, and call 855-220-1144.

An Overview of the Different Medicare Supplement Plans

Medicare Supplement plans are purchased to help relieve some of the burden that Medicare part A & B leave behind in the form of out of pocket expenses. Medicare covers only 80 percent of Part B costs and the 20 percent is left for the individual to pay. Even though it is only 20 percent, it can be too much for a retired person to pay. Because of this, insurance companies decided to create Medicare supplemental insurance plans, to pay for that 20 percent difference to help with finances.

There are 10 different standard Medicare Supplement plans that are sold in most states. These 10 Medicare Supplement plans are A, B, C, D, F, G, K, L, M, N, as well as a high-deductible Plan F option. Not all plans cover the same services.

In general, all Medicare Supplement plans cover at least part of:

  • Medicare Part A and Part B deductibles
  • Skilled nursing facility costs (after you run out of Medicare-covered days)
  • Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  • Medicare Part B coinsurance or copayment
  • Part B excess charges
  • Part A hospice care coinsurance or copayment
  • Blood (first 3 pints)

Two Medicare Supplement plans (Plan K and L) include an out-of-pocket limit. This means that once you have reached a certain amount spent on Medicare-covered services, the Medicare Supplement plan will cover 100% of Medicare-covered costs for the rest of the year.

An overview of the different Medicare Supplement plans and what they cover.
An overview of the different Medicare Supplement plans and what they cover.

* There is also a high-deductible version of Plan F.

Some Facts to Know:

  • All insurance companies that sell Medicare Supplement must offer Plan A. A company must also offer either Plan C or Plan F if it offers any other plan besides Plan A.
  • Each standard Medicare Supplement plan option must provide the same basic benefits. For example, a Plan A policy sold by a company in California will have the same basic benefits as a company in Pennsylvania selling the same lettered plan.
  • Plans E, H, I, and J are no longer offered, but if you already have one, you can keep using it until you decide to switch, then you cannot go back.
  • Not all Medicare Supplement plans may be available in your state. In Massachusetts, Minnesota, and Wisconsin, Medicare Supplement policies are standardized differently.
  • Standardized Medicare supplemental plans do not provide coverage for dental care, hearing aids, vision care, prescription drugs or long-term care.
  • You can see any doctor, whether they accept Medicare assignment or not. Medicare assignment is when your doctor or provider accepts the Medicare-approved amount as full payment.
    • If your doctor accepts assignment, then your Medicare Supplement insurance company will pay your doctor directly.
    • If your doctor does not accept Medicare assignment, you will have to pay your doctor yourself and send in claims to your insurance company.

Medicare SELECT

In some states you can purchase Medicare SELECT, which is a type of Medicare Supplement policy. Medicare SELECT can be any standardized Medicare Supplement plan (plans A-N). It requires the policyholder to use hospitals and doctors in their network. If it is an emergency, then you will not have to stay in network. Medicare SELECT plans often have lower premiums.

Medicare Part B bills can become overwhelming, so a Medicare Supplement plan is beneficial to sustain the costs. At EZ.Insure we are trained to be on your side and get you the best plan in your budget. Get an instant quote by typing your zip code in the bar above, or speak with someone now. You can contact one of our highly trained agents through email at Replies@EZ.Insure, or by calling 855-220-1144. At EZ.Insure we want to help you get coverage, not help insurance companies get right. We know how hard it is dealing with a ton of phone calls and agents hounding you, which is why we want to help, we work for you. Let us help you today!